Work organization and health issues in long term care nursing centers: Comparison of perceptions between caregivers and management

Nursing home work ranks as one of the most hazardous industries in the USA. Nursing aids, who are predominately women of low education and socioeconomic status, are confronted daily with exposures to infectious disease, chemicals, violence, heavy workloads, ergonomic hazards, as well as all kinds of psychological stressors. This study is a pre-intervention assessment of the health and safety, work organization, and psychosocial issues among nursing aids in preparation for selecting appropriate sites for a participatory intervention related to promoting the health of caregivers in long term care centers. Focus groups were conducted in seven nursing centers with nursing aids to provide qualitative information on their health and safety concerns, work organization climate, as well as evaluations of a two-year no-lift program and wellness programs. Open-ended personal interviews were conducted in these seven nursing centers with management to learn about their vision and commitment with employees' health and safety issues, worker participation issues, as well as no-lift program and wellness programs. Common and different issues were identified between perceptions of nursing aids and perceptions of the management, in terms of general health, occupational health, no-lift program and ergonomics, worker involvement and participation, as well as benefits and obstacles of wellness programs. Workplace injuries, stress, and inadequate staffing emerged as major concerns in all focus groups, as well as in management interviews. However, worker participation and appreciation, which were described by the management as “open policy” and “respect”, were perceived very differently by focus group participants.