A pawn in someone's game - a qualitative study on mandatory redeployment of cardiac nurses

Due to a global shortage of nurses, decision-makers have implemented organizational changes to improve nurse retention. In Denmark, it was nationally decided that all nurses, working in hospitals, should participate in weekend shifts in inpatient wards to reduce the workload on inpatient nurses. In a large department of cardiology, the announcement of this upcoming change in outpatient nurses’ working conditions initially led to increased resignments among them.

To explore cardiac nurses’ expectations and perceptions of an organizational change comprising outpatient clinic nurses’ mandatory participation in weekend shifts in the inpatient wards.

In this qualitative explorative study, we conducted six individual and five focus group interviews during January-September 2025. Participants were cardiac nurses (n=21) employed in the outpatient clinic and inpatient wards across a department of cardiology, including charge nurses. Data analysis was inspired by the Rigorous and Accelerated Data Reduction technique in combination with qualitative content analysis.

Analysis identified one overarching theme entitled "High-quality nursing jeopardized by top-down decided redeployment of cardiac nurses" supported by three themes entitled: (1) Struggling to transfer specialized competencies into new settings; (2) Challenged job satisfaction and wellbeing; (3) Coping to manage the present and the future. These findings represent nurses’ perceptions of how redeployment of highly specialized cardiac nurses negatively influence their nurse identity, wellbeing and job satisfaction, which in turn presents a risk to patient safety, and impacts the possibilities for delivering high-quality and person-centered care.

Despite opposite intentions from decision-makers, top-down decided organizational changes, resulting in mandatory redeployment of highly specialized cardiac nurses, may lead to nurses resigning from their jobs due to severely reduced wellbeing, job satisfaction and diminished possibilities for delivering high-quality and coherent cardiac care.