Empowering Nurses: Exploring Self-Managed Organizations in Indian Healthcare

Abstract

Background Given India’s high patient load on the existing healthcare setup, as well as political, social, and organizational challenges, the nursing sector is facing various problems, therefore leading to substandard nursing experiences leading to poor patient care at the parallel healthcare setups, specifically homecare. This paper presents self-managed organizations (also referred to as horizontal management structures) as an effective alternative to existing hierarchical management structures overladen with bureaucracy. Therefore, we are exploring the strategies at self-managed homecare organizations that can make nursing a better and meaningful experience. Method This research paper employs semi-structured interviews to explore the strategies that help create a better nursing experience in horizontal organizational structures. The interviews focused on various aspects, including finances, organizational structure, value system, information flow, concept, and purpose of self-managed homecare organizations that might influence the nursing experience. Theoretical sampling was used to include seven nurses, fifteen patients and twelve management members to examine the nursing experience at self-managed homecare organizations. Results The themes and subthemes revealed what we term the Qualitative Success Enablers (QSEs) of self-managed organizations in the Indian setting emerged from thematic analysis of data. The reflexive thematic analysis yielded three themes: Insightfulness, Enhancing Nursing Experience through Job Enrichment, and Autonomy-Enabled Intrapreneurship. The findings indicate that the horizontal management structure represented by the studied organization in India has shown considerable success in times laden with uncertainties during the COVID-19 pandemic, especially during the delta wave, which revealed the frailty of existing healthcare infrastructure. The organization successfully maintained a better nursing experience and gained patient and employee satisfaction, as revealed by in-depth semi-structured interviews and their analysis. Conclusion In a world of unique challenges, we stand on the brink of significant transformations. Self-managed organizations (SMOs) are vital in India's homecare sector for enhancing nursing experiences and overall organizational performance. Fostering a trust-based environment within SMOs is integral to delivering effective services. The autonomy to design nursing jobs, insightfulness, and innovativeness in the nursing job through suitable training activities, various job enrichment methods, and finding meaningfulness in a job through softer aspects of caregiving result in enhanced nursing experience at SMOs.