Coping with increased managerial tasks: tensions and dilemmas in nursing leadership

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Abstract

The present study explores how increased managerial tasks affect nursing leadership in Norwegian nursing homes. Responding to New Public Management reforms, increased managerial tasks have been implemented by Norwegian central government into public nursing homes. Even though nursing leadership plays a key role in implementing managerial tasks, it is still unclear how nurses describe the influence of increased managerial tasks in nursing leadership. This was a qualitative study, including 100 hours of observations and 18 semi-structured interviews of nurses holding various positions in three public nursing homes. Thematic analysis was used in analysing data. Three changes were identified in the exercise of nursing leadership: (1) leading daily care from a distance; (2) lack of support in problem-solving; and (3) difficulties in adopting new managerial language. The study demonstrates that managers take on a more administrative role that, in turn, weakens their ability to supervise and motivate nurses in daily care. Lack of a reciprocal relationship between managers and nurses in goal achievement has significantly weakened nursing leadership in nursing homes. The study contributes knowledge on how nursing leadership weakens as a response to changes in nurses' roles with increased managerial tasks.

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