THE WORK OF SENIOR NURSE MANAGERS: DEMANDS AND CONFLICTS
This study focuses upon the work of Senior Nurse Managers and was conducted against a backdrop of extensive organisational change within health care services. The aims of the study were to expand current knowledge and understanding about the world of work of Senior Nurse Managers by identifying what it is they do and exploring and explaining the nature of the tensions within that work. The literature relating to managerial work, marginality and coping strategies were reviewed. The study followed a two phased, multi-method approach, the first of which used diary records, observation, intermittent detailed events and interviews to provide information about Senior Nurse Managers' work. Analysis of work content revealed a varied and complex picture, with little or no homogeneity in their work which was characterised by fragmentation, brevity and multiple activities, with varying emphasis upon the nursing or management components of their role. It was recognised that Senior Nurse Managers experienced a range of complex and multi-dimensional demands and conflicts within their work and that choices were made to handle these. One consistent feature of the demands and conflicts was the tension that existed between professional nursing and management, derived from the Senior Nurse Managers' marginal position. The second phase of the study focused upon the demands, conflicts and choices and, through hermeneutical inquiry, an interpretive framework was developed. This framework was deemed by the participants to represent a valuable approach to increasing their understanding of the issues they face and the personal feelings they experience. Recognition of marginal positions and marginal individuals, the need for appropriate and effective management education and the development of robust peer support systems were identified as important implications of the study. It is concluded that the enhanced understanding of Senior Nurse Mangers' work which is provided by this study should benefit Senior Nurse Managers and those with whom they work.
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