Empowering nurses: exploring self-managed organizations in Indian healthcare

Abstract

Background Given India’s high patient load on the existing healthcare setup, as well as political, social, and organizational challenges, the nursing sector is facing various problems, therefore leading to substandard nursing experiences leading to poor patient care at the parallel healthcare setups, specifically homecare. This paper presents self-managed organizations (SMOs) characterized by a horizontal management structure as an effective alternative to existing hierarchical management structures overladen with bureaucracy. Therefore, we are exploring the strategies at self-managed homecare organizations that can make nursing a better and more productive experience. Method This study utilized Constructivist Grounded Theory (CGT), employing semi-structured interviews to explore nursing dynamics in horizontal organizational structures. It delved into crucial aspects like finances, organizational structure, value systems, information flow, and conflict resolution within SMOs. The methodology involved theoretical sampling, prioritizing expert self-management knowledge over mere representativeness. Seven nurses, twelve management members, and fifteen patients from self-managed homecare organizations contributed to the examination of nursing experiences. Constant comparative analysis of data led to the identification of the Qualitative Success Enablers (QSEs), revealing three themes: Insightfulness, Enhancing Nursing Experience through Job Enrichment, and Autonomy-Enabled Intrapreneurship. Results The findings indicate that the horizontal management structure represented by the studied organization in India has shown considerable success in times laden with uncertainties during the COVID-19 pandemic, especially during the delta wave, which revealed the frailty of existing healthcare infrastructure. The organization successfully maintained a better nursing experience and gained patient and employee satisfaction, as revealed by in-depth semi-structured interviews and constant comparative analysis. Conclusion In a world of unique challenges, we stand on the brink of significant transformations. SMOs are vital in India’s homecare sector for enhancing nursing experiences and overall organizational performance. Fostering a trust-based environment within SMOs is integral to delivering effective services. The autonomy to design nursing jobs, insightfulness, and innovativeness in the nursing job through suitable training activities, various job enrichment methods, and finding meaningfulness in a job through softer aspects of caregiving result in an enhanced nursing experience at SMOs. This groundbreaking approach can be extended to other homecare organizations in India, relieving the strain on the existing healthcare system.

Nurse managers’ managerial innovation and it’s relation to proactivity behavior and locus of control among intensive care nurses

“…Nurse managers should consciously leverage such strategies to sustain proactivity. However, they must also examine potential inhibitors like staff shortages, cultural conflicts, excessive organizational bureaucracy, and inadequate feedback mechanisms which can constrain proactivity despite supportive leadership [ 22 ]. Proactively addressing these issues is vital for translating innovative visions into reality.…”

“…The role of the work environment, shaped significantly by managerial practices, cannot be overstated in fostering a culture of proactivity [ 21 ]. Innovative management strategies introduced by Nurse Managers, including but not limited to flexible scheduling, team-based care models, and continuous professional development opportunities, can empower nurses [ 22 ]. Such innovations encourage nurses to take ownership of their work, foster a sense of autonomy, and support their engagement in proactive behaviors.…”