The effect of new public management on intensive care unit staff
The NHS is largely dependent on two groups of professionals – medics and nurses. Recent government changes support the development of a central role for management. The impact of these changes on the roles and relationships of those working in the NHS must be understood in light of the structures already in place within it. Medical dominance in healthcare decision‐making, nursing power emanating from the strength of the medical‐nursing relationship and the hierarchies within and between the two professions all affect and are affected by recent management changes. In intensive care a key feature of the context, insularity, had already significantly modified these structures prior to recent reforms. This paper starts by discussing and contrasting the response of medics and nurses to these changes before highlighting the differences in the way these changes have impacted on staff in intensive care. Analysis is based on data from an observational study of the formation of a new directorate and interviews with senior nurses, medics and managers in intensive care.
First-line nurse managers in university hospitals--captives to their own professional culture?
AIM
This study investigates whether first-line nurse managers in hospitals share common dispositions related to managerial work and leadership, what they are like, and what their relationship is with the various expectations set on them.


METHODS
The first data were collected by focus group interviews in the autumn of 2000 and analysed using qualitative content analysis and frame analysis. The second data set were part of a questionnaire survey addressed to the same managers in 2001 with a focus on their diverse leadership roles.


RESULTS
Among first-line nurse managers, the management frameworks of a nurturing mother and an administrative nurse displayed the strongest prominence, and the emphasis seemed to be evolving towards the administrative. The results from the survey confirmed the findings of this study in relation to first-line nurse managers' management frameworks.


CONCLUSION
The line of development found in this study may add to the permanence of operations and the stability of the operative culture at a university hospital. It may also diminish the opportunities for nursing development in university hospital wards and weaken the potential for a new kind of competence among both managers and their subordinates.
Managerial effectiveness in the NHS. A possible framework for considering the effectiveness of the clinical director.
Examines managerial effectiveness in the NHS, in particular the effectiveness of the clinical director. Based on a qualitative study of an NHS Trust hospital case study, utilizes a social cognitive perspective to analyse the data and draw conclusions. Uses the data to suggest a possible framework for examining the effectiveness of individual directors. The framework may be relevant to other messages, particularly those in professional service organizations. It may also be used as a diagnostic tool to assess these managers. The framework is grounded in the perceptions of the interviewees at the Trust: both clinical directors and managers.