What Is a Good Workplace? Tracing the Logics of NPM among Managers and Professionals in Swedish Elderly Care

Abstract

Neoliberal policies such as new public management (NPM)

Dignity: a prerequisite for attractive work in elderly care

“…This position is an abstract figure stressing approaches of altruism that would be of benefit for elderly care as an institution from a neoliberal economic perspective (i.e. Dahl, 2012;Keisu et al, 2016). The bureaucrats (in this case, managers) use strategies that emphasize a well-functioning bureaucracy when constructing the meaning of attractive work.…”

“…The conflict between elderly people and worker dignity is one essential example of the tensions between identity, power, and position. When professionals articulate the importance of high-quality care, they are positioned within an ongoing tension in seeking to balance their own needs (benefit to self) and the needs of older people (benefiting others; Keisu et al, 2016;Lawless & Moss, 2007). One consequence of their devotion to work is the "blurring of lines" between themselves and their tasks, as well as between their own and their employer's interests (Crowley, 2012).…”

“…One manager even made this quite explicit by saying, "A little bit like Florence Nightingale." According to Lawless and Moss, "references to dignity are often accompanied by references to the centrality of altruism in nursing practice" (2007, p. 228;see also;Keisu et al, 2016). This illustrates the apparent contradiction in the ongoing tension for care workers in seeking to balance their own needs (benefit to self) and the needs of patients (benefiting others).…”

“…One example is the clash between economic and care rationalities (Vabø, 2007). Another example is that, in the Swedish context, the traditional labour relations, care ideals, and practices already established in elderly-care settings run counter to NPM policy (Keisu, Öhman, & Enberg, 2016). However, care workers' professional identity is fundamental to their work, meaning that they are not passive recipients of discourse but rather can employ strategies of resistance (see also Dahl, 2012;Fältholm & Jansson, 2008).…”

“…Still, by not bringing problems to their superiors' attention, they have enabled the smooth functioning of NPM and its reproduction as a neoliberal policy. In comparison, managers are transforming their identity from that of welfare professionals in a professional hierarchy to an assumed empowered position in a managerial hierarchy with a leadership identity (Evetts, 2009;Keisu et al, 2016;Rasmussen, 2012). Another problem is that new types of professionalism focusing on codification, standardization, and managerial control are challenging and obscuring professional autonomy, discretionary judgement, and personal care (Dahl & Rasmussen, 2012;Fältholm & Jansson, 2008;Tufte, 2013).…”