A discourse analysis of managerialism and trust amongst nursing professionals

This study explores the effects of New Public Management (NPM) on trust amongst nursing professionals, nurses and nurse ward managers within the British National Health Service (NHS). Thirty-nine nurses and nurse ward managers, recruited randomly, participated in semi-structured interviews. The original data, collected in 2000-2002, are re-analysed from a discourse analysis perspective. The findings support and extend contemporary research. They show that nurses have a strong professional identity and commitment and that increasing managerialism is eroding trust. Nurses both accommodate and resist managerialist discourses. They conceptualise trust in terms of their own ward environment, line-manager and colleagues. Trust is reciprocal and related to previous experiences and other factors. Trust is beneficial to healthcare organisations, healthcare professionals and their patients. Good communication and openness positively influence the development of trust. Nurse ward managers play a pivotal role in translating contested managerialist discourse into nursing practice to sustain trust and effect professional patient care.