Strategic ambiguity in the role development process

Today's turbulent business and social environment often compels organizations to adopt internal programs that will help them cope with complexity. One organizational sector in which this is particularly true is the health care industry, as managed care programs and competitive forces have changed the way hospitals and clinics operate. This study looks at a specific organizational program designed to cope with these industry changes and considers the impact of the program on the nurses involved. Drawing on theory and research on role development and strategic ambiguity, this case analysis looks at a hospital system in which the nursing role of “care coordinator”; was defined in a strategically ambiguous way. After analyzing interviews with 19 care coordinators, conclusions are drawn regarding affective reactions to strategic role ambiguity, behavioral adaptation to strategic role ambiguity, and the importance of conceptualizing role ambiguity as a systemic process.     

Geriatric Training Needs of Nursing-Home Physicians

Medical care in nursing homes is not provided by board-licensed geriatricians; it mainly comes from physicians in need of educational programs in the field of geriatrics. Such programs, based on curriculum guidelines, should be developed. The purpose of this study was to seek input from nursing home physicians on their perceived needs for training in geriatrics. A mail questionnaire survey was sent to nursing home physicians regarding their opinion on the most needed subjects and preferred training methods. Of the 210 surveys mailed, 132 (63%) were returned. More than a quarter of the respondents had not had any kind of geriatric medical education. A desire for geriatric training was evident, preferably in the form of courses and periodic seminars. Use of medications, infectious diseases, depression, dementia and cardiac disorders were the most important topics indicated by the respondents. These data can be of help in preparing the curriculum for a continuous medical education program in geriatrics, preferably in the form of courses and periodic seminars.