Middle-level managers in specialist healthcare services

– emotional work and organizational changes

Abstract

The study sheds light on the challenges that create emotional work among middle-level managers in specialist healthcare services and the personal strategies they develop. The qualitative research aims to provide insight into how top-level management can provide a working environment to meet the challenges. We interviewed eight middle-level managers in a Norwegian Health Trust. The main findings show overwhelming workloads, unpredictability, time-consuming administrative tasks, lack of leadership, and limited managerial role support. The middle-level managers use personal strategies to close the gap between the bureaucracy’s emotions- and display rules and their personal feelings. The challenges result in continuous emotional work, and over time, the middle-level management role becomes so burdensome that many decide to resign. The study shows that regular meetings between managers at different levels, equalization of power between professions, role clarification, changes in norms, mercantile support, and increased use of NPG as a governing principle can help to reduce emotional dissonance and strengthen the discretion room.