The nurse manager as a professional-managerial class: a case study.

AIM: This study set out to capture the work dynamics and impact of nurse managers during healthcare restructuring. BACKGROUND: The nurse managers are instrumental to healthcare reform in which the ultimate goal is the promotion of a cost-effective healthcare delivery system. METHODS: A case study approach was used. Interviews were conducted with 12 nurse managers working in an acute hospital in Hong Kong. The data was analysed initially by thematic analysis, followed by the extended case method. FINDINGS: This study showed that the coalition of the nurse and manager role gives rise to the professional-managerial class (PMC). These nurse PMCs enjoyed the kind of power, job satisfaction and work autonomy that frontline nurses did not experience. They managed nurses who predominantly occupied the workforce and managed nursing care that composed the main bulk of work in hospital service. CONCLUSIONS: The emergence of a group of nurse managers is essential to a cost-effective service, and to maximize nursing efforts in healthcare.