The Meadows of Madison: An ethnographic study of the organizational climate of a nursing home

Bonnie Cashin Farmer, University of Rhode Island

Abstract

The overall atmosphere of most nursing homes remains overwhelmingly negative in spite of those few homes that are credited with excellence. The concept of organizational climate holds promise for better understanding the complexities and impact of atmosphere in any one nursing home. At the same time, organizational climate as a concept is poorly understood. There is a need to rethink the concept and return to the original notion of weather as its metaphor. The purpose of this ethnographic study is to do this by first describing organizational climate where it can best be captured by its distinctive atmosphere. The Meadows of Madison, an eighty-six bed skilled nursing facility located in New England, enjoys a respectable and unique reputation among health care providers in the area. Participant observation combined with interviewing and document reviews formed the basis of recordings over a ten month period. Weather was used as a metaphor to describe the organizational climate of this facility and to analyze the collected data. The overall sense of climate of the Meadows was captured well in staff, residents', and families' frequent depiction of it as "a nice place if you have to be here". This impression of the Meadows as "nice" reflected three major elements of the organization: its essential structure (including physical features, organizational chart, rules, and decisions), core values (focusing on appearances, service, and residents' rights) and dominant processes (dealing with maintaining building, body, and others), communicating and moving in, within, and out. The founder's vision of a nursing home and regulations were identified as the primary determinants of the Meadows of Madison. These distinctive qualities of the organizational climate permeate the everyday activities of the organization and impact the potentially harsh realities of even a nice place. Organizational climate holds much promise for an enhanced understanding of the organization in general and specifically for the nursing home where calls for reform proliferate at a rapid pace. Organizational climate provides one key to meaningful reform for one of the most challenged organizations in the United States. ^

Subject Area

Gerontology|Health Sciences, Nursing

Recommended Citation

Bonnie Cashin Farmer, "The Meadows of Madison: An ethnographic study of the organizational climate of a nursing home" (1994). Dissertations and Master's Theses (Campus Access). Paper AAI9526560.
http://digitalcommons.uri.edu/dissertations/AAI9526560

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