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The Complex Work of RNs: Implications for Healthy Work EnvironmentsKeywords: cognitive work of nursing , complex adaptive system , complexity science , complex work environments , mindfulness , patient care assignments , prioritizing , RN stacking , RN work complexity , situation awareness , stacking , trade-off decisions , workflow management Abstract: This article describes the complex work of registered nurses (RNs) in current healthcare settings and presents strategies for promoting healthy work environments in the midst of this complexity. First it addresses the complexity in delivering patient care by reviewing recent research on the work of nursing and explaining the concept of RN stacking. Then it considers four important activities for supporting RN decision making and establishing a healthy work environment, namely, “designing out” system barriers to care, designing and implementing appropriate technology, focusing on nursing direct care functions, and supporting the new RN.
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