Nurse middle managers contributions to patient-centred care: A ‘managerial work’ analysis

P.C.B. Lalleman*, Gerhard Smid, J. Dikken, M.D. Lagerwey, M.J. Schuurmans

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

5 Citations (Web of Science)


Nurse middle managers are in an ideal position to facilitate patient‐centred care. However, their contribution is underexposed in literature due to difficulties to articulate this in practice. This paper explores how nurse middle managers contribute to patient‐centred care in hospitals. A combination of time‐use analysis and ethnographic work was used to disclose their contribution to patient‐centred care at a micro level. Sixteen nurse managers were shadowed for over 560 hours in four hospitals. Some nurse middle managers seldom contribute to patient‐centred care. Others are involved in direct patient care, but this does not result in patient‐centred practices. At one hospital, the nurse middle managers did contribute to patient‐centred care. Here balancing between “organizing work” and “caring work” is seen as a precondition for their patient‐centeredness. Other important themes are feedback mechanisms; place matters; with whom to talk and how to frame the issues at stake; and behavioral style. Both “hands‐on” and “heads‐on” caring work of nurse middle managers enhances their patient‐centeredness. This study is the first of its kind to obtain insight in the often difficult to articulate “doings” of nurse middle managers with regard to patient‐centred care through combining time‐use analysis with ethnographic work.
Original languageEnglish
Article numbere12193
Number of pages12
JournalNursing Inquiry
Issue number4
Publication statusPublished - Oct 2017


Dive into the research topics of 'Nurse middle managers contributions to patient-centred care: A ‘managerial work’ analysis'. Together they form a unique fingerprint.

Cite this