Nurses' work experiences 5 years after hospital merger in the province of Quebec/Canada—An exploratory qualitative study

Abstract

In recent years, healthcare organisations in North America have undergone major structural changes. In particular, the province of Quebec in Canada adopted a reform in 2015 which led to the merging of healthcare organisations into centralised regional administrations (the ‘CISSS’). As research indicates negative impacts of mergers on patient outcomes and difficulties for the nursing work group in particular, the present paper aims to answer calls for more research about the long‐term effects of major organisational changes on nurses' professional practice and well‐being. We used an exploratory qualitative research design and report on data collected from 42 nursing professionals, ranging from clinical nurses, nurse practitioners, to head nurses and nursing advisors. Drawing on the job demands‐resources model and the person‐environment fit theory, our findings yield three main conclusions regarding the state of nursing practice 5 years after the 2015 reform: (1) emergence of a new demand for work harmonisation; (2) growing gaps in the nursing practice environment across departments; (3) evidence of a structural disempowerment of the nursing practice in healthcare organisations. There is hope that a vast project for practice harmonisation initiated and led by local senior nursing advisors will bring about positive outcomes for the nursing practice, and nurses' overall working conditions in the province.