Abstract
To contribute to knowledge of how healthcare managers can promote connection and ethnic equality among staff in multicultural organisations. The increase in migrant care workers often leads to deskilling, discrimination, communication difficulties and harsh working conditions. A constructivist grounded theory approach was used to examine the work experiences of healthcare workers in a strategically selected nursing home unit with minority and majority workers well balanced across positions. Three golden rules were identified: (a) take responsibility for the quality of care in the unit, (b) should engage in all aspects of the care work within scope of practice and (c) collaborate and help each other. Organisational measures supporting these norms were also identified. It is possible, by means of golden rules and organisational measures, to foster connection and cooperation among nursing home staff and to promote an inclusive work environment where the workers' skills and competences are recognized across educational and migration backgrounds. Healthcare managers can contribute to challenge the ethnic pyramid often identified in multicultural institutions by implementing diversity-sensitive measures. This may increase the quality of care and the well-being of residents.
Highlights
Both historically and still today, nursing homes are often staffed mainly by women organized in hierarchical teams, with the head nurse on top, auxiliary nurses in the middle and nursing assistants on the bottom (Dahle & Seeberg, 2013; Jervis, 2001; Lopez, 2006)
Whereas the head nurse is professionally, ethically and legally re‐ sponsible for ensuring the quality of care for residents, auxiliary nurses and nursing assistants often provide most of the practical care, as prescribed by those higher in the chain of command (Dahle & Seeberg, 2013; Jervis, 2001; Lopez, 2006; Natsuko, 2011)
A study of Asian nurses in Australia found that most of the participants were satisfied with their working conditions, deficits in the majority language coupled with differences in culture could create misunderstandings (Takeno, 2010)
Summary
Both historically and still today, nursing homes are often staffed mainly by women organized in hierarchical teams, with the head nurse on top, auxiliary nurses in the middle and nursing assistants on the bottom (Dahle & Seeberg, 2013; Jervis, 2001; Lopez, 2006).Whereas the head nurse is professionally, ethically and legally re‐ sponsible for ensuring the quality of care for residents, auxiliary nurses and nursing assistants often provide most of the practical care, as prescribed by those higher in the chain of command (Dahle & Seeberg, 2013; Jervis, 2001; Lopez, 2006; Natsuko, 2011). Studies from multicul‐ tural nursing homes point to discrimination by residents, manag‐ ers or colleagues (Dahle & Seeberg, 2013; Huang, Yeoh, & Toyota, 2012; Näre, 2013; Timonen & Doyle, 2010), while others identify deskilling (Adhikari & Melia, 2015; Iredale, 2005; Likupe, 2015; Riemsdijk, 2013; Seeberg, 2012) Deskilling in this context is defined as the undervaluing of immigrants’ skills, education and experience, which results in various workplace disadvantages Research shows that nursing homes with a multicultural staff may struggle with old hierarchies in new bottles, where class as a distinction intersects with staff members’ race and migration backgrounds
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