Nurse managers’ visions of future challenges in health care organizations

Background: Because of the economic crisis and nursing shortage, the situation for hospitals will be demanding throughout the decade in the 2010s. This poses challenges for nursing management. This article focuses on Finnish health care, particularly on nurse managers. Aim: The aim of this study is to describe and analyse future challenges in hospitals in one hospital district in Finland from the viewpoint of the nurse managers. The research question for this study is as follows: What kinds of future challenges are there in one hospital district from the viewpoint of the nurse managers? Method: The data was collected in the year 2011 from a number of essays (n=60) written by front-line and mid-level nurse managers in one hospital district. The data was analysed using a qualitative content analysis. Findings: Nurse managers saw challenges and threats for the future on the level of society, the hospital, the work unitand for employees. Work-unit level challenges were emphasized in these findings. Conclusion: The study shows that nurse managers have the ability to identify challenges in the future that they can influence by carrying out change management procedures. There is a need for more holistic management and closer interprofessional co-operation in health care for the benefit of patients in terms of customer oriented care. Furthermore, shared leadership is needed, which on a work-unit level means better pair management involving a front-line nurse manager and a physician. One requirement for nurse managers is the need to develop a sense of community. The ability to create environments that promote staff well-being is also important from the viewpoint of staff turnover. Nurse managers are usually well educated, so they should make more of an effort to utilize their education in their management work and update their expertise in management matters as well.