The role of physical design and informal communication

The nurse’s station is flanked on both sides by enclosed rooms. The nurse
manager and care coordinator have offices on the east side of the unit. On the west
side is an unassigned general office as well as the medication (med) room (Figure 9).
A corridor separates the nurse’s station core from the utility rooms, kitchen,
and staff locker room where nurses store their personal belongings (Figure 10). Note
that the staff break room does not appear on the plan because it is located off the unit.
Instead the small break room is situated just off the elevator lobby which is down the
hallway halfway to the nursing unit at the south end of the hospital wing (Figures 11
& 12). The small size of the room accommodates only 2-3 nurses at a time and easily
feels overcrowded. Its size and location make for an unfrequented break room.
During the data collection period, 6N experienced a change in management
that had a significant impact on both the physical layout of space as well as the
staffing and organization of the unit. In early February, the unit’s nurse manager
(NM) left, and the NM from 4S (the oncology/gynecology unit at Crouse) was hired
on 6N for a three month interim position. In order to better understand the unit that
she was to manage, the new NM initially spent time observing 6N and concluded that
there was much room for improvement. She addressed many challenges that she
believed stood in the way of the smooth, efficient functioning of the unit. This section
will address the physical changes to the unit; the organizational impact that resulted
from the change in management will be discussed later in the chapter.
The most significant physical change made by the new NM was the location of
the charge nurse (CN) and unit receptionist (UR). Before the change, the CN and UR
sat at the “back” of the nurse’s station at Desk B2 (Figure 13). This was a problem
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