Hertting Anna, Nilsson Kerstin, Theorell Töres, Larsson Ullabeth Sätterlund
National Institute for Psychosocial Medicine (IPM), Stockholm/Department of Public Health Sciences, Division of Psychosocial Factors and Health, Karolinska Institutet, Stockholm, Sweden.
Scand J Public Health. 2005;33(2):107-13. doi: 10.1080/14034940410019154.
The aim of the study was to explore hospital-based assistant nurses' experiences of psychosocial "stressors", following a period of substantial layoffs (43%) and ongoing healthcare reorganizations.
An interview study was carried out with 11 assistant nurses working in the same hospital. The interviews took place in 1997, in connection with the last round of redundancies, and were followed up in 1998 and then in 2001. Interviews were audiotaped and transcribed; the content was then analysed.
Two main themes were identified from the women's perceived stressors: (a) a hard-hit occupational group experiencing "energy-consuming adjustments", and a "weak position" at the continuing workplace. Job insecurity meant fear of losing valued work tasks in nursing care (de-skilling). The common feature was the duality in the women's descriptions of feeling qualified in nursing care but being treated like a maid, or having intimate practical knowledge but no formal competence; (b) a tougher but underpaid job including "heavy workload" concurrent with "organizational shortcomings", and "frozen salary trends" with a simultaneous feeling of lacking the power to improve their situation.
Our results underscore the importance of the employer's attention to the remaining workers in connection with downsizing, particularly when the reduction of the workforce has been as dramatic as in this case. It is also important to understand the ongoing dilemma (strain) for the assistant nurses, who are faced with increasing demands for further formal qualifications in hospital care, while maintaining a strong occupational desire to keep their highly valued job working close to the patient.
本研究旨在探讨在经历大幅裁员（43%）和持续的医疗重组后，医院助理护士所面临的心理社会“压力源”体验。
对同一家医院的11名助理护士进行了访谈研究。访谈于1997年进行，与最后一轮裁员相关，并在1998年和2001年进行了跟进。访谈进行了录音和转录，然后对内容进行了分析。
从这些女性所感知到的压力源中确定了两个主要主题：（a）一个受重创的职业群体经历着“耗费精力的调整”，以及在持续工作场所中的“弱势地位”。工作不安全感意味着担心失去护理工作中有价值的任务（技能退化）。共同特征是这些女性在描述自己在护理方面有资质但却被当作女仆对待，或者有丰富的实践知识但没有正式资质时存在的双重性；（b）一份更艰巨但报酬过低的工作，包括“繁重的工作量”与“组织缺陷”并存，以及“薪资停滞不前”，同时感觉自己无力改善这种状况。
我们的结果强调了雇主在裁员时关注剩余员工的重要性，尤其是当劳动力减少幅度如本案例这般巨大时。理解助理护士目前所面临的困境（压力）也很重要，她们一方面面临着医院护理工作对进一步正式资质的要求不断提高，另一方面又强烈渴望保住与患者密切接触的高价值工作。
