Environmental turbulence. Impact on nurse performance.

Changes in the external regulatory environment have created turbulence in the internal hospital environment. Nursing administrators must create and maintain clinical environments that support practice; however, little is known about the effects of the dramatic changes in the healthcare environment on nurse performance. The author discusses a study that analyzed the effects of environmental turbulence on nurses' job performance. One characteristic of a turbulent environment, the number of admissions to/discharges from a unit in a 24-hour period, had a negative impact on self-rated quality of performance. The findings give direction to nurse administrators regarding efforts and resources required to support nurse performance in the unstable and rapidly changing healthcare environment.