• Elisabeth Häggström, Kirsti Skovdahl, Birgitta Fläckman, Annika Larsson Kihlgren, and Mona Kihlgren.
• University of Gävle, Gävle, and Neurotec-Department, Karolinska Institutet, Stockholm, Sweden. elisabet.haggstrom@hig.se
• J Clin Nurs. 2004 Sep 1;13(6):687-96.

BackgroundIn Sweden and internationally, little research has focused on the working situation of Enrolled Nurses and Nurses' Aides who form the majority of workers in geriatric care today. With this in mind, it is important to focus on how these occupational groups experience their working situation with older residents in municipal care.Aims And ObjectivesThe aim of the study was to investigate the deeper meaning of work satisfaction and work dissatisfaction at a newly opened nursing home for older residents. The study focused on the narratives supplied by the caregivers at the nursing home. The participants included: one Registered Nurse, sixteen Enrolled Nurses, and three Nurses' Aides. All were directly involved in patient care.DesignThe present study is part of a larger longitudinal study within the municipal geriatric care system in Sweden, with a quasi-experimental design.MethodThe interviews were analysed with a phenomenological-hermeneutic method inspired by the philosophy of Ricoeur.ResultThe caregivers experiences of work satisfaction and work dissatisfaction was expressed in four themes: (i) 'Experience of betrayal' describes how the staff felt let down in several ways; (ii) 'Experience of failing others' describes how the staff felt that they did not pay enough attention to older people, in several different ways; (iii) 'Experience of insufficiency' describes how the staff encountered overwhelming demands from several directions; (iv) 'Experience of work satisfaction' describes how the staff felt that they were given support in various ways. Each theme emerged from several subthemes that originated from the caregivers' narratives.ConclusionsThe study shows that the caregivers' experience of work dissatisfaction overshadows their experience of work satisfaction. It also suggests that their feelings of failing the older residents are connected to their own experiences of feeling betrayed.Relevance To Clinical PracticeThe findings can be used when other nursing homes in municipal care are opened, as a means of preventing work dissatisfaction and increasing work satisfaction among future employees.

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