Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)




The process of how nurses work in relationships to accomplish their work is presented in this dissertation. This study has made the relational work process of nurses explicit. While research demonstrates that increased nurse staffing is associated with better patient outcomes and with nurses experiencing less burnout and job dissatisfaction, the process is not explored in the empirical literature.

The research question was: “What is the process of relational work of the nurse?” Data collection and analysis conformed to the process of classical grounded theory. Interviews were face to face with 23 registered nurses working as direct care staff nurses on inpatient units. Data analysis (constant comparison) occurred concurrently with data collection.

The core category, Coming Together to Get Through, emerged from the data as how nurses worked collectively to accomplish their work. Without the help from their nursing, and physician, colleagues they could not finish each day’s work completely and do the best for their patients. The ten temporal categories of the process are: Spending Time, Knowing Other Nurses and Doctors, Asserting Authority, Trusting and Respecting, Being Approachable, Relying on One Another, Needing Each Other, Helping Each Other, Getting the Work Done, and Did the Best for Our Patients.

This is the first study to empirically discover a basic social process that demonstrates how the nurse works in relationships. The importance of social and relational constructs and their creation in an organization posits relationships as work and the building blocks of work in organizations. Discovery of this substantive theory of relational work allowed for conceptualization of an explicit work process. This empirical knowledge fills a gap in the literature that may affect appropriate staffing levels which in turn impact both patient and professional outcomes. Future research will focus on creation of a scale of the relational work of nurses, the process of interprofessional relational work, and if high levels of relational work are a pathway to decreased levels of moral distress and burnout, as well as improved professional satisfaction, and better patient outcomes.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

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Nursing Commons