Fair management, positive leadership can ameliorate job worries among elder care staff

For nurses working in elder care facilities, the type of facility ownership can affect job insecurity and stability, reports a paper in the March issue of Advances in Nursing Science. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

Fair management and positive leadership can ameliorate job worries among elder care staff—with the potential to improve the care provided to elderly residents. The lead author of the new study was Tarja Heponiemi, PhD, of the Finnish National Institute for Health and Welfare, Helsinki.

More Job Worries for Staff in Some Types of Elder Care Facilities…
The researchers surveyed 1,249 staff members at elder care facilities in Finland regarding job insecurity and job stability. The findings were compared for staff at different types of facilities and different types of ownership. Most of the staff worked at "sheltered care" facilities, where residents typically have a private room or apartment but receive meals and other services as needed. Most staff members were permanent employees who worked double shifts. Two-thirds were practical nurses; most of the rest were practical nurses.

The ownership of the sheltered care facilities was for-profit for 14 percent of staff, not-for-profit (owned by associations or charities) in 29 percent, and public (owned by municipalities) in 31 percent. The remaining staff, 26 percent, worked at not-for-profit nursing homes.

The results suggested staff working at not-for-profit sheltered homes have the highest levels of job insecurity. The same group also had high levels of concern about job stability, as did staff at publicly-owned sheltered homes.

Concerns about job stability and security were also higher for contract staff, as compared to permanent employees. The associations remained significant accounting for other factors, such as the characteristics of the elder care residents (case mix) at each facility.

…But Good Management and Leadership Can Reduce Concerns
The effects were significantly influenced by staff perceptions of management and leadership. In particular, at facilities where staff perceived that management was fair and leadership was positive, the effects on job insecurity and stability were significantly lessened. "Fair management and positive leadership were able to mitigate insecurity in not-for-profit sheltered homes," Dr Heponiemi and coauthors write.

Many countries have seen major changes in the elderly care system in recent years, including a shift from institutional care to sheltered-housing facilities and home care. In Finland, the trend is away from publicly-owned nursing homes and toward care provided in facilities run by for-profit and not-for-profit organizations. The new study looked at how these changes are affecting the psychosocial work environment for elder care staff.

The results show that staff working in not-for-profit sheltered care facilities experience the highest levels of job insecurity and worries about job stability. The study also suggests that "Positive leadership and fair management might help to alleviate job insecurity that employee experiences when working in changing and uncertain environments," Dr Heponiemi and coauthors write.

The findings are especially important in the light of evidence showing that unfairness can affect the quality and productivity of health care work, in addition to its impact on staff health and well-being. Dr Heponiemi and colleagues cite some steps organizations can take to improve management and leadership—for example, "giving open information, practicing two-way communication, and using meeting procedures where staff can express their opinions in matters that involve them."