Work culture within the hospital context in Canada: professional versus unit influences

PURPOSE: This paper sets out to explore health professionals' views and experiences regarding the work culture that exists in their hospital units, and further how patients influence these experiences. DESIGN/METHODOLOGY/APPROACH: The paper employs a qualitative approach involving individual interviews with 60 health professionals in Canada employed in what is conceptualised as "open" (emergency room and maternity care) and "closed" (intensive care, head and neck surgery) units. FINDINGS: The paper finds that the influence of the hospital unit outweighs the influence of professional boundaries but for some groups more than for others. Health professionals in more open units tend to be less satisfied with their work, have more difficult relations with patients, and experience tensions with co-workers and management. Those in closed units tend to be more satisfied with their work, have relatively better relations with patients and co-workers, and tend to have more cooperative relations with management. The different structural conditions of work in open and closed units are also clearly important. RESEARCH LIMITATIONS/IMPLICATIONS: The sample for the study was self-selected from one hospital, which may limit the generalisability of some of the findings. PRACTICAL IMPLICATIONS: The insights garnered from the study may help professionals and managers to develop unit-specific policies to create a more positive workplace culture. ORIGINALITY/VALUE: There is a growing body of research on professional culture and oganisational culture that often does not clearly delineate how the two exist concurrently. The paper explicitly investigates this issue by examining work culture across various health professional groups and also across hospital units, and further how patients figure in these experiences.