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First-line managers’ work situation determines the staff’s well-being


“First-Line Managers are completely dependent on the support and the possibilities they get from above. This is easily forgotten when you discuss the individual manager,” says researcher Heidi Hagerman from the University of Gävle.

Heidi Hagerman

Heidi Hagerman

In her research, Heidi Hagerman has explored how first-line managers’ work situation within elderly care affects themselves and their subordinates. In her study, a number of questionnaires and interviews have been conducted since 2010. As such, the study is unique as it follows line managers and members of staff in the same unit over time.

“For this reason, we can determine that first-line managers’ work situation has an impact on the staff’s work situation. As far as we know, this is the first time a study like this has been conducted from an empowerment perspective within Swedish elderly care. We would like to contribute to a change in the first-line managers’ work conditions so that their well-being is improved, and so they can lead an organisation in better health,” Heidi Hagerman says.

Why are conditions so different?

Heidi Hagerman used to work as a nursing assistant and a nurse within elderly care and in-home care. She observed that places differed widely in terms of how much support and recognition managers gave employees, and in how much time and technical equipment employees had etcetera.

The optimal workplace

At the best workplace Heide ever worked at, the manager’s office was in the next room and there was a morning meeting every day in which they structured the work for the day together.

“It wasn’t very common back then, but this manager wanted to get involved and as she was a district nurse, she knew very much about our everyday situation.”

Heidi continues by telling us that her manager kept her informed about what was going on in the organization. “We felt involved, as we could influence our work. She gave us possibilities, and if we needed support, she was there for us, and she understood.”

Measurable impact objectives overshadow soft values

The interviews showed that first-line managers thought that working together with the staff was the most important thing. This was the only way they could provide good care together. However, that was hard to achieve, as the financial situation and measurable impact objectives counted most.

“They have so many administrative demands on themselves and the soft values are not really recognized in this type of management. One way to facilitate managers’ work would be to let support functions in the administration visit on certain days and provide hands-on assistance.”

Strategies to succeed no matter what

Many first-line managers described strategies they used to succeed no matter the circumstances. One way could be to work more than 40 hours a week, for instance by doing administrative tasks at home in the evening to be able to be more present during the workday. Other options were to arrive at work very early to be with the staff in the morning before they headed out, or to leave the door open so that member of the staff always could come in or to be reachable by phone day and night.

“They want to be easy to reach at all hours, as the activities go on day and night. If something happens during the weekend, they want to know to be able to give the staff support.”

“They are proud of their job”

Researchers could that see that if a manager is given the right conditions, it has an effect on the staff. The managers also experienced continuous development in learning new things and that became a driving force in their everyday work.

“This is the lowest management level and first-line managers are in a vulnerable position. However, even if it is a tough and challenging job, they were proud and took pleasure in it. Working with the staff and older people gave true meaning to the managers,” Heidi Hagerman concludes.


Heidi Hagerman defended her doctoral dissertation "Working Life Among First-Line Managers and Their Subordinates in Elderly Care: an Empowerment Perspective" on 7 May at Uppsala University

External reviewer: Professor Lotta Dellve

Supervisor: Professor Maria Engström, Docent Bernice Skytt och Docent Barbro Wadensten



For more information, please contact:

Heidi Hagerman, lecturer at the study programme in nursing at the University of Gävle
Phone: 073-627 25 05
E-mail: heidi.hagerman@hig.se

Text: Douglas Öhrbom
Photo: Anna Sällberg

Published by: Douglas Öhrbom Page responsible: Anders Munck Updated: 2019-08-23
Högskolan i Gävle
Box 801 76 GÄVLE
026-64 85 00 (växel)