Negotiating Work–Family Balance among Intensive Care Unit Nurses from the Managerial Perspective of Head Nurses: A Qualitative Descriptive Study
DOI:
https://doi.org/10.31674/mjn.2026.v17i04.009Abstract
Background: Intensive care unit (ICU) nurses experience persistent work–family tensions due to high-acuity care demands, rigid shift systems, and emotional labor, particularly among nurses who are also mothers. While organizational support has been widely examined, limited attention has been given to how work–family balance is negotiated and enacted within everyday managerial practice at the unit level. This study aimed to explore how ICU head nurses conceptualize, interpret, and exercise managerial discretion in supporting work–family balance within structural and institutional constraints. Methods: A qualitative descriptive study design was used. Seven ICU head nurses (N = 7) from seven hospitals in Borneo, Indonesia, were purposively recruited based on their managerial responsibilities. Data was collected through in-depth semi-structured interviews and analyzed using reflexive thematic analysis. Results: Three interconnected themes emerged: (1) Framing work–family balance as a contextual managerial dilemma characterized by structural and emotional complexity, differentiated needs, and tensions between professional accountability and flexibility; (2) Experiencing competing role demands under structural constraints, including scheduling rigidity, persistent maternal guilt, and the need to sustain professional vigilance amid personal distress; and (3) Enacting managerial negotiation within organizational constraints through conditional schedule adaptations, relational leadership, and structured shift-swapping mechanisms. Conclusion: Work–family balance in ICU settings is not achieved solely through formal policies but through ongoing managerial negotiation embedded in everyday practice. These findings highlight the pivotal role of head nurses as mediators of job demands and caregiving responsibilities and underscore the need for institutional structures that legitimize sustainable managerial discretion.
Keywords:
ICU Nurses; , Managerial Perspective;, Nurse–Mothers; , Work–Family BalanceDownloads
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