Role Development in the Managed Care Era: A Case of Hospital-Based Nursing

Managed care poses numerous opportunities and challenges for today's health care organizations and their employees. This article investigates the ways that hospital nurses develop and make sense of their professional roles and organizational environments in a changing and often uncertain managed care setting. The case study approach used in this research combined qualitative methodologies to gain a rich, detailed, and contextual understanding of nurses' work roles and organizational experiences. After an analysis of interviews with 24 nurses and observations of nurses' communicative activities on one inpatient unit, the complexity of sensemaking and role development in a managed care environment is considered. Conclusions are then drawn regarding the theoretical and pragmatic implications of nurses' communicative processes, as they attempted to develop and understand their roles in a changing organizational context.