Nurses' perception of senior managers at the front line: people working with clipboards

To provide an original perspective on front-line nurses' perception of senior managers who are not nurses.

A key element of new public management had been the drive for 'hands-on' professional management within the UK National Health Service, meaning the employment of mangers with managerial experience but little or no healthcare experience.

An interpretive qualitative study, based on a single case study design with semi-structured interviews.

Semi-structured interviews were carried out with 31 front-line Scottish National Health Service nurses exploring their perceptions of the role of managers between July-September 2010.

Nursing staff were often unsure of the responsibilities of managers and perceived that there were an unnecessarily high number of managers within the National Health Service. Nursing staff raised concerns over the non-clinical background of managers, including their ability to understand the pressures faced at the front line.

The main reason for conflict between managers and nursing staff was their differing foci. Managers were seen to concentrate on decisions surrounding targets, audits and budgets with little consideration given to the impact of these decisions on patient care.