병원 간호사의 조직침묵에 관한 근거이론적 접근

Nurses’ Organizational Silence in Hospitals: A Grounded Theoretical Approach

Purpose: This study aimed to explore the constructs and context of hospital nurses’ organizational silence. Methods: In-depth interviews were conducted with 17 nurses in small-middle general hospitals as well as big university hospitals. We then derived the key themes using grounded theory method. Results: Nine themes and 30 sub-themes were derived: “Willing to be recognized for performance rather than saying”, “Getting used to the hard-to-speak climate”, “Face the reality that does not change when said”, “Complicated situation that prevents self-regulating decision-making”, “Conflicts that are difficult to confront”, “Unfair responsibilities that I want to evade”, “Leaders who don’t support me”, and “Being blocked in communication”. Consequently, the nurses learned to adopt a climate of silence and “learned organizational silence” behavior. They experienced that prosocial silence was essential for obtaining approval as a member of the group, and defensive silence for protecting themselves in the hierarchical structure and unfair responsibilities. Acquiescent silence originated from a futile relationship with their supervisors, one-way communications, and the unsupportive management system, in which three types of silence appeared sequentially or in combination with each other. Conclusion: Based on these results, nursing managers should identify the context of nurses’ organizational silence and should lessen these silence behaviors.