Differences in ethnicity and cultural background matter to nursing assistants, and managers who act as if they don’t exist create an uncomfortable work environment, according to a recent study of 135 nursing assistants from four New England nursing homes.”
“Country of origin and racio-ethnicity: Are there differences in perceived organizational cultural competency and job satisfaction among nursing assistants in long-term care?” finds that the main factor influencing job satisfaction is “perception of organizational cultural competence.” Non-white workers saw their facilities as less culturally competent and their coworkers’ attitudes toward their race and culture as more negative than their white colleagues did.
The authors cite a model of cultural competence that divides the development of cultural competence into six stages, which begin with denial of any differences and end with integration of diverse views, behaviors, and values into the majority culture. The nursing homes they studied, they hypothesize, are in the third stage, minimizing differences “as the minority group become more like the majority group.”
They recommend several things long-term care managers can do to create a comfortable work environment for employees of different races and cultures. Among their suggestions: fostering better cross-cultural communication and putting policies and training in place so employees know how to respond if a coworker or resident is being treated unfairly because of race or culture.
The article ran in the October/December 2007 issue of Health Care Management Review. It’s free to subscribers only; others must pay $29.95.
Elise Nakhnikian, Senior Online Editor
enakhnikian@phinational.org
This article supports the “culture change” movement but doesn’t explore the connections between ethnic culture, workplace culture and other kinds of cultures. In its Recommendations section it says “The importance of employee-perceived autonomy in predicting job satisfaction should not go unnoticed by managers. A number of nursing homes have successfully implemented practices such as self-scheduling, self-selected long-term resident assignments, and self-managing NA buddy teams that tend to enhance autonomy”. While the article discusses ethnic cultural differences there are other kinds of cultures that can trip up staff, not least of course, the culture of the workplace itself (which is the “culture” many of us want to “change”). People can also operate from other cultural bases too, such as religious and professional cultural values, without necessarily being aware of them. Immigrants are more likely to be aware of ethnic differences in culture simply because they have had no choice but to face the different ways that Americans do things compared to what they learned earlier in life. Someone who hasn’t worked in another culture is less likely to be faced with an awareness of the values and norms through which they themselves usually operate. Instead, if you’ve worked only in the home culture where you grew up, its just a question of “that’s the way we’ve always done it”. While we talk about changing the workplace culture, other cultures we also find in the workplace do not need to be changed (regardless of whether that’s even possible) so much as “brought up to consciousness” Using techniques then such as Learning Circles to build a stronger team culture are great ways for staff simply to talk about their own individual heritage of doing things and then building a common workplace culture that works for them and the residents. Ask questions such as “where you grew up, how did they view old age?” When staff feel heard and respected, and when they feel that they really are a part of decision-making, they start to own the work and will experience much greater job satisfaction (and make less call-ins). The key to it all I suspect is for management to demonstrate respect by team-building and delegation of decision-making to those teams that are ready to talk about their differences, are ready to tolerate a wider range of ways of doing things, and are able to find their own solutions to daily problems. They can intentionally create culture together.