A qualitative study of the work environments of Mexican nurses

Abstract

Background Studies of the nursing work environment are increasingly common in developed countries, but few exist in developing countries. Because of resource differences between the two contexts, researchers need to clarify what aspects of the work environments are similar and different. Objectives To study the perspectives of Mexican nurses about their work environments to determine similarities and differences to results from developed world studies. Design A secondary, directed content analysis of qualitative data from 46 Spanish language interviews using workplace-oriented themes Setting Purposively selected Mexican states from four regions of the country that reflect the country’s socioeconomic differences. Participants Practicing Mexican nurses with at least one year of clinical experience and currently working in nursing. Participants were recruited through convenience and snowball sampling techniques. Methods Initial data collection occurred in 2006 and 2008 during a broader study about professionalization processes that occurred in Mexican nursing between 1980 and 2005. The secondary, directed content analysis focused on an in-depth exploration of a central theme that emerged from the two original studies: The Workplace. The directed content analysis used themes from the global nursing work environment literature to structure the analysis: Professional relationships, organizational administrative practices, and quality of care and services. Results The three themes from the global literature were relevant for the Mexican context and a new one emerged related to hiring practices. By category, the same factors that created positive or negative perceptions of the work environment matched findings from other international studies conducted in developed countries. The descriptors of the category, however, had different conceptual meanings that illustrate the health system challenges in Mexico. Conclusions Findings from this study suggest that studies that seek to measure nursing work environments will most likely apply in Mexico and other Latin American or middle-income countries. Instruments designed to measure the work environment of nurses in these countries may prove relevant in those contexts, but require careful adaptation and systematic translations to ensure it.

Global Nursing-a literature review in the field of education and practice

“…Moving towards the mid‐2010s, global leadership, global competencies and networks have arisen as important questions in the Global Nursing debate (Garner, Metcalfe & Hallyburton, 2009; Harrowing, Mill, Spiers, Kulig, & Kipp, 2010). At the beginning of 2020, the use of nurses’ professional competence in relation to vulnerability in health on a global scale and forming nursing competence in international work has dominated the Global Nursing arena (Brunetto, Farr‐Wharton, & Shacklock, 2012; Gutierrez, Candela, & Carver, 2012; Lesia & Roets, 2013; Squires & Juárez, 2012; Toren, Zelker, & Porat, 2012; Walton‐Roberts, 2012; Zhou, Windsor, Theobald, & Coyer, 2011; Zinsli & Smythe, 2009). Finally, in the mid‐2020s, the question of global leadership, nursing faculty competence, and discussions on nurse professionals and nurse faculty retirement has been key issues (Havens, Warshawsky, & Vasey, 2013; Meum, Ellingsen, Monteiro, Wangensteen, & Igesund, 2013; Tourangeau et al.,2014).…”

“…Challenges in global practice environments were mentioned and often linked to inequalities in nursing practice such as marginalization and differences in professional equality (Kim et al., 2006; Lesia & Roets, 2013; Squires & Juárez, 2012; Toren et al., 2012; Walton‐Roberts, 2012; Zhou et al., 2011; Zinsli & Smythe, 2009). Many nurse professionals live in countries plagued by social instability and civic unrest, which can hinder growth in nursing identity and development of professional competence (Ortiga, 2014; Walton‐Roberts, 2012; Zinsli & Smythe, 2009).…”

“…This was explained to lead to the deprofessionalization of nurses and deskilling with limited employment prospects (Walton‐Roberts, 2012; Zhou et al., 2011). Moreover, it was also described that nurse professionals without resources are often stuck in their localities (Squires & Juárez, 2012). For example, medical supply inventory management issues were mentioned as good illustrations of how context matters, as nurses in high‐income countries would not expect to be without medications for more than a few hours or materials for patient care for more than a shift (Squires & Juárez, 2012).…”

“…Managing changes in gender, class and generational issues were described as essential when facilitating the Global Nursing practice (Brunetto et al., 2012; Havens et al., 2013; Lesia & Roets, 2013; Squires & Juárez, 2012; Toren et al., 2012; Wieck, 2003; Zhou et al., 2011; Zinsli & Smythe, 2009). For the nursing workforce, preferences on work engagement and subordinate communication followed generations (Brunetto et al., 2012; Gerrish & Griffith, 2003; Havens et al., 2013).…”

Assessing geriatric capacity building needs in public hospitals in Mexico

“…Further, at present, Mexican nursing is undergoing its own set of professionalisation shifts that affect care delivery across the healthcare system. These include increased numbers of bachelors prepared graduates, shifts in retirement patterns, task sharing and health worker reforms that affect seniority and benefits (DeMaria, Campero, Vidler, & Walker, ; Squires, ; Squires & Juárez, ; Walker et al, ). These professional factors combined with the twentieth century emphasis on hospital construction and acute care services (Hafner & Shiffman, ), the shortage of nurses and physicians (Aguila et al, ), inequities in access to health care (Rivera‐Hernandez & Galarraga, ), and the persistent challenges of primary care delivery in the country (Berlan & Shiffman, ; Dussault & Franceschini ; Knaul et al, ) mean that no point of care is well prepared to manage the specific care needs of older people.…”