Frontline Worker Satisfaction Related to the Quality of Supervision

By Richard Shank

New research published in the Journal of Aging and Health stresses that job satisfaction of frontline long-term care (LTC) staff reflects the quality of their supervisor.

Previous research indicated that nursing home frontline staff experience more positive work outcomes when they are given personal growth opportunities by, what they perceive to be, quality supervisors. These factors have been shown to increase worker retention, reduce personnel costs, and enhance the quality of care. The present study built upon these findings in an effort to seek the factors that influence satisfaction with supervision (e.g. employee background characteristics, personal and job-related stress, workplace social support, and organizational factors).

Data for this analysis came from a larger study designed to assess the training needs of workers in three different LTC settings in the state of Ohio. The research was conducted in twenty-seven nursing homes, fourteen Assisted Living communities (AL), and eight home health care agencies (HHA). Proportionate random sampling techniques were utilized to select a pool of potential organizations (and respondents within participating organizations) large enough to allow them to analyze organizational-level data.

The factors they used to explain worker satisfaction with supervision were defined as follows: Four index measures of personal stress (financial stress, family-work conflict, health-related stressors, and CES-Depression scale); three components of job-related stress (job design features, such as rating the difficulty of making scheduling changes, perceived adequacy of available training, such as quality of orientation, continuing education, and mentorships, and perceived problems with staff turnover); job-related support, which included a variety of ratings on the quality of staff interactions; and several variables that helped describe the organizational setting (profit status, type of LTC setting, and the percentage of services reimbursed through private pay).

On the whole, respondents frequently reported their main concerns as worries about family while at work, and financial stressors. In addition, over a quarter of the sample audience reported experiencing clinical levels of depression. Scheduling changes did not appear to be overly stressful for workers and they likewise felt that, on the average, they had adequate access to professional development resources. On an organizational level, worker turnover was also a repeated problem.

However, diving deeper into their analysis, the researchers found that the frontline staff who experience particular forms of personal and work-related stress and are less supported in the workplace, are significantly more likely to express dissatisfaction with their superiors. At the organizational level, nursing home staff were significantly more likely than AL and HHA staff to report dissatisfaction with their employer. The same was true of staff working in for-profit organizations that cater to private paying individuals.

These findings suggest that supervisor quality ratings can be improved by stress management programs and paying further attention to teamwork dynamics in the workplace. More practically, they can also be improved by attempts to manage the scheduling process in a way that minimizes employee stress. In short, they demonstrate the need to maintain quality relationships at all staffing levels and promote a supportive teamwork culture that allows staff to become natural mechanisms through which they can manage the day-to-day stresses of the care environment.

However, the researchers also suggest that organizations will unnecessarily distort the relationship between supervisors and their frontline staff whenever they invest less in personnel programs and staff development, and wherever they have high rates of supervisor turnover. Staffing costs make up the bulk of operational expenses and are the easiest to target for short-term solutions. Yet over the long-term, the costs of such budgeting decisions need to be weighed against the unavoidable short-term staffing productivity losses, such as lost productivity, increased job-related stress, and higher rates of turnover.

Source: Noelker, L., Ejaz, F., Menne, H., Bagaka, J. 2009. Factors affecting frontline workers' satisfaction with supervision. Journal of Aging and Health 24(1): 85–101.

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