Nurses’ sensemaking of contradicting logics: An underexplored aspect of organisational work in nursing homes

Abstract

Organisational work, understood as the practices by which care services are organised, is often referred to as the glue in healthcare organisations. In response to healthcare reforms, organisational work in Norwegian nursing homes has undergone extensive changes. With increased standardisation and efficiency demands, new managerial logic often stands in stark contrast to traditional professional logic. Although organisational work is essential for all action in care, there is a lack of research on how contradicting logics influence organisational work in nursing homes. In this study, we combine the institutional logic perspective with sensemaking to demonstrate how nurses create new patterns and routines in organisational work. Our analysis indicates that contradicting logics create incongruous events that nurses attempt to clarify through sensemaking. To illustrate nurses’ sensemaking, we rely on new theoretical developments from the institutional logic perspective. The study contributes with a new understanding of nurses’ organisational work in nursing homes. In addition, by combining the institutional logic perspective with sensemaking, the study adds to previous knowledge in the institutional literature by demonstrating how sensemaking enables contradicting logics to co-exist.