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Role Ambiguity as a Part of Nursing Home Life

Published November 21, 2007 11:14 AM by Brian Garavaglia

An interesting part of working in long-term care, if for that matter any form of health care, is that it is never static and the roles that worked for you one day may not be the ones that will work for you the next day. Most of us seek stability and we often fear change that is rapid. Furthermore, we also seek roles that are clearly defined. 

Health care, and in particular long-term care, does not lend itself to extreme predictability day in and day out. Role ambiguity happens when the roles that we hold are often ill-defined, lack an enduring stability, and have less than the clear and predictable patterns that we often seek in our job statuses. In fact, role ambiguity has been found as one of the leading factors in job burnout, especially among nurses.

However, one entering long-term care has to realize that although job descriptions exist, these descriptions can never be carved in stone. Other professions can rely on job descriptions and roles holding greater predictability, but in health care, with emergency situations constantly arising, role adaptation is the key to success. Administrators, director's of nursing, as well as all other facility staff never know when they may have to respond to an urgent situation, have surveyors come in and start looking over one's shoulder, have to address a difficult problem with a family member that walks into the office, report a cause of abuse or neglect and institute an investigation, as well as a myriad of other factors that suddenly need to be addressed, in addition to their regular daily duties. 

Fortunately or unfortunately these daily unpredictable patterns that do not conform to the stereotypic job description do cause disruptions and ambiguity in the lives of long-term care professionals. No one is exempt, from administrator to line staff. In addition, with what often appears to be daily changes in Medicare, Medicaid, private insurances, as well as state and federal regulations, the lack of predictability and the increase in ambiguity appears at times insurmountable. So how can we deal with it?

First and foremost, those in long-term care must not enter the profession thinking job descriptions are fixed.  In a perfect world all of us would love this. However, when dealing with human beings that are often quite ill, the exigency of any situation often overrides our comfort zones of predictability. Learning to anticipate quick change, being aware that quick change is part of the normal roles of nursing home professionals, and embracing the challenges, and at times the volatility, of change that this environment holds can prepare use to deal with the lack of predictability and role ambiguity with greater comfort. 

Again, all of us often prefer predictability, but given that ours is a profession that often lacks that comfort zone, many of use can deal with it by accepting and embracing the daily changes that are found in our industry. By doing this we will not abate the role ambiguity, but we will prepare ourselves when it does happen-to act proactively and not in a manner that creates unendurable stress or panic reactions. Please share your thoughts and tell me what you think.             


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About this Blog

    Brian Garavaglia, PhD
    Occupation: Long-term care administrator
    Setting: Sterling Heights, Mich.
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