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Alternative careers at the first level of management: First-line nurse managers’ responses to role conflict

Jörg W. Kirchhoff (Faculty of Health and Welfare Studies, Østfold University College, Halden, Norway)
Jan Ch. Karlsson (Faculty of Business, Languages and Social Sciences, Østfold University College, Halden, Norway)

Leadership in Health Services

ISSN: 1751-1879

Article publication date: 8 June 2018

Issue publication date: 12 July 2019




First-line nurse managers are frequently torn between conflicting demands from management and employees, and previous research suggests that nurse managers use a variety of responses to cope with these demands. The purpose of this paper is to explore the influence of social support on nurse managers’ responses to role-conflict.


Two focused ethnographic studies involving participant observation and interviews with seven first-line nurse managers were completed. One study included first-line nurse managers from four units in two municipalities (2005), while the second included three first-line nurse managers from a hospital in Norway (2015-2016).


Three types of responses were identified: the embracing managerialism career, the emphasising managerialism career and the emphasising professionalism career. Emphasising managerialism was associated with role distance from the role of nurse, whereas emphasising professionalism involved role distance from the managerial role.


This study provides insights into first-line nurse managers’ responses to role conflict, by identifying the mechanisms involved and an opportunity to develop a theoretical framework for future studies among nurse managers.



Kirchhoff, J.W. and Karlsson, J.C. (2019), "Alternative careers at the first level of management: First-line nurse managers’ responses to role conflict", Leadership in Health Services, Vol. 32 No. 3, pp. 405-418.



Emerald Publishing Limited

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