The aim of the study was to gain a deeper understanding of the expectations that assistant nurses in the elderly care have on unit manager's leadership and the consequences if the expectations are not met. To answer the purpose of this paper a qualitative research was conducted with interviews with six assistant nurses in municipal elderly care. To analyze the empirical material communication were used as a theoretical concept. Communication includes codes, signals and messages to be interpreted by the parties in a conversation and they can be both verbal and nonverbal. This means that communication is complicated and can cause confusion if it is interpreted wrong. Both literature and the results of the interviews showed that the director has a lot of expectations on him- or herself. What among other things emerged was that the manager should be involved in employees' work, he should be knowledgeable about the organization and be able to give confidence to the families and this by including external characteristics argued the interviewees. Another important part of the result was that the manager should support staff, providing them with appreciation as this makes them feel good and do more at work. The consequence of the result showed a reduced commitment when expectations are not met. The decreased involvement came partly from the unit manager being in a terminal position, among other things, employees do not bring their ideas to the manager's because he do not introduce them without first asking his director for "permission". The second consequence was crap talk. Crap talk turned out to poison the workplace if among other things, conflicts were not handled or if the employees received too little information. / Syftet med studien var att få en fördjupad förståelse för de förväntningar som undersköterskorna i äldreomsorgen har på enhetschefernas ledarskap samt vilka konsekvenserna blir om förväntningarna inte uppfylls. För att besvara syftet genomfördes en kvalitativ studie. Det empiriska materialet består av intervjuer gjorda med sex undersköterskor inom den kommunala äldreomsorgen. För att analysera det empiriska materialet användes kommunikation som teoretiskt begrepp. Kommunikation innefattar koder, signaler och budskap som ska tolkas av parterna i ett samtal och dessa visar sig både verbalt och ickeverbalt. Detta gör att kommunikation är komplicerat och kan leda till missförstånd om det tolkas fel. Både litteraturen och resultaten från intervjuerna visade att chefen har en hel del förväntningar på sig. Det som bland annat framkom var att chefen ska vara engagerad i medarbetarnas arbete, denne ska vara kunnig om organisationen och kunna inge förtroende både till medarbetarna och till de anhöriga. En annan viktig del i resultatet var att chefen ska stödja personalen, ge dem uppskattning då detta gör att de mår bra och gör mer på arbetet. De konsekvenser som följer om förväntningarna inte uppfylls var ett minskat engagemang. Det minskade engagemanget kom bland annat från att chefen befinner sig i en klämposition som till viss del innebär att medarbetarna inte kommer med sina idéer till chefen då denne inte inför dem utan att först fråga verksamhetschefen om ”lov”. Den andra konsekvensen var skitsnack. Skitsnacket visade sig kunna förpesta en hel arbetsplats om bland annat konflikter inte hanterades eller om medarbetarna fått för lite information.

The concept ‘mentoring’ in nursing is not a new concept as such and has probably been used in a variety of situations and given many interpretations. In healthcare, mentoring is aimed at facilitating professional learning and it enables a student nurse to gain clinical skills during practice placements (Gopee 2008:7). In the psychiatric clinical learning environment, unit managers play a vital role regarding student nurses’ attainment of clinical skills during their practical placements. Lack of mentoring can adversely affect the student nurses’ ability to achieve clinical learning outcomes and this will affect their competency as professional nurses at the end of their training. The aim of this study was to explore and describe the perceptions of the student nurses and unit managers in a specific public psychiatric hospital regarding the mentoring role of unit managers within a psychiatric clinical learning environment. The objectives of the study were to explore and describe the perceptions of student nurses regarding the mentoring role of unit managers within the psychiatric clinical learning environment, to explore and describe the perceptions of unit managers regarding their mentoring role within the psychiatric clinical learning environment and to make recommendations to enhance the mentoring of student nurses by unit managers in a psychiatric clinical learning environment. A qualitative, exploratory and descriptive research design was utilized to address the aim and objectives outlined. Semi-structured focus group interviews were conducted separately with a purposefully selected sample of unit managers and student nurses. The data analysis was guided by the constant comparative method of qualitative data analysis of Tesch (1990:113). The process of transforming data into research results led to the emergence of the following themes for student nurses and unit managers: mentoring as a concept, expectations of the mentoring role, enabling factors of mentoring, disabling factors of mentoring and plans to enhance mentoring. Though the two groups of participants were interviewed separately common perceptions emerged in relation to the themes identified. Mentoring as a concept was viewed as a process of teaching, guiding, supporting, leading, supervision, role-modeling and assistance by an experienced, knowledgeable unit manager. Regarding expectations of the mentoring role, participants were of the opinion that unit managers were not prepared for this role through specific training, but used their experience, to guide student nurses. Furthermore, they perceived it as one of the unit manager’s responsibilities. Disabling factors of mentoring encompassed lack of student nurses’ theoretical background knowledge in psychiatric nursing science, unit managers’ lack of knowledge of advancement in the educational arena, the attitudes of student nurses and unit managers, lack of unit managers’ preparation for mentoring, organizational problems and lack of communication between nurse educators and unit managers. Enabling plans for mentoring encompassed training of unit managers for the mentoring role, theoretical preparation of student nurses prior to placement for psychiatric clinical learning experience, student nurses and unit managers to change their attitude addressing organisational problems and enhanced collaboration between educational and clinical facilities. Recommendations were made regarding nursing practice, nursing education and nursing research for future improvements on the mentoring role of unit managers in the psychiatric clinical learning environment. / Dissertation (MCur)--University of Pretoria, 2011. / Nursing Science / unrestricted

Studien ämnar att bidra till en ökad kunskap om hur enhetschefer inom den sociala barnavården förstår, förhåller sig till och arbetar med ett hållbart arbetsliv. Samtidigt ämnar studien att utforska ledarskapets roll i detta. Med anledning av det utgick studien ifrån två frågeställningar om hur enhetschefer tolkar, förstår och förhåller sig till ett hållbart arbetsliv inom den sociala barnavården. Därefter undersöks vilka olika sätt enhetschefer arbetar med olika aspekter inom hållbarhet i arbetslivet, och även dilemman som kan uppstå i detta.För att besvara frågeställningarna utfördes studien utifrån en kvalitativ metod där semistrukturerade intervjuer genomfördes, och analyserades genom en tematisk analys. Urvalet utgick från Sveriges alla kommuner. Totalt intervjuades tio enhetschefer inom den sociala barnavården, varav åtta användes i studien. Av de åtta var intervjupersonernas geografiska plats utspridd mellan mellersta och södra Sverige. I analysen tillämpas även Michael Lipskys teori kring gatunivåbyråkrater. Resultatet av studien påvisar enhetschefernas utgångspunkt i förståelsen av ett hållbart arbetsliv, där balans mellan arbete och privatliv, tydliga förväntningar och goda förutsättningar var framträdande. Enhetschefernas ledarskap i förhållande till ett hållbart arbetsliv tar grund i en form av gemenskap och solidaritet. Resultatet visar även på hur enhetscheferna ser på sig själv och sin egen roll, där ett stort ansvarstagande framkommer. I praktiken värdesätter enhetscheferna relationen till medarbetarna högt, och studien pekar även mot hållbarhetsarbetets komplexitet, där media, organisationen och samhället i stort även påverkar enhetschefernas arbete med hållbarhet i arbetslivet. / The study aims to contribute to an increased understanding of how unit managers in child welfare services comprehend, relate to, and work towards a sustainable working life. Additionally, the study intends to explore the role of leadership in this context. Consequently, the study was based on two research questions regarding how unit managers interpret, understand, and relate to a sustainable working life within child welfare services. Subsequently, it examines the different ways unit managers address various aspects of sustainability in the workplace, as well as the dilemmas that may arise in this process. To answer these questions, the study employed a qualitative method involving semi-structured interviews, analyzed through a thematic analysis. The selection was based on municipalities across Sweden. In total, ten unit managers in child welfare services were interviewed, of which eight were used in the study. The geographical location of the interviewees was spread between central and southern Sweden. The analysis also applied Michael Lipskys theory of street-level bureaucracy. The study's results highlight the unit managers understanding of a sustainable working life, emphasizing the balance between work and private life, clear expectations, and favorable conditions. The leadership of unit managers in relation to a sustainable working life is rooted in a sense of community and solidarity. The results also reveal how unit managers perceive themselves and their role, with a significant sense of responsibility emerging. In practice, unit managers highly value their relationship with employees, and the study also points to the complexity of sustainability work, where media, the organization, and society at large influence the unit managers work towards sustainability in the workplace.

The aim of this study was to investigate unit managers views on staff continuity within municipal home care services to get a wider understanding regarding the organization’s work with staff continuity, which action dilemmas the unit managers encounter and how they handle these. The study was conducted by qualitative research through semi-structured interviews with six unit managers in one middle-sized municipality in Sweden. The results showed a diverseness in working methods regarding staff continuity between the home care services in the municipality. It was also concluded that the home care services are guided by goals and guidelines regarding staff continuity which the unit managers finds unclear and undeveloped. The conclusion highlights that the unit managers finds themselves in a position where the care users needs and requests of a staff continuity does not always match the conditions and regulations within the organization. Lastly the results showed that this position causes the unit managers to make priorities in the work for staff continuity. It can be concluded that the unit managers either finds themselves adjusting to the organizations conditions or regulations or they find solutions to meet the request and needs from the care users regarding staff continuity.

Socialsekreterare är en yrkesgrupp inom vilken det förekommer ett stort antal sjukskrivningar på grund av stressrelaterad psykisk ohälsa. Det framkommer att arbetsmiljön samt ledarskapet har en stor påverkan på de anställdas psykiska hälsa. Syftet med studien var att genom en kvalitativ metod undersöka hur enhetschefer inom socialtjänsten arbetar för att förebygga stressrelaterad psykisk ohälsa bland sina anställda. Vidare undersöktes också huruvida ett rumsligt nära ledarskap har någon påverkan på det förebyggande arbetet. Intervjuer genomfördes med fyra enhetschefer anställda inom socialtjänsten. Som hjälp vid intervjuerna användes en halvstrukturerad intervjuguide med öppna frågor. Analysen utgick från innehållsanalys samt krav, kontroll och stödmodellen. I resultatet framkom att ett rumsligt nära ledarskap är av stor vikt för enhetschefer när det gäller det förebyggande arbetet. Närhet gör att enhetschefer lättare kan följa med i det dagliga arbete, se när arbetsbelastningen på de anställda ökar samt se hur de anställda mår. Det framkommer också att stöd från chef och kollegor är viktigt för att förebygga stress, då man som anställd behöver känna att man inte står ensam med arbetet. Tydlighet i socialsekreterarens yrkesroll framgår också som en viktig faktor, vilket kan påverkas av god introduktion samt mentorskap vid nyanställning. Handledning, regelbundna teammöten, samtal samt mätning och reglering av arbetsbelastning framkommer också som viktiga rutiner i det förebyggande arbetet. / Social workers are a professional group where there are a large number of sick leaves related to stress-related mental illness. It appears that the working environment and leadership have a great impact on the employees´mental health. The aim of the study was to find out through a qualitative method how unit managers within the social services work to prevent stress-related mental illness among their employees. Furthermore, we also looked into whether a spatially close leadership has any impact on the preventive work. Interviews were made with four unit managers within the social services. At the interviews a semi-structured interview guide with open questions was used as a guideline. The analysis was based on content analysis and the demand, control and support model. As a result of the analysis we came to the conclusion that a spatially close leadership is of a great importance to the unit managers regarding the preventive work. To be near the employees makes it easier for the unit managers to follow the daily work, to discover when the employees´ workload increases and to see the well-being of the employees. It also appears that support from the unit manager and the colleagues is important in order to prevent stress, as employees need to feel that they don´t stand alone in their work. Clarity in the professional role also appears as an important factor, which can be influenced by a proper introduction as well as mentoring for newly employed. Guidance, regular team-meetings, conversations as well as measurement and regulation of the workload also appear to be important routines in the preventive work.

HR-funktionens uppgift i en organisation är att tillvarata den mänskliga resursen och se till att goda arbetsförhållanden uppnås. Detta för att kunna attrahera, rekrytera, behålla och utveckla kompetens (Kira 2003). På senare år har arbetsförhållanden och arbetsvillkor uppmärksammats på kommuner i Sverige för bland annat enhetschefer i äldreomsorgen. Arbetsförhållandena, arbetsvillkoren och framför allt den höga personalomsättningen bland dessa, har lett till en problematik som var en av valets viktigaste frågor 2014. Syftet med denna studie är att beskriva arbetsförhållanden för enhetschefer inom mindre kommuner i Sverige, inom den sociala sektorn och belysa hur dessa skulle kunna förbättras. Som studieobjekt har Orsa kommun använts. Resultatet av undersökningen visade att arbetssituationen för enhetschefer är övermäktig, då det är hög arbetsbelastning samt dålig struktur i arbetet. Enhetscheferna själva skulle gynnas av en assistent samt en arbetsbeskrivning för att minska arbetsbelastningen och få struktur i arbetet. Vår slutsats är att kommuner i Sverige borde arbeta med att skapa bättre arbetsförhållanden för enhetschefer samt arbeta för att underlätta arbetsbördan. Vårt förslag till Orsa kommun är att ta hjälp av vår handlingsplan och därmed anställa assistenter till enhetscheferna samt skapa arbetsbeskrivningar. Vidare forskning i ämnet skulle kunna belysa mentorskapets betydelse i den offentliga sektorn inom kommuner i Sverige samt organisationsstrukturens bemärkelse för arbetets attraktivitet. / HR function's role in an organization is to safeguard the human resource and ensure that good working conditions are achieved. This is to attract, recruit, retain and develop skills (Kira 2003). In recent years, working conditions and working conditions attracted the attention of local authorities in Sweden, among other heads of units in the elderly. Working conditions and above all the high staff turnover among these, has led to a problem that was one of the valets important issues in 2014. The aim of this study is to describe the working conditions of unit managers in smaller municipalities in Sweden, the social sector and highlight how these could be improved. We have used Orsa kommun in this study. The results of the survey showed that the employment situation of heads of unit is overpowering when the work structure it poor and the level of stress is high. Unit managers themselves would benefit from an assistant and a job description to reduce the load and the structure of the work. Our conclusion is that municipalities in Sweden should work to create better working conditions for home directors and work to ease the workload. Our proposal to Orsa kommun is to take the help of our action plan and to employ assistants to heads of unit as well as create job descriptions. Further research on the subject could enlighten the importance of mentoring in the public sector within the municipalities in Sweden and the organizational structure to create more attractive work conditions.

The aim of this study was to create an understanding of how unit managers and care workers work with user influence in connection with elderly moving to nursing homes. This study was delimited to analyze two nursing homes in a medium-sized municipality in southern Sweden. The study was based on qualitative semi-structured interviews from two unit managers and six care workers in nursing homes. To analyze the data, Michael Foucault’s theory about power, Pierre Bourdieus's concept of doxa and symbolic power have been used as well as client construction. The result of this study indicates that elderly are given the opportunity to influence through implementation plans, welcome talks, being listened to, relationship-building, feeling homelike, resignation and reluctance, adaption to the conditions that are available and rethinking. The results of the study also shows that elderly were transformed and adapted according to the nursing homes guidelines and routines when moving in. Therefore, there were opinions taken for granted and not questioned within the organizations. With this basis, situations that caused limited influence of the elderly were excused and justified according to the organizations´ implied logic, which was deeply rooted in the workplace structure including the unit managers and care workers.

Syftet med studien var att studera enhetschefers upplevelse av arbetsrelaterad stress, samt hur stressupplevelsen och balansen på deras privatliv varierade. En kvalitativ metod genomfördes med hjälp av en semistrukturerad intervjuguide. Utifrån syfte och Karaseks och Theorells krav-kontroll och stödmodell utformades fyra frågeställningar. Sex enhetschefer intervjuades och det insamlade materialet analyserades med hjälp av en deduktiv tematisk analys. De fyra huvudtemana: krav på arbetsplatsen, kontroll över arbetssituationen, vikten av socialt stöd samt balansen mellan arbete och privatliv var förutbestämda utifrån teorin. Det övergripande resultatet visade på att respondenterna upplevde höga krav och låg kontroll på arbetsplatsen. Vidare framkom det att det sociala stödet var av stor vikt i respondenternas arbetssituation. Modellens förutsedda stressupplevelse stämde överens med enhetschefernas faktiska stressupplevelse och balansen mellan arbete och privatliv visade sig vara begränsad. / The purpose of this study was to study unit managers' experience of strenuous work and work-related stress, as well as how the stress experience impacted on their privacy. A qualitative method was carried out using a semi-structured interview guide. Based on the purpose and Karaseks and Theorell's demand-control and support model, four questions were formulated. Six unit managers were interviewed, and the collected material was analyzed using a deduction thematic analysis. The four main themes: workplace requirements, control of the work situation, the importance of social support and the balance between work and privacy were predetermined based on theory. The overall result showed that respondents experienced high demands and a low level of control at the workplace. Results also showed that social support was of great importance in the respondents' work situation. The model's predicted stress experience was in line with the unit managers' actual stress experience and the balance between work and privacy proved to be limited.

Background: In Swedish elderly care, New Public Management (NPM) can be identified in several different ways, for instance it has entailed changed control principles with an increased element of various standardized instruments. Another important feature is that political governance has become increasingly decentralized. The unit managers within elderly care are the professional group that to a large extent has the responsibility to implement various changes. For unit managers, this means a complex professional role with a responsibility for the staff and their work environment, the budget and the realization of the organization's overall goals in practice. Hence the unit managers' professional role often entails conflicts of loyalty between competing interest on different levels in the organization. Purpose: The purpose of the study is to investigate how the unit manager's work processes and professional role in a medium-sized municipality can be understood in relation to NPM. Methods: The study was conducted through individual interviews with eight unit managers in elderly care. Respondents were recruited through e-mail, all respondents worked in the same medium-sized municipality. The interviews were conducted using an interview guide. We used a qualitative empirically driven thematic analysis method to categorize our data. In our analysis we implored a deductive approach, using several concepts from a critical perspective in relation to NPM. Results: Unit managers' professional role in elderly care in the chosen municipality is largely characterized by budget, administrative work and a lot of time is devoted to evaluating different key figures. Thus, the way in which the professional role of unit managers and elderly care in general is organized, managed, and evaluated in the municipality we studied can be understood as a form of NPM. The position of unit managers is an intermediate position between the organization, staff, caregivers, and relatives. Unit managers are faced with many demands from management, from caregivers and from relatives. The biggest challenge both in the present and in the future is the recruitment of educated and experienced staff.

Bakgrund: År 2019 avslutades Covid-19 pandemin, sjukvården var några av de som blev mest drabbade av denna kris och som var med i kampen om att bekämpa viruset. Arbetsmiljön i form av den fysiska och psykiska delen påverkades inom sjukvården under denna svåra krissituation. Det förelåg brister inom vården redan innan pandemin och det blev därför en utmaning för sjukvården att hantera pandemin. Detta är något som ingår i chefernas arbete, att enligt svensk lag hantera arbetsmiljö på arbetsplatsen. Föreliggande studie undersöker hur arbetet kring den fysiska och psykiska arbetsmiljön har hanterats av sjukvårdschefer i tre olika faser, före-, under- och efterfasen. Syfte: Syftet med studien är att bidra med kunskap när det kommer till sjukvårdschefernas arbete med arbetsmiljön avseende Covid-19, där de centrala faserna är under- och efter-fasen och före-fasen bidrar med en kontext. Delarna av arbetsmiljön som undersökts är den fysiska och psykiska arbetsmiljön. Undersökningen bidrar med ökad förståelse för hur kriser som Covid-19 pandemin påverkar arbetsmiljön inom sjukvården och hur sjukvårdscheferna hanterararbetsmiljön. Metod: Metoden som används i föreliggande studie är den kvalitativa metoden. Författarna genomförde semistrukturerade intervjuer tillsammans med tio enhetschefer på sjukhusorganisationen för att samla in den primära datan för studien. Empiri och slutsats: Studien visar att den fysiska och psykiska arbetsmiljön var mest utsatt i under-fasen av pandemin med viss utsatthet även i efter-fasen där man nu försöker hjälpa de berörda inom personalgruppen med olika typer av stöd, till exempel krisstöd. Det visade sig att den fysiska och psykiska arbetsmiljön var hanterbar i före-fasen trots att arbetsmiljön redan då var under press. I efter-fasen försöker man komma tillbaka till ett normalläge såsom det var innan pandemin. / Background: In 2019, the Covid-19 pandemic ended, healthcare was some of the most affected by this crisis and was involved in the fight against the virus. The physical and psychological aspects of the work environment were affected in healthcare during this difficult crisis. There were already shortcomings in healthcare before the pandemic, so it became a challenge for healthcare to manage the pandemic. This is something that is included in the work of managers, to manage the work environment in accordance with Swedish law. The present study examines how the work on the physical and psychological work environment has been managed by healthcare managers in three different phases, before, during, and after the pandemic. Purpose: The purpose of the study is to contribute knowledge about the work of healthcare managers regarding the work environment with regard to Covid-19, where the central phases are the during and after phases, and the before phase contributes a context. The parts of the work environment investigated are the physical and psychological work environment. The study contributes an increased understanding of how crises such as the Covid-19 pandemic affect the work environment in healthcare and how healthcare managers manage the work environment. Method: The method used in the present study is the qualitative method. The authors conducted semi-structured interviews with ten unit managers at the hospital organization to collect the primary data for the study. Empirics and conclusion: The study shows that the physical and psychological work environment was most vulnerable during the during-phase of the pandemic, with some vulnerability also in the after-phase where efforts are now being made to provide support to healthcare workers. It turned out that the physical and psycological work environment was manageable in the before-phase despite the fact that the working environment was already under pressure. In the after-phase, the goal is to return to a normal state as it was before the pandemic.