Citation

Cooke HA, Baumbusch J. Gerontologist 2020; ePub(ePub): ePub.

Copyright

(Copyright © 2020, Oxford University Press)

DOI

10.1093/geront/gnaa203

PMID

33320166

Abstract

BACKGROUND AND OBJECTIVES: Much of the literature examining the staffing-care quality link in long-term care (LTC) homes focuses on staffing ratios; that is, how many staff are on shift. Far less attention is devoted to exploring the impact of staff members' workplace relationships, or who is on shift. As part of our work exploring workplace incivility and bullying among residential care aides (RCAs), we examined how RCAs' workplace relationships are shaped by peer incivility and bullying and the impact on care delivery.

RESEARCH DESIGN AND METHODS: Using critical ethnography, we conducted 100 hours of participant observation and 33 semi-structured interviews with RCAs, licensed practical nurses, support staff and management in two non-profit LTC homes in British Columbia, Canada.

RESULTS: Three key themes illustrate the power relations underpinning RCAs' encounters with incivility and bullying that, in turn, shaped care delivery. Requesting Help highlights how exposure to incivility and bullying made RCAs reluctant to seek help from their co-workers. Receiving Help focuses on how power relations and notions of worthiness and reciprocity impacted RCAs receipt of help from co-workers. Resisting Help/ing outlines how workplace relationships imbued with power relations led some RCAs to refuse assistance from their co-workers, led longer-tenured RCAs to resist helping newer RCAs and dictated the extent to which RCAs provided care to residents for whom another RCA was responsible.

DISCUSSION AND IMPLICATIONS: Findings highlight 'who' is on shift warrants as much attention as 'how many' are on shift, offering additional insight into the staffing-care quality link.

Language: en

Keywords

Critical ethnography; Horizontal hostility; Nursing aides; Power relations; Workplace relationships