The role of physical design and informal communication

usually leads to expensive renovations may be true in some cases, but hospital
administrators would be wise to begin the process with observation and see how far it
can take them.
4.7 Overall Conclusion
The aim of this study was to understand the roles played by the components of
the nursing unit ecosystem, including culture, organizational factors, technology, and
particularly the physical layout, in the opportunities for informal learning and
communication patterns of a graduate nurse during her orientation period. In addition,
this case study examined whether or not there was a relationship between graduate
nurse communication and interaction patterns, the gaining of competency, and the
reduction of stress. The results of this study suggest that the physical environment
plays an important role by fostering opportunities for informal communication and on-
the-job learning. Specifically, it was found that backstage spaces and clear sightlines
across the unit fostered the formation of relationships that in turn provided the
foundation for effective collaboration. The communities of practice framework can be
aptly applied to these findings and serves as an overarching theme.
A combination of factors was found to influence the GN learning experience
including past experiences, unit culture, personal learning style, unit layout, and
interaction with staff. The finding that their gaining of competencies was not
associated with a reduction in stress suggests that other factors, particularly staffing
levels, have more of an impact on stress than nursing competencies per se. The extent
to which other social, organizational, and personal factors interact with staffing levels
to produce stress or mitigate its effects deserves further study. However, this study
provided support for the notion that the GN experience is indeed influenced by the
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