The role of physical design and informal communication

interaction occurred. These new location categories were developed after several on-
floor meetings and “tours” of the unit with the CNS who helped map out the
boundaries of the different location zones (Figure 2). It is important to note that
shadowing did not occur in patient rooms in the interest of patient privacy.
In addition, the “work task” category was modified to better address the
study’s research questions. The original purpose of this category was to capture
information on specific tasks. Instead the modified version allowed the researcher to
collect data on the types of communication that occurred, with a focus on informal,
on-the-job learning. The existing “with whom” category was also modified to reflect
the actual staff present on 6N. All decisions regarding modifications to the CWM
tool categories were informed by pilot research conducted from November 2007
through January 2008 at both Crouse Hospital and Cayuga Medical Center in Ithaca,
NY. During this period, graduate nurse work patterns were observed, including types
of communication and interaction with other staff. Drafts of new categories were
developed, revised, and discussed with CNS, the nurse manager, and Orientor until
final categories were put in place. This time was also used to familiarize the
researcher to the CWM tool, and to become accurate at coding different types of
communication and interaction. Furthermore, this time spent on the floor prior to the
beginning of the study was instrumental in helping staff become comfortable with the
researcher’s presence.
Data collection with the CWM tool began on January 31 st and continued until
March 21 st . Shadowing of the graduate nurse occurred 1-2 times per week depending
on the work schedules of the graduate nurse and her Orientor and on the dates of
formal orientation classes that took the graduate nurse off the floor. Between 3 and 6
hours of observation were completed each week on the A shift between the hours of
7am and 3pm, for a total of 25 hours of observation.
33