ALL HANDS ON DECK

Systems oriented design as sextant for navigating and mitigating the storms of
Norway’s nursing recruitment crisis.

A MASTER’S THESIS IN SYSTEMS ORIENTED DESIGN
By
Bjarte Hammer Aarland
Supervisor: Andreas Wettre
Arkitektur- og designhøgskolen i Oslo
Institute of Design

 Abstract

Norway’s healthcare system is an integral part of the welfare state and as such a large part of public funding. As a whole, it is almost entirely split in the middle between a governmental and a municipal part. The governmental branch is again split into 20 operational health trusts, differing in size from HelgelandHospital Trust with a budget size of about NOK 2 billion (Helgeland Hospital Trust, 2025), to Oslo University Hospital, about NOK 34,5 billion (Oslo UniversityHospital, 2025). The municipal branch is unevenly divided between 357 municipalities. Oslo, the most populous municipality, budgets close to NOK 3 billion to healthcare services (City of Oslo, 2025). Utsira, the least populated, budget accordingly a little less than NOK 20 million (Utsira
Municipality, 2025). All numbers are 2026 budget ceilings for 2026, except Utsira’s, which is the council manager’s proposal. This thesis will solely focus on the municipal sector as a whole. Shifting governments and mayors have to the best of their abilities made their mark. The macro monetary perspective, though, have over the last few decades remained more or less unchanged. The growing headache is not funding, but rather hiring. In the report «Arbeidsmarkedet for helsepersonell fram mot 2040» Statistics Norway states that nationwide, Norway lacked 5.500 FTE nurses in 2019. However, by 2040, the missing gap will count to 30.000 FTE nurses (Statistics Norway, 2023, p. 63). This thesis will seek to apply the tools provided by systems
oriented design, thus searching for new pathways and solutions.