Cohesion among nurses: a comparison of bedside vs. charge nurses' perceptions in Australian hospitals.

Aim: This study examines the extent to which hospital nurses view their working environment in a positive sense, working as a cohesive group.

Background: Despite the fact that nursing in Australia is now considered a profession, it has been claimed that nurses are an oppressed group who use horizontal violence, bullying and aggression in their interactions with one and other.

Methods: After ethical approval, a random sample of 666 nurses working directly with patients and all 333 critical care nurses employed in three large tertiary Australian hospitals were invited to participate in the study in the late 1990s. A mailed survey examined the perceptions of interaction nurses had with each other. The hypothesis, that level of employment (either Level I bedside nurses or Level II/III clinical leaders) and area of work (either critical care or noncritical care) would influence perceptions of cohesion, as measured by the cohesion amongst nurses scale (CANS) was tested.

Results: In total 555 (56%) surveys were returned. Of these, 413 were returned by Level I and 142 by Level II/III nurses. Of this sample, 189 were critical care and 355 noncritical care nurses. There was no difference between Level I and II/III nurses in mean CANS scores. It is interesting to note that the item rated most positively was "nurses on the units worked well together", however, the item rated least positive was "staff can be really bitchy towards each other" for both Level I and II/III nurses. There was no difference in CANS scores between critical care and noncritical care nurses.

Conclusions: Nurses working in Australian hospitals perceived themselves to be moderately cohesive but, as would be expected in other work settings, some negative perceptions existed.