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Nurse leaders are challenged by ethical issues in today’s complex health-care settings. The purpose of this study was to describe and analyze key elements of moral distress identified by nurse leaders from health-care systems in the USA, Germany, Austria and Switzerland. The aim was to develop an understanding of distressing ethical issues nurse leaders face in the USA and three German-speaking European countries.

This descriptive cross-sectional study surveyed a convenience sample of nurse leaders in the USA, Germany, Austria and Switzerland. The voluntary, anonymous survey also included qualitative questions and was distributed using the Qualtrics® platform. A thematic analysis of the qualitative data in each country was carried out and a comparative analysis identified similarities and differences between the groups of nurse leaders comparing the US data to that from three German-speaking European countries.

The survey was completed by 316 nurse leaders: Germany, Austria, and Switzerland (n = 225) and the USA (n = 91). Similar themes identified as causing all nurse leaders moral distress included a lack of individual and organizational integrity, hierarchical and interprofessional issues, lack of nursing professionalism, patient care/patient safety concerns, finances negatively impacting care and issues around social justice. Within these six themes, there were also differences between the USA and the three German-speaking European countries.

Understanding the experiences associated with distressing ethical situations can allow nurse leaders and organizations to focus on solutions and develop resilience to reduce moral distress in the USA and three German-speaking European countries.

Designing and developing safe systems has been a persistent challenge in health care, and in surgical settings in particular. In efforts to promote safety, safety culture, i.e., shared values regarding safety management, is considered a key driver of high-quality, safe healthcare delivery. However, changing organizational culture so that it emphasizes and promotes safety is often an elusive goal. The Safe Surgery Checklist is an innovative tool for improving safety culture and surgical care safety, but evidence about Safe Surgery Checklist effectiveness is mixed. We examined the relationship between changes in management practices and changes in perceived safety culture during implementation of safe surgery checklists. Using a pre-posttest design and survey methods, we evaluated Safe Surgery Checklist implementation in a national sample of 42 general acute care hospitals in a leading hospital network. We measured perceived management practices among managers (n = 99) using the World Management Survey. We measured perceived preoperative safety and safety culture among clinical operating room personnel (N = 2,380 (2016); N = 1,433 (2017)) using the Safe Surgical Practice Survey. We collected data in two consecutive years. Multivariable linear regression analysis demonstrated a significant relationship between changes in management practices and overall safety culture and perceived teamwork following Safe Surgery Checklist implementation.

The purpose of the paper is to propose a shift from the ideal of immersion to a practice of “committed localism” in the ethnographic study of relational work in the post-bureaucratic and service-based economy.

The paper is based on ethnographic fieldwork following management consultancy projects in a hospital and a manufacturing company in Denmark. The approach was predicated on committed attention to the everyday of consultancy work activities and associated relational dynamics. This involved being present at the client sites, observing and listening in concrete situations of interaction and engaging in conversations with the multiple actors involved, both external consultants and members of client organisations.

The paper shows how “committed localism” was practiced in the ethnographic study of management consultancy as it is relationally accomplished in and through concrete situations of interaction between consultants and different actors in client organizations and the associated meaning production of the involved actors.

The paper develops the notion of “committed localism”, originally introduced by George Marcus, into a methodological concept to challenge the conventional ideal of immersion as the hallmark of “proper” ethnography. Such a shift is particularly pertinent for the ethnographic study of relational processes involving multiple actors occupying different positions in the temporary social spaces of contemporary workplaces.

In this paper, the authors examine the strategies used to reduce labour costs in three public hospitals in South Africa, which were effective and why. In the democratic era, after the revelations of large-scale corruption, the authors ask whether their case studies provide lessons for how public service institutions might re-make themselves, under circumstances of austerity.

A comparative qualitative case study approach, collecting data using a combination of interviews with managers, focus group discussions and interviews with shop stewards and staff was used.

Management in two hospitals relied on their financial power, divisions between unions and employees' loyalty. They lacked the insight to manage different actors, and their efforts to outsource services and draw on the Extended Public Works Program failed. They failed to support staff when working beyond their scope of practice, reducing employees' willingness to take on extra responsibilities. In the remaining hospital, while previous management had been removed due to protests by the unions, the new CEO provided stability and union–management relations were collaborative. Her legitimate power enabled unions and management to agree on appropriate cost cutting strategies.

Finding an appropriate balance between the new reality of reduced financial resources and the needs of staff and patients, requires competent unions and management, transparency and trust to develop legitimate power; managing in an authoritarian manner, without legitimate power, reduces organisational capacity. Ensuring a fair and orderly process to replace ineffective management is key, while South Africa grows cohorts of competent managers and builds managerial experience.

Since the outbreak of the COVID-19 pandemic, most organizations have experienced a sudden and unprecedented drop in revenue and productivity. However, the pandemic did not exclusively negatively impact organizations; rather, it resulted in both negative and positive effects. To delve into the multi-level process through which organizational outcomes change from negative to positive indicators, this study focuses on organizational resilience as a theoretical concept to overcome pandemic-related turmoil.

The authors conducted a multi-level analysis based on grounded theory with a sample of 30 healthcare employees who worked in hospitals and were simultaneously enrolled in a part-time master of business administration (MBA) program at a university in the Midwest. Of the 30 participants, 21 were from a single university hospital (UH), and the remaining 9 participants were from other hospitals (non-UH).

The authors analyzed the data and incorporated three existing perspectives of organizational resilience (attribute, process and multi-level views) into an integrated model. The authors identified 25 first-order concepts and 8 second-order themes and categorized them into 4 aggregate dimensions at different unit levels: organizational field, leadership, operation and individual units.

A resilient hospital operates as a cohesive system, with entities at various levels – from individuals and teams to the broader organization – collaborating seamlessly to foster resilience. Top management team (TMT) should persistently communicate with employees to provide information about the current crisis and clear strategic directions to reduce employees' fear and prevent anomie stemming from future uncertainty. Managers should not only be concerned about employees' physical safety from infection and psychological safety from isolation but also encourage employees to elicit meaningfulness from their work. Furthermore, TMT and human resource (HR) teams should adapt human resource management (HRM) practices to allow for flexibility and optimism in employee roles.

In this study, the authors utilized a qualitative methodology with grounded theory in order to develop a comprehensive model that holds theoretical, methodological and practical significance. Theoretically, the authors' novelty lies in the synthesis of three distinct perspectives: attribute, process and multi-level. The authors merged these approaches into a unified model, identifying precursors of resilience at different levels. Methodologically, the authors focused on hospitals as target samples, which were the foremost and representative organizations severely confronting the crisis and turmoil brought by the pandemic. The authors documented organizations' experiences amidst the crisis as they unfolded in real time rather than in hindsight. This approach highlights the immediacy and significance of the authors' research in the realm of crisis management. Practically, the authors' findings illuminate that organizational resilience can be developed through a collaborative effort. It emerges from coordinated interactions across various organizational actors, from employees and middle managers to the TMT.

The Purpose of the study was to investigate the construct validity and internal consistency of the LaMI among staff in the context of elderly care in Sweden.

Questionnaire data from a longitudinal study of staff working in elderly care were used. Data were collected using the Leadership and Management Inventory. First data collection was for explorative factor analysis (n = 1,149), and the second collection, one year later, was for confirmatory factor analysis (n = 1,061).

The explorative factor analysis resulted in a two-factor solution that explained 70.2% of the total variance. Different models were tested in the confirmatory factor analysis. The final model, a two-factor solution where three items were omitted, showed acceptable results.

The instrument measures both leadership and management performance and can be used to continually measure managers’ performances as perceived by staff to identify areas for development.

Coronavirus disease (COVID-19) has challenged leadership in hospitals worldwide. The experiences of leadership during the pandemic changed leadership significantly. This study aims to describe nurse leaders’ perceptions of what future leadership in hospital settings in the post-pandemic era needs to be like.

A qualitative descriptive study was used. A total of 20 nurse leaders from the Finnish central hospital were interviewed from June to October 2021. The data were analysed using inductive content analysis.

The analysis revealed five main categories describing nurse leaders’ perceptions of future leadership in hospital settings in the post-pandemic era: digitalisation and hybrid working culture, development of sustainable working conditions, moving smoothly to the post-pandemic era, dissolution of traditional regimes of organisation and flexibility in leadership.

In the post-pandemic era, the constantly changing demands and challenges currently facing healthcare systems have significantly increased the complexity of hospital organisations. This requires critical evaluation and change to traditional leadership. Enhancing flexibility and authenticity in leadership, strengthening competencies, implementing a wide range of digital resources and increasing the appeal of the nursing profession to build the next generation of nurses – all of these are needed to provide sustainability in future healthcare.

The results identify the critical points of leadership that need to be developed for future challenges and for maintaining a sufficient supply of qualified professionals. Acting on this information will enhance flexibility in organisations and lead to acceleration of changes and the development of new kinds of leadership in the future

This study explores how emotional intelligence, customer orientation, deep acting and surface acting influence job satisfaction among middle managers in their interactions with customers, colleagues and business partners. By examining these factors, we aim to provide insights into their collective impact on job satisfaction and interpersonal dynamics within organizational contexts.

By involving 95 middle managers at Indonesian Internet service providers as respondents, this research used a questionnaire to collect data. Next, the data were analyzed using the partial least square-structural equation modeling (PLS-SEM) technique, which evaluated measurement models and structural models. A total of twelve hypotheses were tested in this study.

This study found that customer orientation does not have a significant effect on deep acting, thereby nullifying its indirect effect on job satisfaction. Conversely, it's demonstrated that both deep acting and surface acting serve as partial mediators in the relationship between emotional intelligence and job satisfaction. Furthermore, surface acting emerges as a partial mediator in the connection between customer orientation and job satisfaction.

By exploring the relationship between customer orientation, emotional intelligence and job satisfaction among employees, this study seeks to reveal novel insights. The study examines the impact of these critical elements, which are necessary for middle managers to effectively manage their emotions and cultivate significant connections, on their overall job satisfaction and interpersonal dynamics in their diverse responsibilities.

This study aimed to investigate the sensemaking strategies employed by early-career employees working within organizationally constrained environments.

Grounded in the sensemaking-as-accomplishment framework, a longitudinal multi-case study was conducted, involving three early-career employees. These participants were interviewed multiple times concerning tasks they themselves identified as anomalous and ambiguous.

The study's findings illuminate how early-career employees utilize sensemaking strategies to accomplish anomalous-ambiguous tasks. These strategies are interwoven with deliberate efforts to mitigate organizational constraints that exist in the organization or arise during the execution of complex tasks.

Notable limitation pertains to the time gap between task completion and the interviews. Conducting real-time interviews concurrently with task execution or immediately afterward was not feasible due to constraints in participant availability. This research has implications for organizational learning initiatives, particularly those encompassing employee-driven self-learning components. Insights derived from studies like this can inform the development of effective self-learning schemes within organizations.

Previous sensemaking research focused on what takes place in high-reliability organizations. This study explored sensemaking strategies in workplaces that are organizationally constrained.

The purpose of this study is to examine the sociocultural implications of caring for persons with COVID-19 in a developing country context.

In total, 156 nurses participated in the study. Stratified random sampling methodology was used. Data were collected via online self-administered questionnaire. Descriptive and inferential statistics, including ANOVA tests were done.

Nurses experienced stigmatization, discrimination and reduced income. Nurses functioned on the frontline during the COVID-19 pandemic and encountered negative sociocultural experiences from a personal, social and professional perspective. ANOVA showed statistically significant relationships between the conflicts between their work role, family commitments and level of physical interactions with a number of variables.

Data were collected from one Regional Health Authority and may not be representative of the national population of nurses. Further, as the researchers depended on gatekeepers to access participants, the recruitment process may not have been entirely based on randomization as originally agreed.

The findings from this study can be used as a framework to develop context specific programmes and policies to support health professionals, including nurses.

Pandemics, while not new, contribute to serious sociocultural challenges for individuals and families, as well as nurses, as part of their professional roles. In this regard, maintaining effective social networks must be central to effective functioning in crisis situations, such as pandemics.

Nurses have played a key role, working both to identify, isolate and manage those with COVID-19 and supporting those who have non-COVID-19 related health needs. While nurses have been at the forefront delivering care in these uncertain times, doing so puts them at great risk, for not only contracting COVID-19 but also for experiencing negative psychosocial effects that may be due to the nature of their jobs.