Value conflicts in public organisations: a reading of the individual values of hospital nurses and health managers
Les conflits de valeurs dans les organisations publiques : une lecture autour des valeurs individuelles des infirmiers et des cadres de santé hospitaliers.
Résumé
In recent years, hospitals have undergone a series of reforms driven by New Public Management (NPM), which have created significant tensions, particularly regarding values. The health crisis and the challenges related to resource rationalisation have further exposed the ethical tensions faced by healthcare professionals. To explore these tensions, we draw on Schwartz's theory of individual values (1996, 2006), Public Service Motivation (PSM) (Perry and Wise, 1990), and market values (Park and Joaquim, 2012) to analyse value tensions within public hospital organisations. We argue that individual and PSM values help mitigate tensions, while market values tend to intensify them. Based on interviews with 22 healthcare professionals (11 healthcare managers and 11 nurses) in three French public hospitals, we identify three individual values-benevolence, conformity, and universalism-that guide action and help alleviate the ethical tensions experienced by healthcare professionals. These individual values support effective action when public service motivation and open communication between stakeholders are present. Our recommendations emphasise the importance of adopting values-based management, supported by establishing spaces for ethical discussion the need to consider values-based management, supported by spaces for ethical discussion.
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