"Value Beyond Management": Professional Transition Among Senior Head Nurses in China: A Descriptive Qualitative Study...

As the nursing workforce ages, an increasing number of senior head nurses are transitioning from managerial to nonmanagerial roles. However, little is known about how these nurses experience and navigate this professional transition, despite its important implications for workforce sustainability, retention, and knowledge transfer within healthcare organizations. Guided by Schlossberg's 4S transition model, we aim to explore the transition situations, individual traits and psychological resources, external support, and adaptation strategies of senior head nurses transitioning from managerial to nonmanagerial roles.

A descriptive qualitative design was employed. Eighteen female senior head nurses who had recently stepped down from managerial positions were recruited from four tertiary public hospitals in central China using purposive and maximum variation sampling. Data were collected through semistructured interviews and analyzed using inductive thematic analysis. Schlossberg's 4S transition model was subsequently used as a theoretical lens to interpret the inductively derived themes.

Four themes were identified through inductive thematic analysis: (1) Situation: rigid transition policies, chaotic time management, and unstandardized placement procedures; (2) Self: a role shift from the management core to the functional periphery, creating a mismatch between personal work experience and new job demands; (3) Support: an institutional absence of organizational recognition and financial compensation, countered by the compensatory role of social networks; and (4) Strategies: proactive spatial isolation, reconstruction of workplace power boundaries, and the development of a new professional second curve through job crafting.

The transition of senior head nurses from managerial to nonmanagerial roles is a complex process involving identity reconstruction, loss of managerial authority, and adaptation to new professional expectations. Successful adaptation was facilitated by redefining professional value and actively reshaping work roles. Organizational strategies that support transition planning, recognize prior leadership contributions, and utilize the expertise of former nurse leaders may promote workforce sustainability.

This study provides critical insights for nursing workforce management. Healthcare organizations should integrate the transition of senior head nurses into formalized career management frameworks. Furthermore, institutions must implement formal recognition mechanisms for past contributions to enhance organizational belonging. Finally, nursing administrations should establish dual-track career pathways, including advisory or educational roles. These strategies address perceived overqualification and maximize the continued utilization of senior nursing human capital.