Abstract
AIM: To offer a new conceptual framework for formalizing nurses' work in managing emergent organisation in health and social care. BACKGROUND: Much health and social care requires continuous oversight and adjustments in response to contingencies. Nurses have an important role in managing these relationships. EVALUATION: A longstanding programme of research on the social organisation of health and social care work provided the foundations for the article. KEY ISSUE: Nurses' work in managing emergent organisation may be conceptualized as care trajectory management and factors contributing to trajectory complexity are explored. CONCLUSIONS: Care trajectory management is essential for the quality and safety of health and social care but poorly served by existing management frameworks. IMPLICATIONS FOR NURSING MANAGEMENT: Care trajectory management offers a conceptual framework for the development of new management structures to support an important but poorly supported element of nursing practice.