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Kise Hjertstrøm H, Obstfelder A, Norbye B. Making New Health Services Work: Nurse Leaders as Facilitators of Service Development in Rural Emergency Services. Healthcare (Basel). 2018;6(4)doi: 10.3390/healthcare6040128.
Kise Hjertstrøm, H., Obstfelder, A., & Norbye, B. (2018). Making New Health Services Work: Nurse Leaders as Facilitators of Service Development in Rural Emergency Services. Healthcare (Basel, Switzerland), 6(4), . https://doi.org/10.3390/healthcare6040128
Kise Hjertstrøm, Helle, et al. "Making New Health Services Work: Nurse Leaders as Facilitators of Service Development in Rural Emergency Services." Healthcare (Basel, Switzerland) vol. 6,4 (2018). doi: https://doi.org/10.3390/healthcare6040128
Kise Hjertstrøm H, Obstfelder A, Norbye B. Making New Health Services Work: Nurse Leaders as Facilitators of Service Development in Rural Emergency Services. Healthcare (Basel). 2018 Oct 27;6(4). doi: 10.3390/healthcare6040128. PMID: 30373242; PMCID: PMC6316752.
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Healthcare (Basel). 2018 Oct 27;6(4). doi: 10.3390/healthcare6040128.

Making New Health Services Work: Nurse Leaders as Facilitators of Service Development in Rural Emergency Services.

Healthcare (Basel, Switzerland)

Helle Kise Hjertstrøm, Aud Obstfelder, Bente Norbye

Affiliations

  1. Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, 9019 Tromsø, Norway. [email protected].
  2. Department of Health Sciences in Gjøvik, NTNU, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 2802 Gjøvik, Norway. [email protected].
  3. Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, 9019 Tromsø, Norway. [email protected].

PMID: 30373242 PMCID: PMC6316752 DOI: 10.3390/healthcare6040128

Abstract

Nurse leaders in middle management positions in Norway and other Western countries perform additional new tasks due to high demands for quality and efficacy in healthcare services. These nurses are increasingly becoming responsible for service development and innovation in addition to their traditional leadership and management roles. This article analyses two Norwegian nurse leaders efforts in developing an emergency service in rural municipal healthcare. The analysis applies an ethnographic approach to the data collection by combining interviews with the nurse leaders with observations and interviews with six nurses in the emergency service. The primary theoretical concepts used to support the analysis include "organizing work" and "articulation work". The results show that in the development of an existing emergency room service, the nurse leaders drew upon their experience as clinical nurses and leaders in various middle management positions in rural community healthcare. Due to their local knowledge and experience, the nurses were able to mobilize and facilitate cooperation among relevant actors in the community and negotiate for resources required for emergency medical equipment, professional development, and staffing to perform emergency care within the rural healthcare context. Due to their distinctive professional and organizational competency and experience, the nurse leaders were well equipped to play a key role in developing services. While mobilizing actors and negotiating for resources, the nurses creatively balanced these two aspects of nursing work to develop the service in accordance to their expectation of providing the highest quality of nursing care to their patients. The nurse leaders balanced their professional ambitions for the service with legal directives, economic incentives, and budgets. Throughout the development process, the nurses carefully combined value-based and goal-based management concerns. In contrast, other studies investigating nursing management and leadership have described that these orientations are in opposition to each other. This study shows that nurses leading the processes of change in rural communities manage the change process by combining the professional and organizational domains of the services.

Keywords: articulation work; health policy; nurse leaders; organizational work; qualitative research; rural emergency clinic; rural nursing; service development

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