“My hands are tied”: Nurses’ perception of organizational culture in Kenyan private hospitals

Abstract

It is estimated that by 2030 the global shortage of nurses and midwives will be 7.6 million, with African countries among the most adversely affected. Within this context, it is important to understand the specific organizational factors that contribute to registered nurses (RNs)’ decisions to remain or leave their workplaces in East Africa. The aim of this study was to commence exploration of these factors by exploring nurses’ perceptions of organizational culture of selected private hospitals in Kenya. A small-scale exploratory qualitative approach was employed, with eight nurses undertaking semi-structured interviews. There were five female and three male nurses. All participants were RNs; two held a bachelor’s degree in nursing and the rest held diplomas in nursing. The thematic analysis revealed four major themes and nine sub-themes. The major themes included: restrictive work environment, top-down leadership, normalizing the abnormal in team dynamics and professionalism, and ethical concerns. These findings suggest an urgent need for Kenyan private hospital administrators to create a hospital work environment that provides more autonomy for nurses. There is a need for inclusive leadership styles that target hospital organizational structures and processes in order to address nursing workforce team dynamics. A merit-based salary and progressive reward systems are recommended to empower nurses to remain in the workforce.