Complexity compression: nurses under fire

Nurs Forum. 2007 Apr-Jun;42(2):86-94. doi: 10.1111/j.1744-6198.2007.00071.x.


It has been documented that up to 40% of the workday of nurses is taken up by meeting the ever-increasing demands of the systems of healthcare delivery in which nurses are employed. These demands include the need for increasing documentation, for learning new and seemingly ever-changing procedures, and for adapting to turnover in management and administration. Attention to these issues also means that 40% of that workday is not available to patients. Believing that these increasing demands are affecting nurses' decisions to remain in nursing or to leave, a group of Minnesota nurses and nurse educators examined the work environments of nurses and the issues related to those environments. The result of this examination was discovery of a phenomenon affecting all nurses that may be central to the projected shortage of nurses. The phenomenon is complexity compression-what nurses experience when expected to assume additional, unplanned responsibilities while simultaneously conducting their multiple responsibilities in a condensed time frame. The phenomenon was validated by a group of 58 nurses who participated in focus groups that led to the identification of factors influencing the experience of complexity compression. These factors were clustered into six major themes: personal, environmental, practice, systems and technology, administration/management, and autonomy/control. Further validation studies are planned with the population of practicing professional nurses in the state of Minnesota.

MeSH terms

  • Adaptation, Psychological
  • Attitude of Health Personnel*
  • Cross-Sectional Studies
  • Decision Making, Organizational
  • Documentation
  • Focus Groups
  • Health Facility Environment
  • Humans
  • Minnesota
  • Nurse's Role* / psychology
  • Nursing Methodology Research
  • Nursing Staff / organization & administration
  • Nursing Staff / psychology*
  • Organizational Innovation
  • Professional Autonomy
  • Professional Competence / standards
  • Schools, Nursing
  • Self Efficacy
  • Societies, Nursing
  • Systems Analysis
  • Time Factors
  • Total Quality Management / organization & administration
  • Workload / psychology*
  • Workplace / organization & administration
  • Workplace / psychology*