Exploring nurses' experiences of value congruence and the perceived relationship with wellbeing and patient care and safety: a qualitative study.

Alice Dunning,Karen Spilsbury,Judith Johnson,Angela Grange,Gemma Louch

doi:10.1177/1744987120976172

Alice Dunning, Karen Spilsbury + Show 3 more

Open Access

https://doi.org/10.1177/1744987120976172

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Abstract

BackgroundValues are of high importance to the nursing profession. Value congruence is the extent to which an individual’s values align with the values of their organisation. Value congruence has important implications for job satisfaction.AimThis study explored nurse values, value congruence and potential implications for individual nurses and organisations in terms of wellbeing and patient care and safety.MethodFifteen nurses who worked in acute hospital settings within the UK participated in semi-structured telephone interviews. Thematic analysis was utilised to analyse the data.ResultsFour themes were identified: organisational values incongruent with the work environment; personal and professional value alignment; nurse and supervisor values in conflict; nurses’ values at odds with the work environment. Perceived value incongruence was related to poorer wellbeing, increased burnout and poorer perceived patient care and safety. The barriers identified for nurses being able to work in line with their values are described.ConclusionsValue congruence is important for nurse wellbeing and patient care and safety. Improving the alignment between the values that organisations state they hold, and the values implied by the work environment may help improve patient care and safety and support nurses in practice.

Highlights

Values are recognised as important within nursing (Rassin, 2008), and recent policy initiatives to recruit nursing staff based on their values underlines the centrality of values for the profession (NHS England, 2012)
Four key themes were identified, which described the different aspects of value congruence experienced by Registered Nurses (RNs): organisational values incongruent with the work environment; personal and professional value alignment; nurse and supervisor values in conflict; and nurses’ values at odds with the work environment
There was incongruence described by most RNs across all bands, between organisational values and the work environments created in practice

Summary

Introduction

Values are recognised as important within nursing (Rassin, 2008), and recent policy initiatives to recruit nursing staff based on their values underlines the centrality of values for the profession (NHS England, 2012). Studies have revealed a relationship between RN values and concepts of wellbeing such as levels of burnout (Saito et al, 2018) and job satisfaction, and performance outcomes (Atefi et al, 2014). These studies explored either personal values (Atefi et al, 2014) or professional values (Ravari et al, 2013) and found both sets of values to influence RN job satisfaction and performance. Perceived value incongruence was related to Journal of Research in Nursing 26(1–2)

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