The purpose of this two phase comparative study was to explore the relationships between nursing unit environment (shared governance, traditional governance, specialized inpatient care unit) with measures of Registered Nurse (RN) occupational stress and occupation-related outcomes in a hospital with a reputation for excellent nursing care. Survey data from 69 staff nurses in one of the three different patient care areas were analyzed using parametric and nonparametric univariate, bivariate and multivariate analyses as appropriate. A sample of nurses working in each of the units also were interviewed about common work stressors encountered, coping mechanisms used to deal with work stress, decision-making, and sources of work support. No significant differences were found among the three types of nursing unit governance structure on occupational stress, methods of coping with occupational stress, job control, and self-efficacy. Significant differences were found related to amount of supervisor support, co-worker support, unit efficacy, turnover, absenteeism, and job satisfaction. Nurses working in the shared governance and specialty units had more job satisfaction, perceived co-worker support and unit efficacy than RNs working in the traditional governance unit. Specialty unit structure was associated with less turnover and shared governance and specialty unit structure were associated with less absenteeism related to illness. Supervisor support was associated with more positive occupation-related outcomes than unit governance structure. Gender and education were associated with perception of work stress.
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