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This study aims to make visible the dynamic nature of leader–member exchange (LMX) in the changing realm of health-care leadership.

The qualitative study used an open questionnaire, which was distributed amongst nursing staff and managers at a Finnish public university hospital.

The participants described partly LMX theory, but the leader-member relationship was also influenced by the organizational culture and the existing management practices. Nursing staff were found to have a more variable and dynamic role in the LMX relationship than has previously been reported. The research therefore provided novel information for the field of health-care research.

The presented research was limited by the content of the data, as the collected single narratives were rather short; however, the fact that a large number of narratives were collected from diverse participants strengthened the ability to reliably answer the research questions.

Although the participants described partly LMX theory, the leader–member relationship is also influenced by the organizational culture and existing management practices; the finding that nurses have more variable roles in LMX relationships in the health-care context was new insight in this field. Therefore, the presented findings can help decision-makers change the current, perhaps antiquated, leadership practices at health-care organizations.

This study provides new insight into the field of LMX research in terms of the important role of nursing staff, the organizational factors that influence the LMX relationship and the dynamic nature of LMX relationships.

This study aims to increase the understanding of the starting points and presuppositions of organizational learning (OL) processes in a hospital’s surgical department based on the existing theory of OL and to make visible the practical possibilities of the theory in this context.

The study was conducted as a case study. The data were collected from personnel of the hospital’s surgical department and consisted of 26 thematic interviews. The data were analyzed using qualitative theory-driven content analysis.

This study found different starting points for both employee-oriented and organization-oriented learning processes that could potentially progress to different levels of the organization: from individuals to a wider group or from a large group to an individual. The starting point of employee-oriented learning processes was depicted as everyday life problems or situations or was based on the person’s interest. The starting points of organization-oriented learning processes were described as achieving or maintaining the organization’s expected skill levels, pursuing continuous development or pursuing the organization’s specific development needs. Different kinds of presuppositions were also located within the OL processes.

This study produced new practice-based knowledge about the starting points of OL processes and their presuppositions. In health-care organizations, learning is especially important due to intensive and complex changes, and this study provides empirical evidence on how to enhance learning.