Do management and executive share the same perception on the critical issues facing the front-line nursing staff?

Changes in managerial practices increasingly distance managers from staff by promoting rotation. It could be thought that this distance changes the perception managers have of work constraints and resources. This study attempts to tackle staff and leadership disparate views on the issues facing front-line nursing staff. We sent an online questionnaire on work constraints and good practices to nursing chiefs from Belgium hospitals and conducted focus groups with their ‘front-line’ nursing staff in order to compare perceptions. 40% of the chief nurses mentioned as a regular problems for their staff: production pressure, working time, doctors–nurses collaboration and managing new staff. Except for the ‘productive pressure’, these issues are rather considered by the staff as occasional problems. Front-line staffs evaluate infrastructure, heat, working positions as more common problems. However, statistical analyses showed one significant difference in perception: management of incidents/accidents. Health care organizations should promote participatory management tools both to diagnose work constraints and to elaborate action priorities in order to guarantee a shared understanding of decisions making between staff and supervisors.