The organizational projects management led by head nurses: qualitative study from an educational device [La conduite de projets organisationnels portée par les cadres de santé : étude qualitative à partir d’un dispositif pédagogique]

The work of operational coordination led by head nurses (HN) is more known than their abilities to change work organization, as well as, care practices. In this article, we explore organizational projects led by HN. Depending on the situations, they may concern their health care team or involve institutional hierarchy or other teams. We rely on an intervention study, which enabled us to follow 17 organizational projects led by HN for one year. The results of this study highlight as the main condition for success, the HN' efforts to enable mutual understanding with other interested actors. Managers, who engage their health care team in the development of solutions, bring sustainable results. When problems involve the hierarchy, the managers focus on the development of personal relationships. When problems involve other departments, which they depend on, then they engage themselves into integrative negotiations. These results invite to open discussion about work organization and to formalize organizational projects. This intervention study also points out that work – training at operational audit is relevant for HN.