Prepared by
Mrs.d.Pathmavathi.Bsc(N).R.N.R.M
IMPROVING THE PSYCHOSOCIAL WORK ENVIRONMENT FOR THE EMPLOYEES
INTRODUCTION
A healthy job is likely to be one where the pressures on employees are appropriate in relation to their abilities and resources, to the amount of control they have over their work, and the support they receive from people who matter to them. As health is not merely the absence of disease or infirmity but a positive state of complete physical, mental and social well being (WHO, 1986), a healthy working environment is one in which there is not only an absence of harmful conditions but an abundance of health promoting ones. Hence, to maintain such an environment there are number of factors that are to be assessed and interventions taken over and over again in a periodic manner, so that the employees can work in a conducive psychosocial work environment. Today’s seminar will focus on improving the psychosocial work environment for the employees.
I.DEFINITION:
A healthy job is likely to be one where the pressures on employees are appropriate in relation to their abilities and resources, to the amount of control they have over their work, and the support they receive from people who matter to them. As health is not merely the absence of disease or infirmity but a positive state of complete physical, mental and social well being (WHO, 1986), a healthy working environment is one in which there is not only an absence of harmful conditions but an abundance of health promoting ones. Hence, to maintain such an environment there are number of factors that are to be assessed and interventions taken over and over again in a periodic manner, so that the employees can work in a conducive psychosocial work environment. Today’s seminar will focus on improving the psychosocial work environment for the employees.
I.DEFINITION:
1.PSYCHOSOCIAL WORKENVIRONMENT: According to Kristensen, the following are required for optimal social and psychological well-being:
Demands that fit the resources of the person (absence of work pressure)
A high level of predictability (job security and workplace safety)
Good social support from colleagues and managers and access to education and professional development opportunities (team work, study leave)
Meaningful work (professional identity)
A high level of influence (autonomy, control over scheduling, leadership); and
A balance between effort and reward (remuneration, recognition, rewards)
Kristensen’s model for social and psychological well being combines six stressors, relating them to both the individual and the organization. The optimal psychosocial environment for workers, as defined above was based principally on Karasek’s job strain model (karasek & Theorell 1990) and siegrist’s effort-reward imbalance model (Seigrist 1996).
2.POSITIVE PRACTICE ENVIRONMENT: Positive practice environments are characterized by:
Innovative policy frameworks focused on recruitment and retention.
Strategies for continuing education and upgrading.
Adequate employee compensation.
Recognition programmes.
Sufficient equipment and supplies.
A safe working environment.
3.MEANING OF HEALTHY WORK PLACE: Our collective understanding of the term “healthy workplace” has evolved greatly over the past several decades. From an almost exclusive focus on the physical environment (the realm of traditional health and safety), the definition has broadened to include health practice factors (lifestyle) and psychosocial factors (work organization) that can have a positive or negative impact on the employee health.
Demands that fit the resources of the person (absence of work pressure)
A high level of predictability (job security and workplace safety)
Good social support from colleagues and managers and access to education and professional development opportunities (team work, study leave)
Meaningful work (professional identity)
A high level of influence (autonomy, control over scheduling, leadership); and
A balance between effort and reward (remuneration, recognition, rewards)
Kristensen’s model for social and psychological well being combines six stressors, relating them to both the individual and the organization. The optimal psychosocial environment for workers, as defined above was based principally on Karasek’s job strain model (karasek & Theorell 1990) and siegrist’s effort-reward imbalance model (Seigrist 1996).
2.POSITIVE PRACTICE ENVIRONMENT: Positive practice environments are characterized by:
Innovative policy frameworks focused on recruitment and retention.
Strategies for continuing education and upgrading.
Adequate employee compensation.
Recognition programmes.
Sufficient equipment and supplies.
A safe working environment.
3.MEANING OF HEALTHY WORK PLACE: Our collective understanding of the term “healthy workplace” has evolved greatly over the past several decades. From an almost exclusive focus on the physical environment (the realm of traditional health and safety), the definition has broadened to include health practice factors (lifestyle) and psychosocial factors (work organization) that can have a positive or negative impact on the employee health.
II. COMMON PSYCHOSOCIAL HAZARDS
Psychosocial hazards are workplace stressors or work organizational factors that can threaten the mental and the physical health of employees. Some examples of these are:
· Work overload and time pressure
· Lack of influence or control over how day-to-day work is done
· Lack of social support from supervisors or coworkers
· Lack of training or preparation to do the job
· Too little or too much responsibility
· Ambiguity in job responsibility
· Lack of status rewards (appreciation)
· Discrimination or harassment
· Poor communication
· Lack of support for work/family balance
· Lack of respect for employees and the work they do
III. WORK ORGANIZATION STRESS RELATED HAZARDS IN GENERAL.
Poor work organization that is the way we design jobs and work systems, and the way we manage them, can cause work stress or imbalance. If the work organization is poor, it leads to excessive and otherwise unmanageable demands and pressures on the employee, and leading to unsatisfactory working conditions. Similarly, these things can result in workers not receiving sufficient support from others or not having enough control over their work and its pressures.
The aspects of work have the potential for causing harm, they are called ‘stress related hazards’, and they are:
· Work overload and time pressure
· Lack of influence or control over how day-to-day work is done
· Lack of social support from supervisors or coworkers
· Lack of training or preparation to do the job
· Too little or too much responsibility
· Ambiguity in job responsibility
· Lack of status rewards (appreciation)
· Discrimination or harassment
· Poor communication
· Lack of support for work/family balance
· Lack of respect for employees and the work they do
III. WORK ORGANIZATION STRESS RELATED HAZARDS IN GENERAL.
Poor work organization that is the way we design jobs and work systems, and the way we manage them, can cause work stress or imbalance. If the work organization is poor, it leads to excessive and otherwise unmanageable demands and pressures on the employee, and leading to unsatisfactory working conditions. Similarly, these things can result in workers not receiving sufficient support from others or not having enough control over their work and its pressures.
The aspects of work have the potential for causing harm, they are called ‘stress related hazards’, and they are:
WORK CONTENT
Job Content
Monotonous, under-stimulating, meaningless tasks
Lack of variety
Unpleasant tasks
Aversive tasks
Workload and Work pace
Having too much or too little to do
Working under time pressures
Working hours
Strict and flexible working schedules
Long and unsocial hours
Unpredictable working hours
Badly designed shift systems
Participation and Control
Lack of participation in decision making
Lack of control (for example, over work methods, work pace, working hours and the work environment
WORK CONTEXT:
Career Development, Status and Pay
Job insecurity
Lack of promotion prospects
Under-promotion or over-promotion
Work of ‘low social value’
Piece rate payment schemes
Unclear and unfair performance evaluation systems
Being over- skilled or under-skilled for the job
Role in the organization
Unclear role
Conflicting roles within the same job
Responsibility for the people
Continuously dealing with other people and their problems
Interpersonal Relationships
Inadequate, inconsiderate or unsupportive supervision
Poor relationships with the co-workers
Bullying, harassment and violence
Isolated or solitary work
No agreed procedures for dealing with problems or complaints
Organizational Culture
Poor communication
Poor leadership
Lack of clarity about organizational objectives and structure
Home-Work interface
Conflicting demands of work and home
Lack of support for domestic problems at work
Lack of support for work problems at home
IV. IMPACT OF POOR PSYCHOSOICAL ENVIRONMENT ON THE EMPLOYEE
The experience of work problems can cause unusual and dysfunctional behavior at work and contribute to poor physical and mental health. In extreme cases, long-term stress or traumatic events at work may lead to psychological problems and be conductive to psychiatric disorders resulting in absence from work and preventing the worker from being able to work again. The employees may be affected in the following manner:
Become increasingly distressed and irritable
Become unable to relax or concentrate
Have difficulty thinking logically and making decisions
Enjoy their work less and feel less committed to it
Feel tired, depressed, and anxious
Have difficulty sleeping
Experience serious physical problems, such as:
Ø Heart disease,
Ø Disorders of the digestive system,
Ø Increases in blood pressure, headaches
Musculo-skeletal disorders (such as low back pain and upper limb disorders)
At the same time, they may engage in unhealthy activities, such as smoking, drinking and abusing drugs.
V. IMPACT OF POOR PSYCHOSOCIAL ENVIRONMENT ON THE ORGANIZATION:
Job Content
Monotonous, under-stimulating, meaningless tasks
Lack of variety
Unpleasant tasks
Aversive tasks
Workload and Work pace
Having too much or too little to do
Working under time pressures
Working hours
Strict and flexible working schedules
Long and unsocial hours
Unpredictable working hours
Badly designed shift systems
Participation and Control
Lack of participation in decision making
Lack of control (for example, over work methods, work pace, working hours and the work environment
WORK CONTEXT:
Career Development, Status and Pay
Job insecurity
Lack of promotion prospects
Under-promotion or over-promotion
Work of ‘low social value’
Piece rate payment schemes
Unclear and unfair performance evaluation systems
Being over- skilled or under-skilled for the job
Role in the organization
Unclear role
Conflicting roles within the same job
Responsibility for the people
Continuously dealing with other people and their problems
Interpersonal Relationships
Inadequate, inconsiderate or unsupportive supervision
Poor relationships with the co-workers
Bullying, harassment and violence
Isolated or solitary work
No agreed procedures for dealing with problems or complaints
Organizational Culture
Poor communication
Poor leadership
Lack of clarity about organizational objectives and structure
Home-Work interface
Conflicting demands of work and home
Lack of support for domestic problems at work
Lack of support for work problems at home
IV. IMPACT OF POOR PSYCHOSOICAL ENVIRONMENT ON THE EMPLOYEE
The experience of work problems can cause unusual and dysfunctional behavior at work and contribute to poor physical and mental health. In extreme cases, long-term stress or traumatic events at work may lead to psychological problems and be conductive to psychiatric disorders resulting in absence from work and preventing the worker from being able to work again. The employees may be affected in the following manner:
Become increasingly distressed and irritable
Become unable to relax or concentrate
Have difficulty thinking logically and making decisions
Enjoy their work less and feel less committed to it
Feel tired, depressed, and anxious
Have difficulty sleeping
Experience serious physical problems, such as:
Ø Heart disease,
Ø Disorders of the digestive system,
Ø Increases in blood pressure, headaches
Musculo-skeletal disorders (such as low back pain and upper limb disorders)
At the same time, they may engage in unhealthy activities, such as smoking, drinking and abusing drugs.
V. IMPACT OF POOR PSYCHOSOCIAL ENVIRONMENT ON THE ORGANIZATION:
Unhealthy organizations do not get the best from their workers and this may affect not only their performance in the increasingly competitive market but eventually even their survival. The organization may be affected in the following manner:
Increasing absenteeism
Decreasing commitment to work
Increasing staff turn-over
Impairing performance and productivity
Increasing unsafe working practices and accident rates
Increasing complaints from clients and customers
Adversely affecting staff recruitment
Increasing liability to legal claims and actions by stressed workers
Damaging the organization’s image both among its workers and externally
VI. STRATERGIES FOR IMPROVING THE PSYCHOSOCIAL WORK ENVIRONMENT:
Increasing absenteeism
Decreasing commitment to work
Increasing staff turn-over
Impairing performance and productivity
Increasing unsafe working practices and accident rates
Increasing complaints from clients and customers
Adversely affecting staff recruitment
Increasing liability to legal claims and actions by stressed workers
Damaging the organization’s image both among its workers and externally
VI. STRATERGIES FOR IMPROVING THE PSYCHOSOCIAL WORK ENVIRONMENT:
1. Risk Assessment: A risk management approach assesses the possible risks in the work environment that may cause particular psychosocial problems that harms the employees physically or psychologically. Some of the approaches to explore existing risks are:
The employer should ask employees directly about their work problems and whether or not they feel their health may be adversely affected by the work
The employer could ask employees to describe the three ‘best’ and the three ‘worst’ aspects of their job, and to say whether they thought any of those aspects of work place them under too much pressure
Employees could be asked a set of more detailed questions; questions that are tailor-made to specific working contexts are likely to be more useful in designing further actions than any ‘off-the-shelf’ package
Sickness absence, staff turnover, performance levels, accidents and mistakes should be regularly monitored and checked for excesses, changes and patterns.
THE RISK MANAGEMENT CYCLE
The employer should ask employees directly about their work problems and whether or not they feel their health may be adversely affected by the work
The employer could ask employees to describe the three ‘best’ and the three ‘worst’ aspects of their job, and to say whether they thought any of those aspects of work place them under too much pressure
Employees could be asked a set of more detailed questions; questions that are tailor-made to specific working contexts are likely to be more useful in designing further actions than any ‘off-the-shelf’ package
Sickness absence, staff turnover, performance levels, accidents and mistakes should be regularly monitored and checked for excesses, changes and patterns.
THE RISK MANAGEMENT CYCLE
Evaluate Action Plan
Implement Action Plan
Assessment of Risk
Design Action plan reducerisk riskriskRisk
Learning & Further Action
Basic Steps in Risk Management:
Implement Action Plan
Assessment of Risk
Design Action plan reducerisk riskriskRisk
Learning & Further Action
Basic Steps in Risk Management:
Identify, collect and discuss the evidence of psychosocial problems
Investigate the way in which the work of these groups or work places is designed and managed, and examine their working conditions
Work in a team with others who understand the work groups and workplaces and have the group discussions
Identify the main problems and their effects
Discuss the information collected with the responsible managers and other relevant people, such as occupational health specialist
Develop an action plan that is appropriate, reasonable and practical
Inform the employees of the plan and how it will be implemented
Before implementation, determine how this plan might best be evaluated
Implement and evaluate the action plan, discuss the results of the evaluation, and what can be done further Based on the results obtained
Revise action plan and implement a new one to target unaccounted risks
2. Prevention: There are number of ways for prevention of psychosocial problems, these include:
Investigate the way in which the work of these groups or work places is designed and managed, and examine their working conditions
Work in a team with others who understand the work groups and workplaces and have the group discussions
Identify the main problems and their effects
Discuss the information collected with the responsible managers and other relevant people, such as occupational health specialist
Develop an action plan that is appropriate, reasonable and practical
Inform the employees of the plan and how it will be implemented
Before implementation, determine how this plan might best be evaluated
Implement and evaluate the action plan, discuss the results of the evaluation, and what can be done further Based on the results obtained
Revise action plan and implement a new one to target unaccounted risks
2. Prevention: There are number of ways for prevention of psychosocial problems, these include:
Primary prevention--Ergonomics, work environmental design, organizational and management development.
Secondary prevention—Employee education & training.
Tertiary prevention—developing more sensitive &responsive management systems and occupational health provision.
3. Well-designed Work: A Good employer designs and manages work in a way that avoids common problems and prevents as much as possible foreseeable
3. Well-designed Work: A Good employer designs and manages work in a way that avoids common problems and prevents as much as possible foreseeable
psychosocial problems. A well-designed work should include:
Clear organizational structure and practices – Employees should be provided with clear information about the structure, purpose and practices of the organization.
Clear organizational structure and practices – Employees should be provided with clear information about the structure, purpose and practices of the organization.
Appropriate selection, training and staff development – Each employee’s skills. Knowledge and abilities should be matched as much as possible to the needs of each job.
Candidates for each job should be assessed against that job’s requirements. Where necessary, suitable training should be provided. Effective supervision and guidance is important and can help protect staff from stress.
Job descriptions – A job description will depend on an understanding of the policy, objectives and strategy of the organization, on the purpose and organization of work and on the way performance will be measured.
Job descriptions have to be clear – It is important that an employee’s manager and other key staff are aware of the relevant details of the job and make sure that demands are appropriate. The better employees understand their job, the more they will be able to direct the appropriate efforts towards doing it well.
Communication – Managers should talk to their staff, listen to them and make it clear that they have been heard. Communication of work expectations should be comprehensible, consistent with the job description and complete. Commitments made to staff should be clear and kept.
Social environment – A reasonable level of socializing and teamwork ifs often productive as it can help increase commitment to work and to the work group.
4. Best strategies: The best strategies for improving the work environment focus on demands, knowledge and abilities, support and control and include:
Changing the demands of work (e.g. by changing the working environment, sharing the workload differently).
4. Best strategies: The best strategies for improving the work environment focus on demands, knowledge and abilities, support and control and include:
Changing the demands of work (e.g. by changing the working environment, sharing the workload differently).
Ensure that employees have or develop the appropriate knowledge and abilities to perform their jobs effectively (e.g. by selecting and training them properly and by reviewing their progress regularly.
Improve employees’ control over the way they do their work (e.g. introduce flexi-time, job-sharing, and more consultation about working practices.
Increase the amount and quality of support they receive (e.g. introduce ‘people management’ training schemes for supervisors, allow interaction among employees, and encourage co-operation and teamwork).
Stress Management Training – ash employees to attend classes on relaxation, time management, assertiveness training or exercise.
Ergonomics and Environmental Design – Improve equipment used at work and physical working conditions.
Management Development – Improve manager’s attitudes towards dealing with work stress, their knowledge and understanding of it and their skills to deal with the issue as effectively as possible.
Organizational development – implement better work systems and management systems. Develop a more friendly and supportive culture.
VII. PSYCHOSOCIAL ASPECTS OF EMPLOYEES WORKING IN AN INDUSTRY. (ILO 2001)
The above major problems are seen in workplaces. These problems affect nearly all countries, all sectors and all categories o workers. They require immediate and effective action. To meet this challenge, the ILO has a new training package called SOLVE
Stress
TobaccO
AlcohoL&Drugs
HIV/AIDS
ViolencE
SOLVE is an interactive educational programme designed to assist in the development of policy and action to address psychosocial issues at the workplace. Stress, alcohol and drugs, violence (both physical and psychological), HIV/AIDS and tobacco all lead to health-related problems for the worker and lower productivity for the enterprise or organization. Taken together they represent a major cause of accidents, fatal injuries, disease and absenteeism at work in both industrialized and developing countries. SOLVE focuses on prevention in translating concepts into policies and policies into action at the national and enterprise levels. Specific action is developed through micro solve packages which target each of the five identified areas of SOLVE.
SOLVE is designed to assist governments, employers and workers with a view to:
Improving psychosocial working conditions;
Reducing costs and improving productivity; and
Relieving the burden on the worker.
The SOLVE implementation cycle:
Broadening organizational policy through solve to include psychosocial problems
Implementing workplace action through micro solve modules
Evaluate workplace psychosocial problems and modify the concept as needed
Micro solve modules will be developed for each of the major psychosocial problems. The above design of the solve training package is based on the manufacturing industry.
VIII. PSYCHOSOCIAL ASPECTS OF VISUAL DISPLAY UNIT WORK.
The economic advantages of computers at work have overshadowed associated potential health, safety and social problems for workers, such as job loss, cumulative trauma disorders and increased mental stress. The transition from more traditional forms of work to computerization has been difficult in many workplaces, and has resulted in significant psychosocial and sociotechnical problems for the workforce
Visual Display Unit (VDU) technology does affect the work in various ways, but technology is only one element of a larger work system that includes the individual, tasks, environment and organizational factors.
Many working conditions jointly influence the VDU user. The authors have proposed a comprehensive job design model, which illustrates the various facets of working conditions, which can interact and accumulate to produce stress (Smith and Carayon-Sainfort 1989). This model illustrates this conceptual model can be used for the various elements of a work system that can exert loads on workers and may result in stress. At the centre of this model is the individual with his/her unique physical characteristics, perceptions, personality and behavior. The individual uses technologies to perform specific job tasks. The nature of the technologies, to a large extent, determines performance and the skills and knowledge needed by the worker to use the technology effectively. The requirements of the task also affect the required skill and knowledge levels needed. Both the tasks and technologies affect the job content and the mental and physical demands. The model also shows that the tasks and technologies are placed within the context of a work setting that comprises the physical and the social environment. The overall environment itself can affect comfort, psychological moods and attitudes. Finally, the organizational structure of work defines the nature and level of individual involvement, worker interactions, and levels of control. Supervision and standards of performance are all affected by the nature of the organization.
Improving the psychosocial characteristics of VDU work. (Burning Issue)
The first step in making VDU work less stressful is to identify work organization and job design features that can promote psychosocial problems so that they can be modified.
VII. PSYCHOSOCIAL ASPECTS OF EMPLOYEES WORKING IN AN INDUSTRY. (ILO 2001)
The above major problems are seen in workplaces. These problems affect nearly all countries, all sectors and all categories o workers. They require immediate and effective action. To meet this challenge, the ILO has a new training package called SOLVE
Stress
TobaccO
AlcohoL&Drugs
HIV/AIDS
ViolencE
SOLVE is an interactive educational programme designed to assist in the development of policy and action to address psychosocial issues at the workplace. Stress, alcohol and drugs, violence (both physical and psychological), HIV/AIDS and tobacco all lead to health-related problems for the worker and lower productivity for the enterprise or organization. Taken together they represent a major cause of accidents, fatal injuries, disease and absenteeism at work in both industrialized and developing countries. SOLVE focuses on prevention in translating concepts into policies and policies into action at the national and enterprise levels. Specific action is developed through micro solve packages which target each of the five identified areas of SOLVE.
SOLVE is designed to assist governments, employers and workers with a view to:
Improving psychosocial working conditions;
Reducing costs and improving productivity; and
Relieving the burden on the worker.
The SOLVE implementation cycle:
Broadening organizational policy through solve to include psychosocial problems
Implementing workplace action through micro solve modules
Evaluate workplace psychosocial problems and modify the concept as needed
Micro solve modules will be developed for each of the major psychosocial problems. The above design of the solve training package is based on the manufacturing industry.
VIII. PSYCHOSOCIAL ASPECTS OF VISUAL DISPLAY UNIT WORK.
The economic advantages of computers at work have overshadowed associated potential health, safety and social problems for workers, such as job loss, cumulative trauma disorders and increased mental stress. The transition from more traditional forms of work to computerization has been difficult in many workplaces, and has resulted in significant psychosocial and sociotechnical problems for the workforce
Visual Display Unit (VDU) technology does affect the work in various ways, but technology is only one element of a larger work system that includes the individual, tasks, environment and organizational factors.
Many working conditions jointly influence the VDU user. The authors have proposed a comprehensive job design model, which illustrates the various facets of working conditions, which can interact and accumulate to produce stress (Smith and Carayon-Sainfort 1989). This model illustrates this conceptual model can be used for the various elements of a work system that can exert loads on workers and may result in stress. At the centre of this model is the individual with his/her unique physical characteristics, perceptions, personality and behavior. The individual uses technologies to perform specific job tasks. The nature of the technologies, to a large extent, determines performance and the skills and knowledge needed by the worker to use the technology effectively. The requirements of the task also affect the required skill and knowledge levels needed. Both the tasks and technologies affect the job content and the mental and physical demands. The model also shows that the tasks and technologies are placed within the context of a work setting that comprises the physical and the social environment. The overall environment itself can affect comfort, psychological moods and attitudes. Finally, the organizational structure of work defines the nature and level of individual involvement, worker interactions, and levels of control. Supervision and standards of performance are all affected by the nature of the organization.
Improving the psychosocial characteristics of VDU work. (Burning Issue)
The first step in making VDU work less stressful is to identify work organization and job design features that can promote psychosocial problems so that they can be modified.
Improvements in job design should start with the work organization providing a supportive environment for employees; a supportive environment is a good first step. Such an environment enhances employee motivation to work and feelings of security, and it reduces feelings of stress (House 1981).
One very effective means for providing support to employees is to provide supervisors and managers with specific training in methods for being supportive. Supportive supervisors can serve as buffers that “protect” employees from unnecessary organizational or technological stresses.
Three main aspects of job content are task complexity, employee skills and career opportunities. In some respects, these are all related to the concept of developing the motivational climate for employee job satisfaction and psychological growth, which deals with the improvement of employees' intellectual capabilities and skills, increased ego enhancement or self-image and increased social group recognition of individual achievement.
One very effective means for providing support to employees is to provide supervisors and managers with specific training in methods for being supportive. Supportive supervisors can serve as buffers that “protect” employees from unnecessary organizational or technological stresses.
Three main aspects of job content are task complexity, employee skills and career opportunities. In some respects, these are all related to the concept of developing the motivational climate for employee job satisfaction and psychological growth, which deals with the improvement of employees' intellectual capabilities and skills, increased ego enhancement or self-image and increased social group recognition of individual achievement.
Increasing the complexity of the tasks, which means increasing the amount of thinking and decision-making involved, is a logical next step that can be achieved by combining simple tasks into sets of related activities that have to be coordinated, or by adding mental tasks that require additional knowledge and computational skills
The amount of control that an employee has over the job has a powerful psychosocial influence (Karasek et al. 1981; Sauter, Cooper and Hurrell 1989).
At the organization level, employees can participate in structured activities that provide input to management about employee opinions or quality improvement
The demand that is associated with the high levels of concentration required for computerized tasks can diminish the amount of social interaction during work, leading to social isolation of employees. To counter this effect, opportunities for socialization for employees not engaged in computerized tasks, and for employees, who are on rest breaks, should be provided. Non-computerized tasks which do not require extensive concentration could be organized in such a way that employee can work in close proximity to one another and thus have the opportunity to talk among themselves. Such socialization provides social support, which is known to be an essential modifying factor in reducing adverse mental health effects and physical disorders such as cardiovascular diseases (House 1981). Socialization naturally also reduces social isolation and thus promotes improved mental health.
At the organization level, employees can participate in structured activities that provide input to management about employee opinions or quality improvement
The demand that is associated with the high levels of concentration required for computerized tasks can diminish the amount of social interaction during work, leading to social isolation of employees. To counter this effect, opportunities for socialization for employees not engaged in computerized tasks, and for employees, who are on rest breaks, should be provided. Non-computerized tasks which do not require extensive concentration could be organized in such a way that employee can work in close proximity to one another and thus have the opportunity to talk among themselves. Such socialization provides social support, which is known to be an essential modifying factor in reducing adverse mental health effects and physical disorders such as cardiovascular diseases (House 1981). Socialization naturally also reduces social isolation and thus promotes improved mental health.
Since poor ergonomic conditions can also lead to psychosocial problems for VDU users, proper ergonomic conditions are an essential element of complete job design
Finding Balance- Since there are no “perfect” jobs or “perfect” workplaces free from all psychosocial and ergonomic stressors, we must often compromise when making improvements at the workplace. Redesigning processes requires thinking about how to achieve the best “balance” between positive benefits for employee health and productivity
Five elements of the work system - physical loads, work cycles, job content, control, and socialization-function in concert to provide the resources for achieving individual and organizational goals through compensatory balance.
Increased staffing levels, increasing the levels of shared responsibilities or increasing the financial resources put toward worker well being are other possible solutions.
Increased staffing levels, increasing the levels of shared responsibilities or increasing the financial resources put toward worker well being are other possible solutions.
IX. PSYCHOSOCIAL WORK ENVIRONMENT AND NURSING.
a. Models related to psychosocial work environment.
Before knowing the influence of psychosocial work environment on the working conditions in the nursing field, it would be appropriate to examine few models related to psychosocial work environment.
1. Karasek’s job Strain Model: The dimensions of this model are psychological demands (amount of work, complexity of work, and time constraints) and decision latitude (the capacity to use one’s qualifications and develop new job skills, and the opportunity to choose how to do one’s work and to influence related decisions). Social support has been included in the model to take into account the support of superiors and colleagues (team spirit, assistance, and co-operation) (Johnson & Hall 1988). The principal hypothesis of this model is that job strain results from the combined effects of increased psychological demands and low demands and low decision latitude in the workplace, and this brings a higher risk of health problems. Social support is expected to moderate the effect of job strain.
a. Models related to psychosocial work environment.
Before knowing the influence of psychosocial work environment on the working conditions in the nursing field, it would be appropriate to examine few models related to psychosocial work environment.
1. Karasek’s job Strain Model: The dimensions of this model are psychological demands (amount of work, complexity of work, and time constraints) and decision latitude (the capacity to use one’s qualifications and develop new job skills, and the opportunity to choose how to do one’s work and to influence related decisions). Social support has been included in the model to take into account the support of superiors and colleagues (team spirit, assistance, and co-operation) (Johnson & Hall 1988). The principal hypothesis of this model is that job strain results from the combined effects of increased psychological demands and low demands and low decision latitude in the workplace, and this brings a higher risk of health problems. Social support is expected to moderate the effect of job strain.
2. Siegrist’s Effort-Reward Imbalance Model: This model rests on the hypothesis that a work situation characterized by a combination of a high level of effort expended and little reward received (money, esteem, and career opportunities) can have pathological effects on health (Siegrist 1996). The model assumes that we exert effort at work in exchange for rewards. Rewards are usually of three types: money, esteem (respect) and career opportunities, including job security.E.g. Having a demanding but an unstable job or achieving at a high level with out being offered any promotion prospects.
3. Kristensen model: Kristensen in 1999 added two dimensions to the models of karasek and Seigrist, namely, the meaning of work and the predictability of work.
b. Background of the problems of psychosocial work environment. (Research contribution) - There many studies conducted in relation to the psychosocial work environment for the nurses, some of the key points include:
The problem of retaining qualified and experienced staff has highlighted the need to look at various aspects of work and the work environment which affect job satisfaction and in turn influence quality of service (Edwards & Bur nard 2003).
Studies indicate a high level of dissatisfaction among nurses, and the presence of various health problems and absenteeism, following structural and organizational changes in the health care system. (Baumann et al. 2001).
In order to attract new recruits and retain experienced personnel, findings suggest that investment is needed to achieve improvements in the work environment of health care workers (Baumann et al. 2001, Canadian Nursing Advisory Committee (CNAC) 2002).
3. Kristensen model: Kristensen in 1999 added two dimensions to the models of karasek and Seigrist, namely, the meaning of work and the predictability of work.
b. Background of the problems of psychosocial work environment. (Research contribution) - There many studies conducted in relation to the psychosocial work environment for the nurses, some of the key points include:
The problem of retaining qualified and experienced staff has highlighted the need to look at various aspects of work and the work environment which affect job satisfaction and in turn influence quality of service (Edwards & Bur nard 2003).
Studies indicate a high level of dissatisfaction among nurses, and the presence of various health problems and absenteeism, following structural and organizational changes in the health care system. (Baumann et al. 2001).
In order to attract new recruits and retain experienced personnel, findings suggest that investment is needed to achieve improvements in the work environment of health care workers (Baumann et al. 2001, Canadian Nursing Advisory Committee (CNAC) 2002).
The importance of modifying the job constraints of the work environment and of involving all participants in order to address problems of recruiting and retaining nurses and maintain accessibility to healthcare and quality of services (Ministere de la Sante et des Services sociaux 2001).
Few studies have targeted organizational or situational stressors in attempts to improve the work environment and work related health (Mikkelsen & Sakvik 1999).
Few studies have targeted organizational or situational stressors in attempts to improve the work environment and work related health (Mikkelsen & Sakvik 1999).
Most disturbing is that over 75% of the nurses reported that unsafe working conditions interfered with the ability to deliver quality care. This finding points the connection between nurse work satisfaction, the environment, and patient safety (ANA, 2001b)
Interventions to improve psychosocial work environments are most effective when health care workers participate in designing and implementing action plans that target specific problems (Lavoie-Tremblay, Melanie et al. 2005).
The two main challenges of participatory workplace interventions are to involve managers and all relevant participants and to establish and/ or maintain trust within work teams (Lavoie-Tremblay, Melanie et al. 2005).
The two main challenges of participatory workplace interventions are to involve managers and all relevant participants and to establish and/ or maintain trust within work teams (Lavoie-Tremblay, Melanie et al. 2005).
Positive outcomes of the interventions include reductions in absenteeism, effort-reward imbalance, and job strain (Lavoie-Tremblay, Melanie et al. 2005).
Negative outcomes include a drop in social support from supervisors and colleagues, a decrease in decision latitude, and an increase in psychological distress (Lavoie-Tremblay, Melanie et al. 2005).
c. Strategies for improving the psychosocial work environment for nurses.
1.The American Nurses Association Bill of Rights for Registered Nurses states “Nurses have the right to work in an environment that is safe for themselves and their patients”.
This means, the physical, emotional, and social environment needs to be addressed. To change this unhealthy practice environment, leaders in clinical practice and educational settings need to begin to view all nurses, including students, new nurses, and aging experienced nurses, as customers who deserve quality practice environments that exceed their expectations.
2.First of all, the physical environment in which nurses learn and practice need to be examined. Safety and feasibility to perform one’s job and professional responsibilities should be studied and promoted. Physical comfort is essential for practicing nurses if they are to provide this to the patient as their customer.
3.Assessment of how the structural and organizational environment affects the attitudes, satisfaction, and turnover of practice nurses needs to be priority for the nursing administrators. When seeking a place of employment, nurses need to evaluate the environment in which they are planning to work. They should question how the environment is being improved to accommodate the stressful workplace.
4.Retention of Nurses. Special attention needs to be given to the environment for retaining the baby boomer generation of nurses, who are our most experienced nurses and may provide some stability to the nursing profession. Strategies for retaining these seasoned and wise older nurses include – flexible part-time work, frequent rest periods, coaches to assist then with the newer technology, respect, and new roles that are les physically demanding (elimination of heavy lifting).
5.Leadership. Nurses who are leading or being led by traditional forms of leadership need to examine and become more aware of current leadership practice theories. Few characteristics of leaders are multilateral, multidirectional, relational, interacting, intersecting and integrating. Leader should have emotional intelligence qualities like, self-awareness, self-management, social awareness, and leadership management. Nurse administrators need to share their honest concerns in a humble manner with other nurses, realizing that all nurses provide some type of leadership each day in practice. If the leadership theories are understood and modeled by nurse managers, staff nurses may begin to see the benefits and learn to lead others, such as student nurses and new graduates, in the manner, thus promoting a healthier practice environment.
6.A need for Magnet Status. An international effort to transform our current less than acceptable nursing environment into more nurturing practice environments is the movement for more nursing divisions to seek “Magnet Status”. Magnet Status signifies the ability of an agency to attract and retain professional nurses who have high job satisfaction because they can give quality care in their work environment. There are fourteen forces of magnetism, Mc clure and Hinshaw found eight essential factors identified by practicing nurses that need to be present within one’s practice environment to be able to provide quality patient care:
Working with other nurses who are clinically competent.
Good Nurse-physician relationships and communication.
Nurse autonomy and accountability.
Supportive nurse manager-supervisor.
Control over nursing practice and practice environment.
Support for education.
Adequate nurse staffing.
Concern for patient is paramount.
The nurses need to assess for the presence or absence of these magnetic forces in their agency and adopt ways to maintain psychosocial work environment.
7.Reform in Roles is needed. The nursing profession needs change, or nurses will continue to leave, exacerbating the present shortage that already creates unsafe working environment. The nurse must be educated in a standardized high-level skill set. This will lead to a clear understanding of the competencies of a nurse and improved status and satisfaction. Hence, at least a baccalaureate degree should be the absolute minimum required for nurses to maintain equal standing with other health care professionals and to participate as partners on interdisciplinary teams (Barter & Mc Farland, 2001). This will boost our self-identity and help us to maintain a psychosocial work environment in pace with other multidisciplinary teams.
8.Application of negotiation skills
“Speak when you are angry and you will make the best speech you will ever regret” said Ambrose Bierce. Hence we need to set limits before a negotiation begins.
Opportunities for a nurse to use negotiation skills are multidimensional. There are three key skills a nurse must adopt:
Preparing an overall plan to be achieved during a negotiation.
Selecting a strategy and using it while taking part in a negotiation, and evaluating the conduct of negotiation.
Regardless of the level of administrative involvement, every nurse negotiates. All social interaction involves negotiation. Hence, nurses should continue to develop and refine these key skills by seizing every opportunity to enter into the art of negotiating, which will help us to develop relationships, not conquests.
9.Establishing a criterion-Based performance appraisal for nurses.
A nursing management can use performance appraisal tool, so that the management will know how the staff is performing and the staff will know what they must do in order to improve their performance. They not only evaluate staff performance but indicate what behaviors would lead to improve performance.
Purpose of performance appraisal as viewed by management and staff.
Management staff
Inform staff of how they are performing - Inform management of needs,
Improve staff performance aspirations and goals.
Determine the quality of manpower -Highlight staff performance
Standardize and summarize information - Determine how rewards can be attained
Into statistics to enable comparisons of -Concentrate particulars on how the
Manpower individual did & how the individual
Can do better.
10.Executive team development is essential.
Executive team development consists of a series of activities designed to ensure that the collective talents and energies of nursing administrators are used to address organizational concerns. Although the process is not a linear one, it is composed of distinct sets of activities, which include:
Defining and clarifying group purposes
Establishing and refining group norms
Attending to group productivity
Selecting and integrating new team members
Responding to individual and group developmental needs.
As this occurs, there is a high likelihood that nursing practice environment will also be strengthened.
11.Creating a caring environment.
Perhaps the most important responsibility for the nurse in any leadership or management role is to create an environment of caring- caring for staff members as well as for patients and the families. Staff members who feel that their managers sincerely cars about them and the work they do are able to pass that feeling of caring on to their patients and other customers. Caring for the staff members can be demonstrated through the following measures (Mc Neese-Smith, 1997):
Offering sincere positive recognition for both individuals and teams.
Praising and giving thanks for a job well-done
Spending time with staff members to reinforce positive work behaviors
Meeting the staff members personal needs whenever possible, such as accommodating scheduling needs for family events and being flexible in times of illness
Negative outcomes include a drop in social support from supervisors and colleagues, a decrease in decision latitude, and an increase in psychological distress (Lavoie-Tremblay, Melanie et al. 2005).
c. Strategies for improving the psychosocial work environment for nurses.
1.The American Nurses Association Bill of Rights for Registered Nurses states “Nurses have the right to work in an environment that is safe for themselves and their patients”.
This means, the physical, emotional, and social environment needs to be addressed. To change this unhealthy practice environment, leaders in clinical practice and educational settings need to begin to view all nurses, including students, new nurses, and aging experienced nurses, as customers who deserve quality practice environments that exceed their expectations.
2.First of all, the physical environment in which nurses learn and practice need to be examined. Safety and feasibility to perform one’s job and professional responsibilities should be studied and promoted. Physical comfort is essential for practicing nurses if they are to provide this to the patient as their customer.
3.Assessment of how the structural and organizational environment affects the attitudes, satisfaction, and turnover of practice nurses needs to be priority for the nursing administrators. When seeking a place of employment, nurses need to evaluate the environment in which they are planning to work. They should question how the environment is being improved to accommodate the stressful workplace.
4.Retention of Nurses. Special attention needs to be given to the environment for retaining the baby boomer generation of nurses, who are our most experienced nurses and may provide some stability to the nursing profession. Strategies for retaining these seasoned and wise older nurses include – flexible part-time work, frequent rest periods, coaches to assist then with the newer technology, respect, and new roles that are les physically demanding (elimination of heavy lifting).
5.Leadership. Nurses who are leading or being led by traditional forms of leadership need to examine and become more aware of current leadership practice theories. Few characteristics of leaders are multilateral, multidirectional, relational, interacting, intersecting and integrating. Leader should have emotional intelligence qualities like, self-awareness, self-management, social awareness, and leadership management. Nurse administrators need to share their honest concerns in a humble manner with other nurses, realizing that all nurses provide some type of leadership each day in practice. If the leadership theories are understood and modeled by nurse managers, staff nurses may begin to see the benefits and learn to lead others, such as student nurses and new graduates, in the manner, thus promoting a healthier practice environment.
6.A need for Magnet Status. An international effort to transform our current less than acceptable nursing environment into more nurturing practice environments is the movement for more nursing divisions to seek “Magnet Status”. Magnet Status signifies the ability of an agency to attract and retain professional nurses who have high job satisfaction because they can give quality care in their work environment. There are fourteen forces of magnetism, Mc clure and Hinshaw found eight essential factors identified by practicing nurses that need to be present within one’s practice environment to be able to provide quality patient care:
Working with other nurses who are clinically competent.
Good Nurse-physician relationships and communication.
Nurse autonomy and accountability.
Supportive nurse manager-supervisor.
Control over nursing practice and practice environment.
Support for education.
Adequate nurse staffing.
Concern for patient is paramount.
The nurses need to assess for the presence or absence of these magnetic forces in their agency and adopt ways to maintain psychosocial work environment.
7.Reform in Roles is needed. The nursing profession needs change, or nurses will continue to leave, exacerbating the present shortage that already creates unsafe working environment. The nurse must be educated in a standardized high-level skill set. This will lead to a clear understanding of the competencies of a nurse and improved status and satisfaction. Hence, at least a baccalaureate degree should be the absolute minimum required for nurses to maintain equal standing with other health care professionals and to participate as partners on interdisciplinary teams (Barter & Mc Farland, 2001). This will boost our self-identity and help us to maintain a psychosocial work environment in pace with other multidisciplinary teams.
8.Application of negotiation skills
“Speak when you are angry and you will make the best speech you will ever regret” said Ambrose Bierce. Hence we need to set limits before a negotiation begins.
Opportunities for a nurse to use negotiation skills are multidimensional. There are three key skills a nurse must adopt:
Preparing an overall plan to be achieved during a negotiation.
Selecting a strategy and using it while taking part in a negotiation, and evaluating the conduct of negotiation.
Regardless of the level of administrative involvement, every nurse negotiates. All social interaction involves negotiation. Hence, nurses should continue to develop and refine these key skills by seizing every opportunity to enter into the art of negotiating, which will help us to develop relationships, not conquests.
9.Establishing a criterion-Based performance appraisal for nurses.
A nursing management can use performance appraisal tool, so that the management will know how the staff is performing and the staff will know what they must do in order to improve their performance. They not only evaluate staff performance but indicate what behaviors would lead to improve performance.
Purpose of performance appraisal as viewed by management and staff.
Management staff
Inform staff of how they are performing - Inform management of needs,
Improve staff performance aspirations and goals.
Determine the quality of manpower -Highlight staff performance
Standardize and summarize information - Determine how rewards can be attained
Into statistics to enable comparisons of -Concentrate particulars on how the
Manpower individual did & how the individual
Can do better.
10.Executive team development is essential.
Executive team development consists of a series of activities designed to ensure that the collective talents and energies of nursing administrators are used to address organizational concerns. Although the process is not a linear one, it is composed of distinct sets of activities, which include:
Defining and clarifying group purposes
Establishing and refining group norms
Attending to group productivity
Selecting and integrating new team members
Responding to individual and group developmental needs.
As this occurs, there is a high likelihood that nursing practice environment will also be strengthened.
11.Creating a caring environment.
Perhaps the most important responsibility for the nurse in any leadership or management role is to create an environment of caring- caring for staff members as well as for patients and the families. Staff members who feel that their managers sincerely cars about them and the work they do are able to pass that feeling of caring on to their patients and other customers. Caring for the staff members can be demonstrated through the following measures (Mc Neese-Smith, 1997):
Offering sincere positive recognition for both individuals and teams.
Praising and giving thanks for a job well-done
Spending time with staff members to reinforce positive work behaviors
Meeting the staff members personal needs whenever possible, such as accommodating scheduling needs for family events and being flexible in times of illness
Providing guidance and support for professional and personal growth
Maintaining a positive, confident attitude and a pleasant work environment.
Staff members who feel that their work is valued and that they are respected and cared about as individuals are able to further contribute to a positive, caring environment in which to provide excellent patient care. Demonstrate respect and concern for every person at every level in the organization is an important leadership quality that the new nurse can use to develop a caring environment.
12.Motivation to work. Motivation to work is the willingness to work. Motivation is important in a service industry such as nursing as motivation and human relations variables are important for productivity, it is a state of mind in which a person views goals, it is a process of felt need, behavior, and goal attainment/blockage, frustration, and cycle repetition. There are many theories of motivation that can be applied like, Maslow’s, Hawthorne studies. Personal and economic rewards are powerful motivators in nursing. The core of what motivates nurses is the work itself, and the manager’s job is to create an environment that fosters motivated behavior.
13.Contribution of organization culture. The literature clearly suggests that there are many changes in organizational culture and management practices and style that can eliminate or reduce the exposure to, and effects from, the psychosocial hazards. Some examples are:
Encouraging workers to participate in decision-making related to their jobs
Encouraging workers to voice concerns and make suggestions-and then listening!
Improving employees trust in the agency, and the manager’s trust of employees
Demonstrating fairness in management style and application of policies
Improving supervisors communication effectiveness and “people skills”(emotional intelligence)
Training and evaluating supervisors in giving rewards and appreciation appropriately
Instituting 360 degree feedback for performance measurement
Instituting flexible work options
Supporting work/ life/ family balance with policies, practices and culture
Consistently demonstrating respect for all workers and the work they do
Measuring employee stressors and satisfaction regularly, and then acting on the satisfaction regularly, and then acting on the results in consultation with the employees.
14. A need for supportive manager/ employer
Employees with supportive managers will have significant job satisfaction, trust of managers and commitment to the organization. The employees may experience lower levels of role overload, job stress depressions, and poor health, work-family interference, fatigue, absenteeism and intent to leave the job. Supportive managers are those who do the following:
Give positive feedback to employees
Practice two-way communication (good listeners)
Show respect for employees
Focus on output, not hours
Demonstrate consistently
Coach and mentor employees
Focus on creating a more supportive work environment.
d. STRATEGIES FOR THE DEVELOPMENT OF POSITIVE PRACTICE ENVIRONMENTS (ICN TOOL KIT 2007)
The process of developing positive practice environments is multifaceted, occurs on many levels of an organization and involves a range of players. As a starting point, each organization should develop a workforce profile that includes such metrics as absenteeism, vacancy and turnover rates, as well as demographic information like age, and experience. This type of data provides a solid base for decision-making. For their part, nurses can advance the development of positive practice environments by:
Continuing to promote the nursing role
Defining the scope of nursing practice so nurses, other disciplines, and the public are aware of the profession’s evolution
Lobbying for professional recognition and remuneration
Developing and disseminating a position statement on the importance of a safe work environment
Ensuring that other disciplines are involved in the development of policies for safe work environments
Supporting research, collecting data for best practice, and disseminating the data once it is available
Encouraging educational institutes to enhance teamwork by providing opportunities for collaboration and emphasizing teamwork theory.
Presenting awards to health care facilities that demonstrate the effectiveness of positive practice environments through recruitment and retention initiatives, reduced dropout rates, public opinion, improved care and higher patient satisfaction rates.
e. LACKINGS IN NURSING FOR MAINTAINANCE OF PSYCHOSOCIAL WORK ENVIRONMENT
Assertiveness. There are barriers that nurses must overcome to become assertive they are-
Female gender role socialization. Women are expected to be passive, dependent, subjective, intuitive, empathetic, sensitive, interpersonally oriented, weak, in consistent, and emotionally unstable. Assertive behavior is more than demanding your rights from others and keeping others from manipulating. In a social sense assertiveness is the ability to communicate with others about who you are, how you live, what you do, and what you want and the ability to make them feel comfortable talking about themselves.(i.e., self-disclosure). This social conversation allows nurses to discover mutually rewarding relationships or to identify people with whom they have few common interests.
Cyber phobia / Tech nophobia Nurses need to overcome their “techno phobia” because clearly, nursing care can be improved with the appropriate use of technology and ironically, it is technology that will likely give nurses more time to do “nursing”. Technology holds promise and potential for addressing some of nursing’s and health care’s greatest challenges (Bradley, 2003). Nurses must therefore keep the environment of patient care first and foremost in their technology development agenda. In addition, nurses must embrace technology, understand it, and bend it to their own purposes, so that nursing can take its rightful place in the provider hierarchy (Simpson, 2003).
Generational attitudes: Today, practicing nurses come from different generations (the veteran generation, the baby boomer generation, generation X, and the millennial generation), which further challenges this complicated health care working environment. Tension arise when nurses from these different generations come together to practice nursing, these various generational attitudes, work habits, and expectations of nurses often lead to misunderstandings and conflict in the workplace, leading to poor psychosocial work environment.
Communication: “No man has a good enough memory to be a successful liar”. – Abraham Lincoln. Faulty reasoning and poorly expressed messages are major barriers to communication. Lack of clarity and precision resulting from inadequate vocabulary, poorly chosen words, platitudes, poor organization of ideas, and lack of coherence are common. To form supportive environments in order to work better with others, we should be descriptive rather than judgmental, define mutual problems and express willingness to find a solution collaboratively. Through conversations, we can celebrate togetherness by building something that is “ours”.
Leadership and Fellowship: We need great followers as well as great leaders. Leaders contribute only about 20% to the success of organizations. Followers do the remaining 80%. We spend more time reporting to others than having them report to us. Some leaders have been such good followers that their peers have asked them to take on leadership responsibilities. Leadership is an art, hence leadership and fellowship should involve intimacy and personal covenants that people at work make with each other.
CONCLUSION
Psychosocial problems at workplace are a real challenge for the workers and their employing organizations. As organizations and their working environment transform, so do the kinds of problems that employees may face. All companies should assess their workplace environment at least twice a year in order to see where improvements could be made. Staying in contact with employees and managers can help employers track changes and find areas that are in need of change in order to create a positive workplace environment. None of these changes is simple to achieve or can be accomplished overnight. They require, in most cases, a serious commitment from leaders, and a transformational leadership style to change the culture of the organization, and the patience to make changes over the long term. ‘Work in itself can be a self-promoting activity as long as it takes place in a safe, development- and health-promoting environment’.
REFERENCES:
1. Lavoic.M. Tremblay.Journal of Advanced Nursing. Improving the psychosocial work environment. Blachwell.Philadelphia.49 (6). 655-664.
2. Huston. J.Carol. Professional issues in nursing. Technology in health care workplace.
I edition. Lippincott. Philadelphia. 2006. (13) 260-263.
3. Tomey. A.M. Guide to nursing management and leadership.
VII edition. Mosby. USA. 2004. 17-327.
4. Poteet.G.W. Nursing clinics of North America. Symposium on nursing administration.
W.B.Saunders. Philadelphia. 1983.18(3). 427-499.
5. Cherry.B. Jacob.R.S. Contemporary Nursing issues. Trends and management.
III edition. Mosby. USA. 2005. (16) 384.
6. Huber.L.Diane. Leadership and nursing care management.
III edition. Mosby.USA. 2006.481-713.
7. International council of nurses. Positive practice environments: Quality workplaces=
Quality patient care. Information and action tool kit 2007.
8. Weber Janet. Nursing clinics of North America. Creating a Holistic Environment for Practicing Nurses. W.B.Saunders. Philadelphia.2007. (42). 295-307.
9. Lin Laura. Liang.A.Bryan. Nursing Forum. Addressing the Nursing Work Environment to Promote patient Safety. 42(1). 20-29.
10. Webster.s. Clare. A. Collier.E Journal of psychosocial nursing and mental health services. Creative Solutions. May 2005.43 (5). 42-49.
11. www.ilo.org/encyclopaedia/? Print&nd=857100102.
12. Burton. Joan. Industrial Accident Prevention Association. Creating healthy Workplaces. Health Strategy. IAPA. November 2006.
13. Gold David. Safework.Addressing psychosocial problems at work. ILO.2001.
14. Leka Stavroula. Protecting workers’ Health: Work organization and stress. Series
No.3 World health Organization. Switzerland. 2003. 1-25.
Maintaining a positive, confident attitude and a pleasant work environment.
Staff members who feel that their work is valued and that they are respected and cared about as individuals are able to further contribute to a positive, caring environment in which to provide excellent patient care. Demonstrate respect and concern for every person at every level in the organization is an important leadership quality that the new nurse can use to develop a caring environment.
12.Motivation to work. Motivation to work is the willingness to work. Motivation is important in a service industry such as nursing as motivation and human relations variables are important for productivity, it is a state of mind in which a person views goals, it is a process of felt need, behavior, and goal attainment/blockage, frustration, and cycle repetition. There are many theories of motivation that can be applied like, Maslow’s, Hawthorne studies. Personal and economic rewards are powerful motivators in nursing. The core of what motivates nurses is the work itself, and the manager’s job is to create an environment that fosters motivated behavior.
13.Contribution of organization culture. The literature clearly suggests that there are many changes in organizational culture and management practices and style that can eliminate or reduce the exposure to, and effects from, the psychosocial hazards. Some examples are:
Encouraging workers to participate in decision-making related to their jobs
Encouraging workers to voice concerns and make suggestions-and then listening!
Improving employees trust in the agency, and the manager’s trust of employees
Demonstrating fairness in management style and application of policies
Improving supervisors communication effectiveness and “people skills”(emotional intelligence)
Training and evaluating supervisors in giving rewards and appreciation appropriately
Instituting 360 degree feedback for performance measurement
Instituting flexible work options
Supporting work/ life/ family balance with policies, practices and culture
Consistently demonstrating respect for all workers and the work they do
Measuring employee stressors and satisfaction regularly, and then acting on the satisfaction regularly, and then acting on the results in consultation with the employees.
14. A need for supportive manager/ employer
Employees with supportive managers will have significant job satisfaction, trust of managers and commitment to the organization. The employees may experience lower levels of role overload, job stress depressions, and poor health, work-family interference, fatigue, absenteeism and intent to leave the job. Supportive managers are those who do the following:
Give positive feedback to employees
Practice two-way communication (good listeners)
Show respect for employees
Focus on output, not hours
Demonstrate consistently
Coach and mentor employees
Focus on creating a more supportive work environment.
d. STRATEGIES FOR THE DEVELOPMENT OF POSITIVE PRACTICE ENVIRONMENTS (ICN TOOL KIT 2007)
The process of developing positive practice environments is multifaceted, occurs on many levels of an organization and involves a range of players. As a starting point, each organization should develop a workforce profile that includes such metrics as absenteeism, vacancy and turnover rates, as well as demographic information like age, and experience. This type of data provides a solid base for decision-making. For their part, nurses can advance the development of positive practice environments by:
Continuing to promote the nursing role
Defining the scope of nursing practice so nurses, other disciplines, and the public are aware of the profession’s evolution
Lobbying for professional recognition and remuneration
Developing and disseminating a position statement on the importance of a safe work environment
Ensuring that other disciplines are involved in the development of policies for safe work environments
Supporting research, collecting data for best practice, and disseminating the data once it is available
Encouraging educational institutes to enhance teamwork by providing opportunities for collaboration and emphasizing teamwork theory.
Presenting awards to health care facilities that demonstrate the effectiveness of positive practice environments through recruitment and retention initiatives, reduced dropout rates, public opinion, improved care and higher patient satisfaction rates.
e. LACKINGS IN NURSING FOR MAINTAINANCE OF PSYCHOSOCIAL WORK ENVIRONMENT
Assertiveness. There are barriers that nurses must overcome to become assertive they are-
Female gender role socialization. Women are expected to be passive, dependent, subjective, intuitive, empathetic, sensitive, interpersonally oriented, weak, in consistent, and emotionally unstable. Assertive behavior is more than demanding your rights from others and keeping others from manipulating. In a social sense assertiveness is the ability to communicate with others about who you are, how you live, what you do, and what you want and the ability to make them feel comfortable talking about themselves.(i.e., self-disclosure). This social conversation allows nurses to discover mutually rewarding relationships or to identify people with whom they have few common interests.
Cyber phobia / Tech nophobia Nurses need to overcome their “techno phobia” because clearly, nursing care can be improved with the appropriate use of technology and ironically, it is technology that will likely give nurses more time to do “nursing”. Technology holds promise and potential for addressing some of nursing’s and health care’s greatest challenges (Bradley, 2003). Nurses must therefore keep the environment of patient care first and foremost in their technology development agenda. In addition, nurses must embrace technology, understand it, and bend it to their own purposes, so that nursing can take its rightful place in the provider hierarchy (Simpson, 2003).
Generational attitudes: Today, practicing nurses come from different generations (the veteran generation, the baby boomer generation, generation X, and the millennial generation), which further challenges this complicated health care working environment. Tension arise when nurses from these different generations come together to practice nursing, these various generational attitudes, work habits, and expectations of nurses often lead to misunderstandings and conflict in the workplace, leading to poor psychosocial work environment.
Communication: “No man has a good enough memory to be a successful liar”. – Abraham Lincoln. Faulty reasoning and poorly expressed messages are major barriers to communication. Lack of clarity and precision resulting from inadequate vocabulary, poorly chosen words, platitudes, poor organization of ideas, and lack of coherence are common. To form supportive environments in order to work better with others, we should be descriptive rather than judgmental, define mutual problems and express willingness to find a solution collaboratively. Through conversations, we can celebrate togetherness by building something that is “ours”.
Leadership and Fellowship: We need great followers as well as great leaders. Leaders contribute only about 20% to the success of organizations. Followers do the remaining 80%. We spend more time reporting to others than having them report to us. Some leaders have been such good followers that their peers have asked them to take on leadership responsibilities. Leadership is an art, hence leadership and fellowship should involve intimacy and personal covenants that people at work make with each other.
CONCLUSION
Psychosocial problems at workplace are a real challenge for the workers and their employing organizations. As organizations and their working environment transform, so do the kinds of problems that employees may face. All companies should assess their workplace environment at least twice a year in order to see where improvements could be made. Staying in contact with employees and managers can help employers track changes and find areas that are in need of change in order to create a positive workplace environment. None of these changes is simple to achieve or can be accomplished overnight. They require, in most cases, a serious commitment from leaders, and a transformational leadership style to change the culture of the organization, and the patience to make changes over the long term. ‘Work in itself can be a self-promoting activity as long as it takes place in a safe, development- and health-promoting environment’.
REFERENCES:
1. Lavoic.M. Tremblay.Journal of Advanced Nursing. Improving the psychosocial work environment. Blachwell.Philadelphia.49 (6). 655-664.
2. Huston. J.Carol. Professional issues in nursing. Technology in health care workplace.
I edition. Lippincott. Philadelphia. 2006. (13) 260-263.
3. Tomey. A.M. Guide to nursing management and leadership.
VII edition. Mosby. USA. 2004. 17-327.
4. Poteet.G.W. Nursing clinics of North America. Symposium on nursing administration.
W.B.Saunders. Philadelphia. 1983.18(3). 427-499.
5. Cherry.B. Jacob.R.S. Contemporary Nursing issues. Trends and management.
III edition. Mosby. USA. 2005. (16) 384.
6. Huber.L.Diane. Leadership and nursing care management.
III edition. Mosby.USA. 2006.481-713.
7. International council of nurses. Positive practice environments: Quality workplaces=
Quality patient care. Information and action tool kit 2007.
8. Weber Janet. Nursing clinics of North America. Creating a Holistic Environment for Practicing Nurses. W.B.Saunders. Philadelphia.2007. (42). 295-307.
9. Lin Laura. Liang.A.Bryan. Nursing Forum. Addressing the Nursing Work Environment to Promote patient Safety. 42(1). 20-29.
10. Webster.s. Clare. A. Collier.E Journal of psychosocial nursing and mental health services. Creative Solutions. May 2005.43 (5). 42-49.
11. www.ilo.org/encyclopaedia/? Print&nd=857100102.
12. Burton. Joan. Industrial Accident Prevention Association. Creating healthy Workplaces. Health Strategy. IAPA. November 2006.
13. Gold David. Safework.Addressing psychosocial problems at work. ILO.2001.
14. Leka Stavroula. Protecting workers’ Health: Work organization and stress. Series
No.3 World health Organization. Switzerland. 2003. 1-25.
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