51. Nurse middle managers contributions to patient-centred care: A 'managerial work' analysis.
- Author
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Lalleman, PCB, Smid, GAC, Dikken, J, Lagerwey, MD, and Schuurmans, MJ
- Subjects
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ACADEMIC medical centers , *HOSPITAL wards , *LEADERSHIP , *NURSE administrators , *NURSES , *NURSING practice , *NURSING services administration , *RESEARCH funding , *EMPLOYEES' workload , *ETHNOLOGY research , *MANAGEMENT styles , *JUDGMENT sampling , *PATIENT-centered care , *DATA analysis software , *DESCRIPTIVE statistics , *HOSPITAL nursing staff , *FIELD notes (Science) - Abstract
Nurse middle managers are in an ideal position to facilitate patient-centred care. However, their contribution is underexposed in literature due to difficulties to articulate this in practice. This paper explores how nurse middle managers contribute to patient-centred care in hospitals. A combination of time-use analysis and ethnographic work was used to disclose their contribution to patient-centred care at a micro level. Sixteen nurse managers were shadowed for over 560 hours in four hospitals. Some nurse middle managers seldom contribute to patient-centred care. Others are involved in direct patient care, but this does not result in patient-centred practices. At one hospital, the nurse middle managers did contribute to patient-centred care. Here balancing between 'organizing work' and 'caring work' is seen as a precondition for their patient-centeredness. Other important themes are feedback mechanisms; place matters; with whom to talk and how to frame the issues at stake; and behavioral style. Both 'hands-on' and 'heads-on' caring work of nurse middle managers enhances their patient-centeredness. This study is the first of its kind to obtain insight in the often difficult to articulate 'doings' of nurse middle managers with regard to patient-centred care through combining time-use analysis with ethnographic work. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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