Unpacking the Dynamics of Paradoxes across Levels

Based on an in-depth case study of a healthcare organization, this chapter shows how paradoxical tensions were transferred between managers and professionals at different levels as they were dealing with them. It adds to the existing literature on nested tensions by showing more precisely how tensions transfer not only through discourse, but through control of specific structures and tools, according to actors’ power and views. The results shed light on how paradoxical tensions undergo transformation and surface, as actors at a higher level mobilize and impact others at a lower level. While previous studies have suggested that managers’ ability to embrace and deal with paradoxical tensions like quality and efficiency favours organizational change and maximizes organizational performance, the findings explained in this chapter question whether this permanent quest for performance could also compromise workers’ experience.