Going beyond “two-getherness”: Nurse managers’ experiences of working together in a leadership model where more than two share the same chair

摘要

Highlights ? New leadership solutions are called for to make the workload of nurse managers in critical and intensive care units more manageable. ? Multilaterally shared leadership between nurse managers, based on a strict division of tasks and a rotating schedule, may solve some problems (e.g., excessive workload) and also provide broader competence and access to more knowledge. ? Greater awareness is needed concerning the risk of reduced decision-making power, and also the need to cope with the increasing number of internal relations. Abstract Objective To explore nurse manager experiences of working in leadership constellations where more than two managers share leadership, and to compare this multilateral sharing form to what is known about experiences of working in joint leadership in pairs. Design and setting A qualitative design based on semi-structured interviews with nurse managers in two multilaterally shared leadership constellations at two intensive care units at an emergency hospital in Sweden. Data were analysed using a thematic and comparative approach. Findings The comparative analysis identified four aspects that differ decisively from the positive picture in the literature on joint pair leadership: the perception of mandate with reduced decision-making power and reduced access to forums, the way of working with a strict division of tasks and a rotating schedule, a need to cope with the increasing number of internal relations and a feeling of doubt concerning trust . Conclusion Shared leadership between nurse managers has gone from being a tight collaboration based on a feeling of “two-getherness”, to being an organisational solution multilateral in character. In this transformation, a weakening of leadership qualities has occurred. Further research is necessary on how this new organisational solution impacts the nurse managers, their staff and the care provided in healthcare organisations generally.