‘Nurses are seen as general cargo, not the smart TVs you ship carefully’: the politics of nurse staffing in England, Spain, Sweden, and the Netherlands

Abstract

Nurse workforce shortages put healthcare systems under pressure, moving the nursing profession into the core of healthcare policymaking. In this paper, we shift the focus from workforce policy to workforce politics and highlight the political role of nurses in healthcare systems in England, Spain, Sweden, and the Netherlands. Using a comparative discursive institutionalist approach, we study how nurses are organised and represented in these four countries. We show how nurse politics plays out at the levels of representation, working conditions, career building, and by breaking with the public healthcare system. Although there are differences between the countries – with nurses in England and Spain under more pressure than in the Netherlands and Sweden – nurses are often not represented in policy discourses; not just because of institutional ignorance but also because of fragmentation of the profession itself. This institutional ignorance and lack of collective representation, we argue, requires attention to foster the role and position of nurses in contemporary healthcare systems.

Job crafting as retention strategy: An ethnographic account of the challenges faced in crafting new nursing roles in care practice

“…Current workforce shortages and staff turnover rates have turned the organisation and positioning of nursing work into a core challenge for many healthcare systems. 2 In this context, nurse differentiation and job crafting have been identified as important retention strategies. [26][27][28] Both strategies involve broadening the scope of roles and tasks in which nurses can engage-making it possible for nurses from differing training backgrounds to enter the profession and/or to pursue an attractive career.…”

“…Such investments should not only be aimed at increasing or retaining nursing numbers, but also at improving the political position of nurses in healthcare organisations. 2 Hospital managers, physicians, and nurses themselves all have an important part to play here. It is only through a shared recognition of this need to change and through structural organisational investments that the nursing profession can develop into a more attractive occupational choice for new generations of healthcare professionals.…”

“…44 Hence, these policies can potentially attract or retain specific groups of nurses while simultaneously reinforcing a perceived lack of appreciation for nurses in general. 2 It is therefore very important to be sensitive to the effects that job crafting and nurse differentiation interventions have on individual professionals as well as on the professional groups into which job crafting is introduced as a strategic intervention.…”