The role of first line managers in healthcare organisations - a qualitative study on the work life experience of ward managers

The role of a first line manager (FLM) in Swedish healthcare has gone through major changes, from a divided role involving both nursing work and supervision to a pure management role. Along with these changes, the experienced core work and meaning of work have been altered. This also means that conditions for work that could regenerate the invested resources of the FLMs have been altered as well. The aim of this study was to describe the ward managers' experiences of their professional role, their work and how they are handling their everyday practice. Furthermore, the aim has been to interpret these experiences through the lens of regenerative work. Five ward managers at a Swedish hospital setting were followed for approximately four years. The study has had an interactive and pragmatic approach. Data were collected through interviews, observations and a continuous dialogue forum (three years). Four themes are presented in this paper: from supervisor to manager; loyalty; talking about it and dialogue forum. These themes are then discussed in order to understand basic conditions for the regenerative work of the FLM. The most central finding is the importance for the FLMs to make sense of their world through narratives and that the organisation does not provide for this.