Differences in Autonomy and Nurse-Physician Interaction Among Rural and Small Urban Acute Care Registered Nurses in Canada

Abstract

Canada, two groups of acute care nurses were compared on the work satisfaction variables of autonomy and nurse-physician interaction based on whether their workplace community population was rural (10,000 or less) or small urban (>10,000 but <100,000). For this analysis, the variable “size of community” served as a proxy indicator for hospital size. Kanter’s (1993) theory on the structure of power in organizations was the basis of the hypotheses. As predicted, the rural RNs (n=811) working in the smaller hospital organizations had significantly higher levels of autonomy [F(1, 1229)= 5.602, p<0.05] and higher levels of nurse-physician interaction [F(1, 1229)=27.78, p<0.001] than the small urban RNs (n=427). The findings suggest that the size of an organization or hospital setting does have an influence on the level of autonomous practice and interaction between nurses and physicians.