what nursing staff expect from their superiors

In the medico-social sector, economic changes, social development, successive reforms, paradoxical injunctions, cost rationalization strategies, the current Covid-19 health crisis, the emergence of mechanisms of organizational structure (prescribed work, rules and procedures, etc.) and the The rise of individualism changes the terms of the management relationship, which binds an employee to his manager.

In fact, professionals in this sector express strong relationship and organizational expectations with their hierarchical superiors, as we show in a recent research article. This quality of relationship influences not only the employee’s behavior and health in the workplace, but also his or her desire to remain a member of his or her organization. The challenge is even more important now because nursing homes (accommodation establishments for dependent seniors), or even establishments that welcome people with disabilities, find it difficult to recruit and retain employees.

But how to build this new relationship? The interviews we conducted with about fifty managers (directors of establishments and middle managers) and operations staff (caregivers, teachers, etc.) made it possible to make the outline to identify courses of action to improve relationships.

“Someone who knows how to listen to us”

In the context of the relationship with his superior, the employee without hesitation or in the apparent formation of expectations (material, relational, etc.), understands the promises and tries to determine his manager’s obligations to him. The quality of the managerial relationship therefore depends on the way the manager views the fulfillment of the terms of this relationship (expectations, promises, obligations) to his superior.

Interpersonal communication therefore plays an important role in maintaining and developing the management relationship. A nurse’s aide, for example, explains that she wants her more:

“Someone close to us, who knows how to listen to us when we speak. »

According to our interviews, operations employees more broadly expect their managers to communicate with empathy, to recognize everyone’s work and to value initiative and creativity. They also need efforts to recruit and integrate new employees, with each role clearly defined to avoid conflicts, or with the equipment needed to work efficiently.

The results of the interviews also showed that the managers of the operational teams, whether they were facility directors or middle managers (department heads, nurse coordinators, etc.), as well as their employees, were expecting their superiors (regional directors, etc.) communication, listening, empathy, trust and social and technical support.

Employees expect a manager who knows how to listen to them.
Thierry Zoccolan/AFP

However, these same managers, who find themselves between a rock and a difficult place, notice the deterioration of the relationship not only with their superiors (particularly linked to the lack of dialogue and inadequacy). in support), but also in their “members”. A middle manager thus laments the consequences of the lack of autonomy that he needs to establish a suitable work organization:

“The days follow each other and there is a gradual loss of meaning and carry. After a while, you clearly become a performer.»

This uncomfortable position may even lead some managers to avoid entering into direct contact with their collaborators or managing conflicts, as they have little power in situations that require financial means. or managerial or relational skills they do not have. Confrontation with their collaborators then risks destroying them.

More than technical skill

To determine the terms of the management relationship, prevent its damage or try to repair it if necessary, the manager and the managed are therefore invited to add exchanges and interactions. In fact, formal (annual interviews for example) and informal (discussions around the coffee machine) are important to clarify the terms of the management relationship (expectations, promises and perceived obligations) and the its evolutions (expectations of individual change over time as a result of individual or organizational changes).

For more, regular exchanges allow him to provide his partner with information about the evolution of the context or his difficulty in respecting certain terms of their relationship. Admittedly, the superior cannot satisfy all the needs of his companions, but nonetheless, he can explain to them the reasons that prevent him from doing so in order to avoid feelings of frustration or disappointment, as it were. construction director:

“If I deal with, for example, requests for additional hiring, it does not depend on us. For this, I can organize small group meetings, possibly with the help of a little support.»

To enhance this communication, the selection, support and professional development of managers should not be limited to the evaluation and development of technical and professional skills, as is always the case. They also need to be concerned with cognitive skills, to allow the manager to manage paradoxical injunctions, analyze and adapt the organization of work, as well as social skills. It is actually needed to promote trust and exchange, to recognize and give more meaning to work, or to manage conflicts.

This article emphasizes the role that can be played in managing the loyalty relationship of professionals (operational employees and managers) in the medico-social sector from the point of view of management. However, it should be remembered that staff retention also depends on other organizational factors (wages, social climate, work organization, etc.) and individual factors (professional choices, personality, personal factors. values, etc.).

More broadly, a collective reflection on the improvement of working conditions and interpersonal relationships is essential in the sector to strengthen staff, to fight against institutional abuse, as revealed at the start of years of the Orpea scandal, and thus preserve health. to all.

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