Ulf Ericsson

The role of first line managers in healthcare organisations – a qualitative study on the work life experience of ward managers

The role of a first line manager (FLM) in Swedish healthcare has gone through major changes, from a divided role involving both nursing work and supervision to a pure management role. Along with these changes, the experienced core work and meaning of work have been altered. This also means that conditions for work that could regenerate the invested resources of the FLMs have been altered as well. The aim of this study was to describe the ward managers’ experiences of their professional role, their work and how they are handling their everyday practice. Furthermore, the aim has been to interpret these experiences through the lens of regenerative work. Five ward managers at a Swedish hospital setting were followed for approximately four years. The study has had an interactive and pragmatic approach. Data were collected through interviews, observations and a continuous dialogue forum (three years). Four themes are presented in this paper: from supervisor to manager; loyalty; talking about it and dialogue forum. These themes are then discussed in order to understand basic conditions for the regenerative work of the FLM. The most central finding is the importance for the FLMs to make sense of their world through narratives and that the organisation does not provide for this.

On the organisation of sustainable prerequisites for the subjective well-being and growth of individuals

The effects that work has on individuals are not unknown. The importance of work in terms of the subjective well-being and growth of individuals through their work, however, is not as extensively discussed and documented. Risk factors and unhealthy factors have long been discussed at the expense of positive conditions for well-being and personal growth. We like to call work with that type of potential regenerative work. Hence, that is the type of work that we have chosen to focus on in this study. The following research objectives have guided us through the study: Which everyday work processes may contribute to sustainable prerequisites for the subjective well-being and growth of individuals? The study takes an explorative approach to two workplaces—a care unit at a hospital and a manufacturing company. Our aim is to increase the understanding of prerequisites for the well-being and growth of individuals through their work. Three themes emerged in this type of regenerative work: performance, general overview and participation, and dialogue. These themes are problemised by looking at their potential in relation to the organisation of the work. Prerequisites for performance, general overview and participation, and finally dialogue prove to be more efficient in contexts where the complexity of the work and organisation is acknowledged and where there is room for inter-subjective sense-making and self-organising.

A Jigsaw Puzzle with No Given Solution The Financial Crisis, Trust, Loyalty and Fair-play

Based on one-to-one interviews and focus group interviews with management representatives, trade union representatives, and blue- and white-collar workers this article investigates how the global financial crisis was handled in Swedish industry. In the light of the crisis agreement signed between trade union IF Metall and company representatives how can the implementation of the agreement be described? How were these new conditions interpreted and how were they experienced? Three conceptual themes emerged, trust, loyalty, and principle of fair-play. Large differences were shown that were related to attitudes towards blue- and white-collar workers, recognition of work, and the size of the town.

Working with Stories: Street-Level Bureaucrats and Their Work with Individuals with Psychiatric Disability Exposed to Interpersonal Violence

ABSTRACT The focus of our attention is the meeting between street-level bureaucrats and individuals with psychiatric disability exposed to interpersonal violence. Based on 11 interviews, we illustrate how stories are understood, used, and made meaningful to the street-level bureaucrat. The contribution of this article is first of all that of being a framework, from a storytelling point of view, for the work and organizational experiences of street-level bureaucrats. Second, by paying attention to the story part of these relationships, we can better understand the situation of individuals with psychiatric disability exposed to interpersonal violence given their interaction with different street-level bureaucrats.

Support to individuals with comprehensive disabilities: Ideas in the Swedish Disability Act

The purpose of this study was to determine and describe the ideas, that is, a mental construction of perceived reality and values, which are expressed in the Swedish Disability Act and its Government Bill. By means of text analysis, four concepts of reality and values have been identified: (1) Citizenship and justice, (2) The collective and integration, (3) The individual and autonomy, and (4) Decentralization and power shifts. The study also shows that social rights and social citizenship have been strengthened via legislation for individuals with comprehensive disabilities. It is also demonstrated that there is considerable room in the legislation for conflicts between the two concepts and values of collective/integration and the individual/autonomy. It can also be observed that there is a considerable risk that citizens are not treated in a similar manner as regards the interpretation and application of the Disability Act, which may lead to lack of legal security.

Housing support workers as equilibrists between instrumentality and situation

Community-based psychiatry as an arena for studying work efforts is relatively unexplored. The professional role of a housing support worker (HSW) in congregated supported housings for people with severe mental illness (SMI) is fairly new. The role has emerged due to major changes in Swedish mental care and services. Our aim was to describe the work experiences of HSWs and to understand the conditions provided when work assignments are being constructed. By doing this we provide an important piece of the puzzle in understanding the processes in contemporary congregated supported housings for people with SMI. Four focus group interviews were conducted and included 25 participants. Four different facilities of congregated supported housings for people with SMI were represented in the material. The interpretation of the material was inspired by a constructionist approach. The work of an HSW is experienced as complex and ambiguous. Together with different significant actors (including objects), the HSWs are negotiating the content of the responsibilities. Thus, different actors help co-construct the work content. Furthermore, the HSWs are caught between two different logics, one that is related to a complex practice and one that is related to instrumental and routine-based ideas. The complex emotional work of an HSW is often not supported by the principles of the organization. The findings can be helpful when organizing the work in congregated supported housings for people with SMI. This paper highlights the importance of bridging the gap between organizational demands and expectations and the individual preconditions and basic needs.