Nursing Home Manager Role in Managing Aging Workers: A Qualitative Research in Nursing Homes

Nursing home manager (NHM) has now a great challenge: managing an aging staff ensuring higher level of quality assistance and enforcing health and safety regulations.Aim of this research was to analyze NHM awareness of professional role in managing aging workers in order to think up solutions to improve working condition and quality of assistance.On the basis of preliminary literature search, an ethnographic quality approach was applied. This study was based on a retrospective data collection of administrative data and on the analysis of responses to semi structured interviews on these topics. A comprehensive description was made and results were discussed with an expert occupational physician. Key points emerging are: (a) NHM were usually involved in individual job task description, but their awareness of responsibilities in health and safety management of nursing staff was not clear; (b) NHM were not usually consulted by their occupational physician (OP); (c) work modifications indicated by OP were often considered by NHM generic and not contextualized; (d) organization consequences of work restrictions were not shared among OP, Chief of staff and NHM; (e) when work restrictions were preceded by OP's case discussion with relevant parties, there was a better management of nursing staff. On the bases of these results, main suggestions to improve management will include: new approaches for nursing staff risk assessment, better definition of NHM role and duty, specific pathways of learning for NHM and for registered nurses, involvement of registered nurses in nursing assistants' management, OP case discussion with relevant parties, improvement in scientific documentation for fitness to work process, implementation of procedure for work restriction management.