The influence of empowered work environments on the psychological experiences of nursing assistants during COVID-19: a qualitative study

Abstract

Background Nursing Assistants (NA) who feel empowered tend to perform their duties better, have higher morale and job satisfaction, and are less likely to leave their jobs. Organizational empowerment practices in hospitals likely shape the psychological experiences of empowerment among these personnel; however, little is known about this relationship. Objective We used qualitative inquiry to explore the relationship between organizational empowerment structural components and feelings of psychological empowerment among hospital frontline workers during a public health emergency. Methods Kanter’s Theory of Structural Empowerment and Spreitzer’s Psychological Empowerment in the Workplace Framework were applied to identify the conceptual influences of organizational practices on psychological experiences of empowerment. In-depth interviews were conducted with a convenience sample of NAs, caring for hospitalized COVID-19 patients. Directed content analysis was performed to generate a data matrix consisting of the psychological experiences of meaning, competence, self-determination, and impact embedded under the organizational structural components of information, resources, support, and opportunity. Results Thirteen NAs (mean age = 42 years, 92% female) completed interviews. Information, or lack thereof, provided to the NAs influenced feelings of fear, preparation, and autonomy. Resources (e.g., protocols, equipment, and person-power) made it easier to cope with overwhelming emotions, affected the NAs’ abilities to do their jobs, and when limited, drove NAs to take on new roles. NAs noted that support was mostly provided by nurses and made the NAs feel appreciated, desiring to contribute more. While NAs felt they could consult leadership when needed, several felt leadership showed little appreciation for their roles and contributions. Similar to support, the opportunity to take care of COVID-19 patients yielded a diverse array of emotions, exposed advances and gaps in NA preparation, and challenged NAs to autonomously develop new care practices and processes. Conclusion Management and empowerment of healthcare workers are critical to hospital performance and success. We found many ways in which the NAs’ psychological experiences of empowerment were shaped by the healthcare system’s empowerment-related structural conditions during a public health emergency. To further develop an empowered and committed critical workforce, hospitals must acknowledge the organizational practice influence on the psychological experiences of empowerment among NAs.

A qualitative assessment of factors affecting nursing home caregiving staff experiences during the COVID-19 pandemic

“…Improving the employment outlook of CNA and EVS nursing home staff members may help ensure nursing home capacity and employee retention, as participants reported quickly burning out under the added pressure of an ongoing pandemic. Empowering CNAs has previously been associated with increased staff retention in US nursing homes [ 12 ] and a qualitative study with CNAs found the availability of resources, such as equipment and staffing, may help to enable coping with the increased emotional burden of the COVID-19 pandemic [ 13 ]. One observation of note from our findings was that when a participant stated they had received hazard pay, or other financial incentive for working during the pandemic, they tended to make more positive statements about their facility and its overall handling of the pandemic.…”

Considerations in the Use of Work-From-Home (WFH) for Post-Pandemic Planning and Management

“…Thus, an early study of remote work found that "it may be possible to enhance employees' work performance through management efforts to improve employees' remote work self-efficacy" (Staples et al, 1998). Elaborating further, a study during Covid-19 recommended creating "empowered environments ... by ensuring that employees have access to important information, resources, and support … and provid[ing] opportunities for growth and development" (Travers et al, 2020). Other researchers have focused on the virtues of "transformational leadership," with one study Considerations in the use of work-from-home (wfh) for post-pandemic planning and management describing transformational leaders as those who are able to "act as inspirational role models, consider their employees individually … [and who also] motivate their employees through an effective communication of a positive vision for the future" (Bark et al, 2016).…”

Sambandet mellan egenmakt och välbefinnande

“…Begreppet egenmakt används även i sammanhang där avsikten är att stärka vårdares moraliska och etiska förhållningssätt (Khoshmehr, Barkhordari-Sharifabad, Nasiriani & Fallahzadeh 2020;Travers, Schroder, Norful & Aliyu 2020). Ny forskning visar att begreppet egenmakt kan användas för att beskriva utvecklingen av strukturella system som möjliggör en vårdares välbefinnande (Roji & Jooste 2018).…”