In the development of health promoting hospital organizations, 1st line managers hold a key position through their closeness to practice and integrated response-bility for practice, economy and staff. The purpose of this report is to contribute to the development of sustainable supportive structures that can strengthen managers’ own working conditions and their opportunities to balance their commitment and stress at work. The two studies describes managers’ (a) approaches to demarcations in manager practice, (b) perceived opportunities to communicate stress and problems in their organization, and (c) suggestions regarding how managers’ stress can be handled and how early signs of stress can be guarded in health care organizations. Each study started with qualitative interviews (n=10, n=6). Thereafter, the results were discussed with 1st line managers (n=71) in 13 focus groups, regarding interventions and changes.
Study 1. Strategies for demarcations between work tasks and life spheres were more or less flexible, firm, or permeable. They were characterized by different level of controlling and adapting to the present situation, others’ needs or one’s own needs. These strategies were seldom outspoken. Further, they were resulting mainly from personal experience, which made the managers ask for increased external support in boundary-setting regarding working conditions that were constantly changing and difficult to demarcate.
Study 2. Communication of stress within the organization was hindered be-cause the system was perceived to oppress problem descriptions. Fear was expressed that the higher levels in the organization considered lower level managers’ communication about their stress a failure. That could risk losing one’s reputation and career possibilities. One’s nearest manager was seen as the most important channel for meeting and managing stress. Surveys and other stress measuring methods require an open climate to handle the information received, and that actions are taken to address potential problems.Focus groups. Supportive structures that can improve managers’ own working conditions and their opportunities to balance commitment and stress at work concern:
- Possibilities for communicating stress and problem descriptions through elaborated “manager to manager”-dialogues; rewarding communication of problem descriptions in the line organization; dialogue-based development projects to influence values and culture; and an overview over the recruiting process in practice
- Efforts to increase one’s self-awareness and handling strategies through supervision; room for recurrent dialogues with manager colleagues; and health status dialogues with occupational health service that address individual sustainability in the manager work
- Clarity regarding responsibility, resources and guidelines for manager responsibility in the organization; increased direct support by resource functions; and a recruitment process permeated by a health promoting perspective
Results from this report can be used as knowledge base when formulating policies and plans for actions in order to prevent, discover, and adjust stress and exhaust-tion among managers in public health care organizations.
Göteborg: Göteborgs universitet, 2011. Vol. 45, no 1, 53 p.