Nurses' Experiences of Restructuring in Three Ontario Hospitals


  • This research was funded by a grant from the National Health, Research and Development Program (Project 6606-6284-012), Government of Canada and supported by the Nursing Effectiveness, Utilization and Outcomes Research Unit, which is funded by the Ontario Ministry of Health.

Dr. Blythe, School of Nursing, McMaster University, Faculty of Health Sciences, Room 2J33, 1200 Main Street West, Hamilton ON, Canada L8N 3Z5. E-mail:


Purpose: To describe the effects of restructuring, particularly redeployment, on nurses' personal and work lives, and to compare the utility of “survivor syndrome” and empowerment as alternative concepts for understanding these effects and planning change.

Methods: Twenty-six focus groups or interviews were held with 59 nurses working in three hospitals in Ontario, Canada.

Findings: Participants described how restructuring strategies had affected them as individuals, as members of nursing teams, and as employees. In each of these aspects of their work lives, relationships became less integrated, their work activities became less controllable, and the changes compromised their ability to deliver effective care.

Conclusions: Restructuring intensifies structural weaknesses in professions, such as nursing, whose members are primarily employed by bureaucracies. Nurses may not find survivor syndrome a useful model to explain their low morale following restructuring because it identifies nurses as “patients” in need of therapy. An empowerment model that takes into account nurses' concerns about uncertainty and integration may be more fruitful for devising strategies to enhance their ability to practice effectively in hospital settings.