We’re told, ‘Suck it up’: Long-Term Care Workers’ Psychological Health and Safety

  • Susan Braedley
  • Prince Owusu
  • Anna Przednowek
  • Pat Armstrong
Article

Abstract

This pilot study analyzes interview research with long-term residential care nursing staff in four Canadian provinces, revealing relationships between workers’ psychological health and well-being and working conditions that include work overload, low worker control, disrespect and discrimination. Further, individual workers are often required to cope with these working conditions on their own. The findings suggest that these psychological health and safety hazards can be addressed by both individual workplaces and government regulation, but are currently ignored or mis-recognized by many employers and even by workers themselves. These findings indicate opportunities for improving psychological health and safety in long-term residential care work.

Keywords

Long-term care Work Gender Racialization Psychological health and safety Mental health Canada 

References

  1. Andersen, E. A. (2009). Working in long-term residential care: A qualitative metasummary encompassing roles, working environments, work satisfaction, and factors affecting recruitment and retention of nurse aides. Global Journal of Health Science, 1(2), 2–41.CrossRefGoogle Scholar
  2. Armstrong, H., Armstrong, P., Banerjee, A., Daly, T., & Szebehely, M. (2009). They deserve better: The long-term care experience in Canada and Scandinavia. Ottawa: Canadian Centre for Policy Alternatives.Google Scholar
  3. Armstrong, P. (2004). There are not enough hands: Conditions in Ontario's long-term care facilities. Ottawa: Canadian Union of Public Employees.Google Scholar
  4. Armstrong, P. (2012). The mental health of women health care workers. Thinking women and health care reform in Canada. In P. Armstrong, B. Clow, K. R. Grant et al. Toronto, Women's Press, pp 193-214.Google Scholar
  5. Armstrong, P. (2013a). Regulating care: Lessons from Canadae. In G. Meager and M. Szebehely (eds) Marketisation in Nordic eldercare. Stockholm, Normacare.Google Scholar
  6. Armstrong, P. (2013b). Skills for Care. In P. Armstrong & S. Braedley (Eds.), Troubling care: Critical perspectives on research and practices (pp. 101–112). Toronto: Canadian Scholars Press.Google Scholar
  7. Armstrong, P., Armstrong, H., Banerjee, A., Daly, T., & Szebehely, M. (2011). Structural violence in long-term residential care. Women’s Health and Urban Life, 10(1), 111–129.Google Scholar
  8. Armstrong, P., & Jansen, I. (2015). The mental health of health care workers: A Woman’s issue? In N. Khanlou & B. Pilkington (Eds.), Women's mental health: Resistance and resilience in community and society (pp. 19–32). New York: Springer.CrossRefGoogle Scholar
  9. Artazcoz, L., C. Borrell, I. Cortàs, V. Escribà-Agüir and L. Cascant (2007). Occupational epidemiology and work related inequalities in health: a gender perspective for two complementary approaches to work and health research. Journal of Epidemiology and Community Health 61(Suppl 2): ii39-ii45.Google Scholar
  10. Astrakianakis, G., Chow, Y., Hodgson, M., Haddock, M., & Ratner, P. (2014). 0421 noise-induced stress among primary Care Workers in Long Term Care Facilities in British Columbia, Canada. Occupational and Environmental Medicine, 71(Suppl 1), A54.CrossRefGoogle Scholar
  11. Baines, D., & Cunningham, I. (2011). Using comparative perspective rapid ethnography in international case studies: Strengths and challenges. Qualitative Social Work, 1–16.Google Scholar
  12. Bakan, A. A. B., & Stasiulis, D. K. (1997). Not one of the family: Foreign domestic workers in Canada. Toronto: University of Toronto Press.CrossRefGoogle Scholar
  13. Banerjee, A., Armstrong, P., Daly, T., Armstrong, H., & Braedley, S. (2015). “Careworkers don't have a voice:” epistemological violence in residential care for older people. Journal of Aging Studies, 33, 28–36.CrossRefGoogle Scholar
  14. Banerjee, A., Daly, T., Armstrong, P., Szebehely, M., Armstrong, H., & Lafrance, S. (2012). Structural violence in long-term, residential care for older people: Comparing Canada and Scandinavia. Social Science & Medicine, 74, 390–398.CrossRefGoogle Scholar
  15. Barlem, E. L. D., & Ramos, F. R. S. (2015). Constructing a theoretical model of moral distress. Nursing Ethics, 22(5), 608–615.CrossRefGoogle Scholar
  16. Bonde, J. P. E. (2008). Psychosocial factors at work and risk of depression: A systematic review of the epidemiological evidence. Occupational and Environmental Medicine, 65(7), 438–445.CrossRefGoogle Scholar
  17. Bourbonnais, R., Comeau, M., Vezina, M., & Dion, G. (1998). Job strain, psychological distress, and burnout in nurses. American Journal of Industrial Medicine, 34(1), 20–28.CrossRefGoogle Scholar
  18. Braedley, S. (2009). How do work environments affect Women's maternal health? Lessons from Canada. Women & Environments International 80/81(spring 2009): 9-11.Google Scholar
  19. Braedley, S. (2013). A gender politics of long-term care: Towards an analysis. In P. Armstrong & S. Braedley (Eds.), Troubling care: Critical perspectives on research and practices (pp. 59–70). Toronto: Canadian Scholars Press.Google Scholar
  20. Braedley, S., & Martel, G. (2015). Dreaming of home: Long term residential care and (in)equities by design. Studies in Political Economy, 95, 59–81.CrossRefGoogle Scholar
  21. Chu, C. H., Wodchis, W. P., & McGilton, K. S. (2014). Turnover of regulated nurses in long-term care facilities. Journal of Nursing Management, 22(5), 553–562.CrossRefGoogle Scholar
  22. Daboussy, M., & Uppal, S. (2012). Work absences in 2011. Perspectives on labour and income. Ottawa: Statistics Canada.Google Scholar
  23. Daly, T. (2015). Dancing the two-step in Ontario’s long-term care sector: More deterrence-oriented regulation = ownership and management consolidation. Studies in Political Economy, 95, 29–58.CrossRefGoogle Scholar
  24. Daly, T., Banerjee, A., Armstrong, P., Armstrong, H., & Szebehely, M. (2011). Lifting the ‘violence veil’: Examining working conditions in long-term care facilities using iterative mixed methods. Canadian Journal on Aging/La Revue canadienne du vieillissement, 30(02), 271–284.CrossRefGoogle Scholar
  25. Daly, T., & Szebehely, M. (2011). Unheard voices, unmapped terrain: Care work in long term residential care for older people in Canada and Sweden. International Journal of Social Welfare, 21(2), 139–148.CrossRefGoogle Scholar
  26. Egan, M., Bambra, C., Thomas, S., Petticrew, M., Whitehead, M., & Thomson, H. (2007). The psychosocial and health effects of workplace reorganisation. 1. A systematic review of organisational-level interventions that aim to increase employee control. Journal of Epidemiology and Community Health, 61(11), 945–954.CrossRefGoogle Scholar
  27. Enns, V., Currie, S., & Wang, J. (2015). Professional autonomy and work setting as contributing factors to depression and absenteeism in Canadian nurses. Nursing Outlook, 63(3), 269–277.CrossRefGoogle Scholar
  28. Fujisawa, R., Colombo, F. (2009). The long-term care workforce: Overview and strategies to adapt supply to a growing demand. OECD Health Working Papers, no. 44, OECD. doi:10.1787/225350638472.
  29. Glenn, E. N. (1992). From servitude to service work: Historical continuities in the racial division of paid reproductive labor. Signs, 18(1), 1–43.CrossRefGoogle Scholar
  30. Glenn, E. N. (2010). Forced to care: Coercion and caregiving in America. Cambridge: Harvard University Press.Google Scholar
  31. Gomez-Cantorna, C., Clemente, M., Fariña-Lopez, E., Estevez-Guerra, G. J., & Gandoy-Crego, M. (2015). The effect of personality type on palliative care nursing staff stress levels. Journal of Hospice and Palliative Nursing, 17(4), 342–347.CrossRefGoogle Scholar
  32. Government of Canada. (2013). National Standard of Canada for psychological health and safety in the workplace. Ottawa: Mental Health Commission.Google Scholar
  33. Health Employers Association of British Columbia. (2014). Health and safety in action summary status report phase 1. HEABC: Vancouver.Google Scholar
  34. International Labour Organization (2013). Ten keys for gender-sensitive OSH practice: Guidelines for gender-mainstreaming in occupational safety and health. Geneva: International Labour Organization.Google Scholar
  35. Kaiser, H. A. (2009). Canadian mental health law: The slow process of redirecting the ship of state. Health Law Journal, 17, 139–194.Google Scholar
  36. Karasek, R. A., & Theorell, T. (1992). Healthy work: Stress, productivity, and the reconstruction of working life. New York: Basic Books.Google Scholar
  37. LaMontagne, A. D., Keegel, T., Louie, A. M., & Ostry, A. (2010). Job stress as a preventable upstream determinant of common mental disorders: A review for practitioners and policy-makers. Advances in Mental Health, 9(1), 17–35.CrossRefGoogle Scholar
  38. LaMontagne, A. D., Martin, A., Page, K. M., Reavley, N. J., Noblet, A. J., Milner, A. J., Keegel, T., & Smith, P. M. (2014). Workplace mental health: Developing an integrated intervention approach. BMC Psychiatry, 14(1), 131–142.CrossRefGoogle Scholar
  39. Laxer, K. (2013). Counting carers in long-term residential care in Canada. In P. Armstrong & S. Braedley (Eds.), Troubling Care (pp. 73–88). Toronto: Canadian Scholars Press.Google Scholar
  40. Laxer, K., Jacobsen, F. F., Lloyd, L., Goldmann, M., Day, S., Choiniere, J. A., & Rosenau, P. V. (2016). Comparing nursing home assistive personnel in five countries. Ageing International, 41(1), 62–78.CrossRefGoogle Scholar
  41. Marcella, J., & Kelley, M. L. (2015). “death is part of the job” in long-term care homes. SAGE Open, 5(1), 1–15.CrossRefGoogle Scholar
  42. March, L., Smith, E. U., Hoy, D. G., Cross, M. J., Sanchez-Riera, L., Blyth, F., Buchbinder, R., Vos, T., & Woolf, A. D. (2014). Burden of disability due to musculoskeletal (MSK) disorders. Best Practice & Research Clinical Rheumatology, 28(3), 353–366.CrossRefGoogle Scholar
  43. Martin, A., Sanderson, K., & Cocker, F. (2009). Meta-analysis of the effects of health promotion intervention in the workplace on depression and anxiety. Scandanavian Journal of Work, Environment and Health, 35(1), 7–18.CrossRefGoogle Scholar
  44. Matheson, A., O'Brien, L., & Reid, J. A. (2014). The impact of shiftwork on health: A literature review. Journal of Clinical Nursing, 23(23–24), 3309–3320.CrossRefGoogle Scholar
  45. McGilton, K. S., Boscart, V. M., Brown, M., & Bowers, B. (2014). Making tradeoffs between the reasons to leave and reasons to stay employed in long-term care homes: Perspectives of licensed nursing staff. International Journal of Nursing Studies, 51(6), 917–926.CrossRefGoogle Scholar
  46. Messing, K. (1997). Women's occupational health: A critical review and discussion of current issues. Women & Health, 25(4), 39–68.CrossRefGoogle Scholar
  47. Messing, K. (1998). One-eyed science: Occupational health and women workers. Philadelphia: Temple University Press.Google Scholar
  48. Messing, K. (2005). Women's occupational health in Canada: A critical review and discussion of current issues. In Canada, Women's health forum. Canada: Health.Google Scholar
  49. Messing, K., & Mager Stellman, J. (2006). Sex, gender and women's occupational health: The importance of considering mechanism. Environmental Research, 101(2), 149–162.CrossRefGoogle Scholar
  50. Messing, K., & Silverstein, B. A. (2009). Gender and occupational health. Scandinavian Journal of Work, Environment & Health, 35(2), 81–83.Google Scholar
  51. Muntaner, C., Li, Y., Xue, X., Thompson, T., O’Campo, P., Chung, H., & Eaton, W. W. (2006). County level socioeconomic position, work organization and depression disorder: A repeated measures cross-classified multilevel analysis of low-income nursing home workers. Health & Place, 12(4), 688–700.CrossRefGoogle Scholar
  52. Oliffe, J. L., & Han, C. S. (2014). Beyond workers’ compensation Men’s mental health in and out of work. American Journal of Men's Health, 8(1), 45–53.CrossRefGoogle Scholar
  53. Oliffe, J. L., & Phillips, M. J. (2008). Men, depression and masculinities: A review and recommendations. Journal of Men's Health, 5(3), 194–202.CrossRefGoogle Scholar
  54. Ontario Health and Safety Association. (2010). Ontario health care health and safety committee under section 21 of the occupational health and safety act, guidance note for workplace parties #3, occupational health and safety (OHS) education and training. Toronto: Ontario Health and Safety Associaton.Google Scholar
  55. Page, K. M., LaMontagne, A. D., Louie, A. M., Ostry, A. S., Shaw, A., & Shoveller, J. A. (2013). Stakeholder perceptions of job stress in an industrialized country: Implications for policy and practice. Journal of Public Health Policy, 34(3), 447–461.CrossRefGoogle Scholar
  56. Pereira, S. M., Fonseca, A. M., & Carvalho, A. S. (2011). Burnout in palliative care: A systematic review. Nursing Ethics, 18(3), 317–326.CrossRefGoogle Scholar
  57. Piers, R. D., Van den Eynde, M., Steeman, E., Vlerick, P., Benoit, D. D., & Van Den Noortgate, N. J. (2012). End-of-life care of the geriatric patient and nurses’ moral distress. Journal of the American Medical Directors Association, 13(1), 80. e87–80. e13.CrossRefGoogle Scholar
  58. Pijl-Zieber, E. M., O. Awosoga, S. Spenceley, B. Hagen, B. Hall and J. Lapins (2016). Caring in the wake of the rising tide: Moral distress in residential nursing care of people living with dementia. Dementia 0 (0):1–22.Google Scholar
  59. Public Services Health and Safety Association. (2016). Mental Health Resources. Retrieved 15 July 2016, from http://www.pshsa.ca/mentalhealth/.
  60. Quality Palliative Care in Long Term Care Alliance. (2012). Personal Support Worker Competencies. Retrieved 10 July 2016, from www.palliativealliance.ca/.../QPC_LTC_PSW_Competency_Brochure_Final_May_2_2012_V2_1.pdf.
  61. Rai, G. S. (2010). Burnout among long-term care staff. Administration in Social Work, 34(3), 225–240.CrossRefGoogle Scholar
  62. Ray, S. L., Wong, C., White, D., & Heaslip, K. (2013). Compassion satisfaction, compassion fatigue, work life conditions, and burnout among frontline mental health care professionals. Traumatology, 19(4), 255–267.CrossRefGoogle Scholar
  63. Rosenfield, S. (2012). Triple jeopardy? Mental health at the intersection of gender, race, and class. Social Science & Medicine, 74(11), 1791–1801.CrossRefGoogle Scholar
  64. Sabo, B. (2011). Reflecting on the concept of compassion fatigue. Online Journal of Issues in Nursing, 16(1). http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-16-2011/No1-Jan-2011/Concept-of-Compassion-Fatigue.aspx.
  65. Sabo, B. M. (2006). Compassion fatigue and nursing work: Can we accurately capture the consequences of caring work? International Journal of Nursing Practice, 12(3), 136–142.CrossRefGoogle Scholar
  66. Slocum-Gori, S., Hemsworth, D., Chan, W. W., Carson, A., & Kazanjian, A. (2013). Understanding compassion satisfaction, compassion fatigue and burnout: A survey of the hospice palliative care workforce. Palliative Medicine, 27(2), 172–178.CrossRefGoogle Scholar
  67. Squires, J. E., Hoben, M., Linklater, S., Carleton, H. L., Graham, N., & Estabrooks, C. A. (2015). Job satisfaction among care aides in residential long-term care: A systematic review of contributing factors, both individual and organizational. Nursing Research and Practice, 2015, 1–24.CrossRefGoogle Scholar
  68. Stansfeld, S., & Candy, B. (2006). Psychosocial work environment and mental health—A meta-analytic review. Scandinavian Journal of Work, Environment & Health, 32(6) 443–462.Google Scholar
  69. Statistics Canada (2012). Work absence rates 2011. Ottawa: Statistics CanadaGoogle Scholar
  70. Szeto, A. C., & Dobson, K. S. (2013). Mental disorders and their association with perceived work stress: An investigation of the 2010 Canadian community health survey. Journal of Occupational Health Psychology, 18(2), 191–197.CrossRefGoogle Scholar
  71. Tan, L., Wang, M.-J., Modini, M., Joyce, S., Mykletun, A., Christensen, H., & Harvey, S. B. (2014). Preventing the development of depression at work: A systematic review and meta-analysis of universal interventions in the workplace. BMC Medicine, 12, 74–85.CrossRefGoogle Scholar
  72. Thomas, D. R. (2006). A general inductive approach for analyzing qualitative evaluation data. American Journal of Evaluation, 27(2), 237–246.CrossRefGoogle Scholar
  73. Torjman, S. (2013). Financing long-term care: More money in the mix. Canada: Caledon Institute of Social Policy Ottawa.Google Scholar
  74. Vogel, M., Braungardt, T., Meyer, W., & Schneider, W. (2012). The effects of shift work on physical and mental health. Journal of Neural Transmission, 119(10), 1121–1132.CrossRefGoogle Scholar
  75. Yassi, A., & Hancock, T. (2005). Patient safety–worker safety: Building a culture of safety to improve healthcare worker and patient well-being. Healthcare Quarterly, 8, 32–38.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Susan Braedley
    • 1
  • Prince Owusu
    • 1
  • Anna Przednowek
    • 1
  • Pat Armstrong
    • 2
  1. 1.School of Social WorkCarleton UniversityOttawaCanada
  2. 2.SociologyYork UniversityTorontoCanada

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