Table 3 The emerging themes, categories, and indicators from the constant comparative analysis method

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Insightfulness - Insightfulness in the context of nursing experience refers to the capacity of nurses to apply advanced critical thinking abilities, spontaneous insightful and innovative solutions, and creativity in their day-to-day jobs, offering immediate as well as long-term approaches to patient care. It encompasses integrating diverse perspectives, including fairness, ethics, and evidence-based practice, into their decision-making and problem-solving processes. The nurses at SMOs are enabled to apply insights in day-to-day jobs spontaneously as and when the need arises, given they are trusted and have enough freedom to be innovative.

1. The Freedom to Experience Meaning

This concept challenges the conventional belief that work’s meaning is solely determined by individual viewpoints, highlighting the profound importance of a shared sense of meaningfulness among colleagues. It underscores that in SMOs, nursing is not confined to purely career-driven motivations; rather, it acknowledges satisfaction from tending to the compassionate and softer aspects of caregiving for a better nursing experience along with being insightful through the freedom to apply critical thinking skills in their day to day jobs as nurses. This counters the bias towards a purely career-centric approach, emphasizing the value of more profound meaning and personal satisfaction in the workplace derived from being insightful and creative. It demonstrates the nurses’ problem-solving capacities as they do not feel excessively controlled and micro-managed to perform their tasks rigidly.

2. Expansive Nursing Intelligence

Expansive Nursing Intelligence embodies the nurses’ capacity to employ advanced critical thinking skills and insights that transcend the confines of clinical duties, embracing a comprehensive perspective on homecare. Its goal is to improve the holistic care provided to homecare patients, thereby improving their overall well-being and outcomes. This, in turn, elevates the nursing experience, fostering recognition and career advancement for nurses.

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Enhancing Nursing Experience through Job Enrichment -

SMOs involve this unique approach to achieving organizational excellence. These strategies encompass integrating additional job support, cultivating a culture marked by group harmony and cooperation, utilizing compact and specialized teams, role rotation, and a dedicated effort to nurture critical thinking among employees as a means of job enrichment. These ways of job enrichment contribute to enhancing the nursing experience at SMOs.

1. Assisting in supplementary jobs

Assisting in supplementary jobs through the utilization of Information and Communication Technology (ICT) solutions, like the Dr. Dashboard software developed by GL Tech, leads to job enrichment and enhances the nursing experience at the SMOs. These ICT tools alleviate the administrative burden by enabling nurses to efficiently manage tasks beyond their core caregiving responsibilities, such as recording patient information, health data, treatment records, nursing information, and caregiver details. Moreover, they facilitate seamless communication and data sharing among the team. This, in turn, enhances nurses’ job enrichment, satisfaction, and nursing experience and contributes to the organization’s growth and efficiency.

2. Rotating Team Duties

“Rotating Team Duties” is a progressive approach adopted by Self-Managed Organizations (SMOs) to ensure job enrichment in self-managed homecare organizations. In this practice, team members are empowered to express their interest in and assume particular responsibilities within the team, breaking away from the conventional belief that duties should be rigidly predefined and assigned based on predetermined roles. In SMOs, team members have the autonomy to adapt and distribute duties according to their needs and preferences, all while ensuring that essential tasks are effectively accomplished. This flexible approach fosters a dynamic and adaptive task allocation system within the organization, which, in turn, contributes to job enrichment and a better nursing experience.

3. Small Team Size

Implementing a “Small Team Size” approach in a self-managed homecare organization entails deliberately maintaining a limited number of team members, often capped at a maximum of two individuals. This strategic choice is instrumental in enhancing nurses’ job performance. It enriches their job by paying attention to softer aspects of caregiving as they provide homecare to the same patients over long periods, leading to a superior nursing experience. It fosters a patient-focused approach, ensuring a more personalized and attentive care experience. This patient-focused approach also enriches the job experience of nurses as they are able to provide more humane care, focusing on softer aspects like empathy, compassion, and genuine concern for patients’ well-being while performing their caregiving jobs.

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Autonomy-enabled Intrapreneurship -"Autonomy-Enabled Intrapreneurship” in the context of SMOs signifies a proactive and entrepreneurial mindset that empowers employees to foster innovation, take initiative, and champion transformative change within the organization through enhanced autonomy given to the nurses. This approach encourages nurses to drive progress and growth through greater discretion on designing and performing their jobs while ensuring the implementation of necessary safeguards to maintain a proactive and balanced organizational ecosystem. In nursing, autonomy-enhanced entrepreneurship promotes a superior nursing experience by allowing healthcare professionals greater independence, autonomy, and control over their work. It promotes nurse leadership, ultimately leading to improved patient care, job satisfaction, and overall organizational excellence.

1. Protecting and Expanding Organizational Ecosystem

“Protecting and expanding organizational ecosystem” entails preserving and enriching a distinctive work culture through training and deconditioning, promoting a collaborative and creative atmosphere for open expression, and retaining employees who align with the organization’s values. Accepting natural departures for those who don’t fit the ecosystem avoids immediate firing, reducing job insecurity and fostering a respectful and supportive work environment, ultimately enhancing the nursing experience.

2. Safeguarding and Fostering Freedom Parallel to Safeguards

“Safeguarding and Fostering Freedom in parallel with Safeguards” signifies a guiding principle within SMOs that underscores the significance of striking a delicate equilibrium. It involves providing employees, especially those in roles that demand critical thinking and expertise, with the freedom to make autonomous decisions while concurrently establishing protective measures to avert unwanted outcomes. This approach acknowledges that curtailing this freedom may result in adverse consequences, including ethical dilemmas, coordination challenges, diminished motivation, reduced care quality, and overall dissatisfaction among nurses, therefore leading to a better nursing experience. Consequently, it recognizes the indispensability of both granting autonomy and implementing safeguards as fundamental tenets of the organization’s core values, ultimately leading to a more rewarding nursing experience.

3. Leadership in Nursing

“Leadership in nursing” at SMOs encompasses the proactive and unwavering commitment demonstrated by nurses within SMOs, to advocate for social justice, fairness, and positive change. It entails taking a leading role in efforts aimed at achieving justice and inspiring transformative actions that ultimately enhance the nursing experience. Nurse leaders are motivated by their core principles and values, driven by a profound sense of duty, a strong belief in the significance of taking action, and an enduring commitment to improving the healthcare environment. Essentially, it signifies a determined dedication to causing positive change and making a meaningful impact that extends beyond their immediate caregiving responsibilities, ultimately resulting in a better nursing experience.