BackgroundMiddle managers play a key role in promoting a caring culture in nursing homes.
However, there is limited knowledge about middle managers’ inner motives and their
experiences of their responsibility in developing a caring culture.Research aimThe aim of the study is to get a deeper understanding of middle managers’ motives and
their experiences of their responsibility to develop a caring culture in nursing
homes.Research designA qualitative design with a hermeneutic approach inspired by Gadamer was chosen which
guided the interpretation of data. Qualitative semi-structured interviews were
conducted.Participants and research contextData were collected from thirteen middle managers in nursing homes, in six
municipalities in northern Norway in September and October 2021.Ethical considerationsThe study was approved by the Norwegian Centre for Research Data. Oral and written
informed consent was obtained from participants.FindingsThe findings show that the middle managers had non- egoistic motives to promote a
caring culture as expressed in their attitudes and actions. They felt responsible to
promote a caring culture where both patients and staff experienced care and were
respected and recognized as unique individuals. Middle managers as good role models are
responsible for being present and raising awareness of the importance of care in the
nursing home culture by systematically reflecting on care values. However, a strong
focus on the financial and administrative demands limits the middle managers’
possibilities to promote a caring culture and prevented them from always acting as they
wanted to act, which often causes moral distress.ConclusionBeing in contact with inner motives, enables the leader to promote a homelike and
caring culture where both patients and staff feels respected and recognized as unique
individuals. This study highlights the importance of systematic reflection on caring
values in nursing homes which leads to value awareness among all actors.