Abstract

Health care support workers have patient-facing roles within care teams but little autonomy; work is allocated. This study reports work stress experiences of Health Care Assistants (HCAs; UK support workers) in a dementia unit in 2018 towards the end of national austerity, a period of significant staff reduction in the UK National Health Service. HCAs (15; 40% of total) were individually interviewed, and in a focus group (6). Analysis revealed high job demands but low job resources. HCAs were altruistic regarding stressful dementia care but tension from the work environment was high. Difficulties directly or indirectly related to staff shortage: workload, inadequate staffing, and reliance on inexperienced temporary staff who required supervision, poor team skill mix, and poor shift patterns. Serious relationship issues for HCAs were exposed so post-hoc interviews with nurses (n = 10) from the same unit were undertaken for further insight. HCAs considered nurses unsupportive, poor leaders and disrespectful of their experience. Nurses considered HCAs obstructive, compounded by failure to recognise nurses’ professional responsibilities. Coping by HCAs was mainly through short, time-out breaks but these were constrained by lack of staff cover. Tensions had been left to fester. Better awareness of managers is required that staffing impacts extend beyond workload.

Keywords: Workplace Stress; Job Stress; Job Strain; Health Care Assistants; Healthcare Support Worker; HCA; Dementia

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