Hard nosed or pink and ﬂ uffy? An examination of how middle managers in health care use the competing metaphors of business and care to achieve desired outcomes : An examination of how middle managers in health care use the competing metaphors of business and care to achieve desired

doi:10.4324/9780203391495-15

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Hard nosed or pink and ﬂ uffy? An examination of how middle managers in health care use the competing metaphors of business and care to achieve desired outcomes

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ABSTRACT

It is striking when listening to health care managers describing their work how they move frequently between metaphors of caring and those associated with a business-oriented approach. They talk of caring, of sharing, of the values of service, of being ‘pink and ﬂ uffy’. In contrast, they clearly appreciate the pressures on them to respond to business expectations, to be efﬁ cient, to argue ﬁ nances, to ‘blacken their hearts’ in the way they manage others.