Nurse Managers' Decisions About Work Schedules-Dealing With Conflicting Priorities: A Case Study.

aimTo examine how nurse managers perceive and respond to conflicting priorities between patients' needs, employees' well-being and organisational objectives in decisions regarding work scheduling.

designAn embedded case study of nurse managers' decisions about new work scheduling in community healthcare in a Norwegian municipality.

methodsWe accessed internal and national policy documents outlining the potential benefits of increasing full-time positions in healthcare and conducted 24 semi-structured interviews in January and February 2019. During the thematic data analysis, institutional logics emerged as a theoretical lens to understand nurse managers' conflicting priorities and responses.

resultsWe found that nurse managers handled conflicting priorities by prioritising an employee logic in a way that allowed them to combine this with elements of managerial and professional logics within the institutional context.

conclusionThe institutional logics perspective extends our understanding of how nurse managers interpret the values, norms and practices underlying their priorities. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Nurse managers should (1) recognise that multiple institutional logics may be available to guide their responses to conflicting priorities and (2) carefully consider how to combine employee involvement with managerial and organizational responsibilities. IMPACT: We studied how nurse managers perceive and respond to conflicting priorities in work scheduling decisions. Nurse managers are embedded in institutional contexts with co-existing logics and their decisions can be understood through an employee logic, but also in combination with managerial and professional logics. Nurse managers should carefully consider their work scheduling decisions from the perspectives of different logics, ensuring that the decisions benefit employees, patients and their employer. REPORTING

methodThe study is reported according to COREQ guidelines. PATIENT OR PUBLIC CONTRIBUTION: This study did not include patient or public involvement in its design, conduct, or reporting.