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It has been documented that up to 40% of the workday of nurses is taken up by meeting the ever-increasing demands of the systems of healthcare delivery in which nurses are employed. These demands include the need for increasing documentation, for learning new and seemingly ever-changing procedures, and for adapting to turnover in management and administration. Attention to these issues also means that 40% of that workday is not available to patients. Believing that these increasing demands are affecting nurses' decisions to remain in nursing or to leave, a group of Minnesota nurses and nurse educators examined the work environments of nurses and the issues related to those environments. The result of this examination was discovery of a phenomenon affecting all nurses that may be central to the projected shortage of nurses. The phenomenon is complexity compression-what nurses experience when expected to assume additional, unplanned responsibilities while simultaneously conducting their multiple responsibilities in a condensed time frame. The phenomenon was validated by a group of 58 nurses who participated in focus groups that led to the identification of factors influencing the experience of complexity compression. These factors were clustered into six major themes: personal, environmental, practice, systems and technology, administration/management, and autonomy/control. Further validation studies are planned with the population of practicing professional nurses in the state of Minnesota.

The purpose of this study was to ascertain the interest by executives of major corporations in having occupational health nurses engage in more advanced activities, and to ascertain the available support for advanced educational preparation for nurses. A questionnaire was sent to a systematic sample of 404 of the 808 executives of the Forbes 500 corporations with a 57% return rate. Over 90% of the corporations with health care departments employed registered nurses. Functions nurses currently performed varied by size of the corporation and by type of industry. Activities corporations would like nurses to perform were more advanced, such as conducting research, analyzing trends, and developing special health programs.

: In recent years, health care organizations have been moving away from a culture that responds to errors and near misses with "shame and blame" and toward a fair and just culture. Such a culture encourages and rewards people for speaking up about safety-related concerns, thus allowing the information to be used for system improvement. In part 1 of this series, we reported on findings from a study that examined how nursing schools handled student errors and near misses. We found that few nursing schools had a policy or a reporting tool concerning these events; and that when policies did exist, the majority did not reflect the principles of a fair and just culture. This article, part 2 of the series, describes several strategies that nursing schools can use for creating such a culture.

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