This post is an automatic translation from a text written in Slovenian. Translation is generated with use of DeepL Pro tool. Original text is postaed and available here: https://paradim.si/category/slovensko-zdravstvo-2022-23/
What are workplace relations? What are we talking about or aiming at when we use these words?
We can distinguish several components. Certainly part of the thinking goes to what we perceive from others: about the role we play and about ourselves. Whether others value my contribution and whether they have respect for my personal ways. Do they perceive my efforts and what is their response to them? All the colleagues in the team play a role in this, all the others we meet at work, and of course the relationship with the leader or the management team plays a special role.
Thinking further, we can certainly add to this beginning: what happens when there are problems at work. Whether it is obstacles to the work itself, or obstacles to cooperation with team members, perhaps there are conflicts; does anyone care about that? What happens? How important is it to others, primarily to those in leadership, what happens to us in doing our work?
Next: maybe someone could also use these words to describe general well-being. So, am I satisfied with the work, are we working in a way that also feels right to me, is there the necessary fairness between us, is there help and cooperation between us, is there a relaxed or more formal atmosphere? Here we are already touching on a broader area, which in organisational parlance is called organisational culture. It covers all the values, beliefs, approaches to work, the nature of relationships that prevail at work and similar subjects.
How is work going – can I help?
This is the kind of question that should be a regular part of the vocabulary of a leader who is doing the job as a leader is meant to do it. To briefly repeat: the manager is responsible for designing the system and the way of working, the leader for implementation. Do we have any problems in getting things done? Or is there something missing? Also, are we perhaps not getting on well enough with our colleagues in the team? If we were to describe the role of the manager in simple words, it would go something like this: to encourage and create commitment to the mission of our work (i.e. in the case of healthcare, caring for patients), to coordinate the work of individual members (making sure that each fulfils his/her role), to mobilise (accepting opinions, taking into account insights and experiences) and to enable all colleagues (asking, how can I help you?).
The poor state of relations in healthcare (especially in critical institutions in the current crisis) has been repeatedly highlighted in public debates. And why does this bad situation exist? If we look at the scientific research on leadership in healthcare, I think the most central finding is this: there is no real leadershipin healthcare .
The organisational culture in healthcare as a whole places a high value on medical or health professionalism and competence. This is also true of the leadership role, and clinical expertise is essential for appointment to this role. All the subsequent stakes are then placed accordingly. A leader has many tasks that require this kind of competence. He or she spends a lot of time on this part of the role and therefore less time is left to do the ‘leadership part’ of the role. In the interviews, these managers both cite efficient use of time as the second of the two core competences (the first mentioned above). In healthcare vocabulary, the word ‘high professionalism’ is often used, which of course aims at clinical professionalism, but in this struggle within this leadership role, the other one – leadership professionalism – is therefore losing out again and again.
Culture and internalised thinking
Everything presented is usually logical to healthcare staff and is not defined as a problem situation. This may be right, but in this case we must at least ask ourselves: who will then exercise the leadership role? A leadership role in the sense that it is necessary to build good relationships and for the effective and efficient functioning of the organisation. Just as the first part is logical, that managers invest primarily in their clinical expertise, so (in terms of organisational theory) it is a very logical outcome that relationships in such an organisation are poor, or at least that they are left to chance.
Organisational culture is the sum total of the thinking, beliefs, views, ways of addressing problems, interrelationships that a group has formed through its actions and problem solving. This mindset is then used by staff to teach all newcomers to the group and is (mostly) presented as the only correct way. In the health system, role expectations are transmitted in this way, including (often problematic) attitudes towards nursing staff. The organisational culture in Slovenian healthcare has been described as hierarchical and inward-looking (and lacking group identity).
Conclusion
The term internalisation means that a certain way of thinking has become part of us and is our way of understanding the world around us. There are a number of changes currently being announced in the Slovenian healthcare system, and this thinking is part of the overall change. It is only the staff in the Slovenian health service who can do this rethinking. Can you invite some critical thinking and rethink your own beliefs and views about your work environment? This reflection and building of working conditions, primarily relationships, is primarily or directly directed at you, but indirectly, of course, it is experienced by all of us who come into contact with healthcare as patients.
The sources on which the content of the record has been based are:
Kovačič, H. and Rus, A. (2015). Leadership competences in Slovenian healthcare. Zdravstveno varstvo 54(1), pp. 11-17.
Savič, B. S. (2006). Organizacijska kultura in uvajanje sprememb v slovenskih bolnišnicah: subkulture in mesto zdravstvene nege. Obzornik zdravstvene nege 40, pp. 187-196.
Savič, B. Capacity of middle management in health-care organizations for working with people – the case of Slovenian hospitals. Human Resources for Health 2013 11:18.
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