Challenges to Good Work in Nursing: A Cross Cultural Comparison of Factors Influencing Quality of Care in a Health Related Profession

Good work is defined as work that is effective, ethical, and engaging. The purpose of this review is to explore the meaning of good work and the strategies used to sustain commitment to quality care among nurses in different cultures. Guided interviews were conducted to examine the meaning of good work among nurses from the United States, Iran, and Hong Kong. Nurses in all settings associated good work with quality care. Teamwork and a positive work environment supported nurses ’ commitment to quality care. Conflicting values, staff shortage resulting in long hours and undesirable nurse-to- patient ratios, fragmented care, and lack of autonomy contributed to the distress nurses experienced across cultures. Other obstacles to good work were unique to a particular culture. Role ambiguity, lack of recognition, limited equipment and medications and poor professional relationships and were problematic for nurses in Iran. Unclear future development of the nursing profession and conflict among health professionals were impediments to good work in Hong Kong. Competencies required to sustain good work and promote quality care included team building, self-reflection, goal setting, and communication skills. Across cultures nurses expressed the need for greater emphasis on the core values of the nursing profession to ensure development of performance competencies necessary for the fulfillment of nursing’s commitment to quality care in a global world. To achieve this end, a multi-site pilot study was conducted to evaluate the usefulness of a toolkit in promoting professional development and the competencies required to perform good work in nursing. This review points to the need for development of a common understanding of nursing’s core values and the competencies needed to support nurses ’ commitment to quality care across cultures