According to a study in the March issue of Advances in Nursing Science, the type of facility ownership can affect job insecurity and stability for nurses working in elder care facilities. Fair management and positive leadership can alleviate job insecurities amongst care staff for the elderly, and potentially improve the level of care elderly residents receive.

Lead researchers, Tarja Heponiemi, PhD, of the Finnish National Institute for Health and Welfare, Helsinki, and her team conducted a new survey that involved 1,249 staff members at elder care facilities in Finland, with regard to their views on job insecurity and job stability. The team compared the findings, categorizing staff according to the different types of facilities and various types of ownership.

They noted that the majority of care staff worked at “sheltered care” facilities, where residents generally have a private room or apartment and receive meals and other services as needed. The majority of carers consisted of permanent employees who worked double shifts, of which two-thirds of care staff were practical nurses, with the majority of the remaining nurses also being practical nurses.

14% of ownership of the sheltered care facilities was for-profit, whilst 29% of care facilities were non-profit organizations owned by associations or charities, and 31% of care facilities were public, being owned by municipalities. The rest of the staff of 26% worked at non-profit nursing homes.

According to the findings, care stuff working at non-profit sheltered homes reported the highest levels of job insecurity and levels of concern about job stability, together with care staff at publicly owned sheltered homes.

Contract staff also reported feeling more concerned about job stability and security than those who were permanently employed. The researchers note that the findings remained unchanged after adjusting for other factors, including characteristics of the elder care residents (case mix) at each facility.

The researchers observed that the findings were substantially influenced by how the staff perceived their management and its leadership abilities, for instance, at facilities where staff thought the management to be fair with a positive leadership style, the effects on job insecurity and stability were substantially lower.

Dr Heponiemi comments: “Fair management and positive leadership were able to mitigate insecurity in not-for-profit sheltered homes.” In recent years, several countries have experienced major changes in the care system for the elderly. For instance, a shift from institutional care towards sheltered-housing facilities and home care.

In Finland, the trend moves from publicly owned nursing homes towards care by profit- and non-profit organizations. The new study examined the impact of these changes on the psychosocial work environment for elder care staff.

According to the findings, those working for non-profit sheltered care facilities feel the highest levels of job insecurity and concerns about job stability. In addition, the study also revealed that, “Positive leadership and fair management might help to alleviate job insecurity that employee experiences when working in changing and uncertain environments,” said Dr Heponiemi.

The findings are of particular significance given that the evidence demonstrates that unfairness can impact the quality and productivity of health care work, in addition to the affects on staff health and their well-being.

Dr. Heponiemi and his team describe steps organizations can implement to improve management and leadership, for instance, “giving open information, practicing two-way communication, and using meeting procedures where staff can express their opinions in matters that involve them.”

Written by Petra Rattue