Work environment in the South African military health service experienced by nurses: A qualitative study

Abstract

BackgroundThe South African Military Health Service (SAMHS), which is an authoritarian and rigidly hierarchical corporate organisation, provides health services to soldiers, military veterans and their dependents. Moreover, it has its own set of rules and regulations, allowing little room for initiative and freedom of action on the part of nurses. ObjectiveIn the study, we aimed to explore and describe the experiences of nurses working in South African Military health institutions with regard to their work environment. MethodsA descriptive phenomenological research design was used. Sixteen nurses from three hospitals and eight clinics that serve the SAMHS in various parts of the country were purposively selected, and individual semi-structured interviews were held. Data was transcribed and analysed using Tesch’s methodology. ResultsThe nurses highlighted concerns associated with the culture and traditions of the military, including adjustment problems because of inadequate induction, inappropriate use of military rank by senior officers, dual role conflict and a lack of professional development opportunities. Participants highlighted effective communication between staff, adequate staffing and development opportunities as contributing toward a healthy work environment. ConclusionAccording to the participants, a rigid, authoritarian and controlled military culture contributed to an unhealthy work environment for the practice of military nursing. However, attributes contributing to a healthy work environment were also described by the participants. The study findings provided a basis for recommendations for induction programmes; communication strategies; personal empowerment; planning and optimising adequate resources; and personal and professional development opportunities through conferences, meetings, training and workshops for nurses.