Nurse managers in perioperative settings and their reasons for remaining in their jobs - a qualitative study.

Aim The study describes what helps nurse managers maintain the strength to keep going as leaders. Background Good leadership is important for the quality of patient care, patient satisfaction in care and efficiency. Many nurse managers stay on despite challenges at work. Methods Twelve nurse managers were interviewed. Data were analysed by systematic text condensation according to Malterud. Results The results were as follows: A-Walking side by side with my employees; B-Knowing that I mean something to my employees; C-Talking to myself-asking myself tough questions; D-Having someone to talk to, to decrease the feeling of being alone; E-Leading and managing in my own way-the fear of not succeeding is my motivation. Conclusion The nurse managers built their own strategies to get through and get on when difficult situations arose. In order to succeed in leading their employees, the nurse managers gathered their inner strength through moving caritatively back and forth between the 'secret room' and the 'staff room' in the house of leadership. Implications in Nursing Management The manuscript gives insights into where nurse managers found sources of strengths in their everyday work. To realize their employees' strengths and motivation made a difference for nurse managers as a driving force. By having someone to talk to and by asking themselves tough questions, they were prepared for the challenges that came.