Many European countries restructure their health care systems by applying neo-liberal ideologies and new public management policies. How do the nurses organize their professional practice in the context of restructuring? More specifically we discuss similarities and differences in nurses' knowledge at work, working conditions, work-life balance and social position in diverse organizational settings and regional conditions in Europe. Our data consist of ethnographic observations, life story interviews and thematic interviews of 18 nurses in six European countries completed by focus group interviews. We are especially interested in the practical aspects of professional knowledge and how the nurses exercise professional judgment as they solve practical problems at work. We assume that there is some cognitive and social indeterminacy for being creative and strategic, even in the context of standardized institutional requirements. Finally, we discuss the meanings of restructuring and professional strategies in the light of the periods, generations, professions and contexts.