Characteristics of a Decentralized Nursing Unit

Decentralized nursing units lack a formal hub where nurses gather to discuss patients and gather supplies, instead spreading the nursing stations throughout the hospital. These decentralized nursing units can increase the best patient outcome in some ways, but can also lower job satisfaction for the nurses.

Distance

• Charting substations for decentralized nurse units are closer to the patient. Nurses do not have to walk as far to reach private patient rooms. Less time spent walking helps nurses get more work done and reduces physical strain on the nurses. Since nurses are closer to the patient, they are more available to the patient for patient care, which includes providing emotional support, educating the patient about her health condition, ensuring the patient is comfortable, administering treatments and checking for vital signs.

Interaction

• Decentralized nursing units dramatically reduce the number of interactions, leading nurses to prefer one centralized communication hub over multiple stations. Health care professionals prefer face-to-face, informal communication when trying to think through solutions to problems. Nurses are sometimes unaware of what is happening in other areas of the hospital, despite the use of information technology. Nurses have fewer opportunities to learn from each other and receive briefings about patients. When hospitals are decentralized and a lot of information is communicated through information technology, hospitals must find ways to increase face-to-face communication.

Noise

• Nurses and physicians are more likely to talk in the hallway in a decentralized nurse unit, which can create distressing noise for patients. In quieter environments, patients tend to recover faster. While nurses sometimes talk in hallways, disturbing patients, the centralized nurse units have higher noise levels where the nurses gather together. Nurses are more likely to burn out when they work in a loud environment, while patients develop headaches, prolonged wound healing and irritability.

Stations

• A decentralized nurse unit is smaller than a centralized unit. They are made up of multiple stations distributed throughout the medical center. The stations are pointed towards a few patient rooms each. The required supplies and technology are located at mini-stations instead of at one station. A multidisciplinary station is located in the center and provides all necessary information about families, physicians and visiting staff. This station is run by a unit clerk. Even when the hospital layout is decentralized, nurse units tend to form informal hubs where they cluster together and interact.

Patient Individual Rooms

• Patients are happy with the private rooms they receive, which allow them privacy as they recover. When sharing a room, patients have to worry about noisy fellow patients who sometimes have a lot of visitors and are unfriendly. Social contact with family members tends to increase healing for the patient being visited, but can reduce the healing rate for the roommate.