Coping strategies of enrolled nurses in nursing homes: shifting between organizational imperatives and residents' needs.

In today's nursing homes, which can be considered modern versions of "total institutions", enrolled nurses expend much energy coping with problems which arise from the day-to-day care of seriously impaired patients. The problems they encounter include the burden of never ending work, having to cope with deviant and problematic behaviour, handling emotional disturbance and, on a more abstract level, balancing self-interest and power with love and affection. The grounded theory approach was used to discover the coping strategies employed by enrolled nurses. On the criterium of favouring either organizational imperatives or residents' needs, six strategies were differentiated, and placed into one of two categories. The discovery during research of two distinct nursing teams, each inclining towards the strategies available within one of these two categories, not only has important theoretical implications, but also practical consequences for the training of student nurses, the labour market and the quality of care.