Being a nurse leader in bedside nursing in hospital and community care contexts in Norway and Sweden

Background: The changes of health care that have been going on the latest decades have affected nurse leaders’ role in bedside nursing in hospitals and community care in Norway and Sweden as in many other countries. Aim: This study aimed at describing nurse leaders’ working situation, role experience and role performance in bedside nursing in hospital and community care contexts in Norway and Sweden. Methods: Twenty-four nurse leaders in three hospitals and ten nursing homes/sheltered accommodations in urban and rural areas in Norway and Sweden participated in qualitative interviews. Data was analyzed using inductive content analysis. In addition background information was used for providing deeper understanding of the leaders’ working situation. Findings: The leader responsibilities concerned safeguarding the quality in daily care, upholding a good workplace environment, developing nursing care, and keeping the budget in balance. Being in an ‘in-between’ position with more responsibility than authority in the role was common for all leaders. Four characteristic groups of leaders; ‘the patient guardian’, ‘the manager’, ‘the climber’, and ‘the unconscious’, illustrated different pattern found. Conclusion: Our study illuminates the necessity of improvement of competence requirements, authority-responsibility balance, administrative and emotional support, and competence development in regard to bedside nurse leaders