Social Capital and Sustainable Work: Evidence from Nursery Schools to Nursing Homes

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Social Capital and Sustainable Work Evidence
from Nursery Schools to Nursing Homes

• Carrie Leana
• University of Pittsburgh
• Center for Health and Care Work
• www.business.pitt.edu/chcw/

CMU Tepper September 10,2010
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Recent and On-Going Research

• Contexts with important policy public
  implications
• Childcare centers
• Public schools
• Special education classrooms
• Nursing homes
• In each, organizational performance has
  important implications for the larger society
• In each, social capital is a real but
  under-utilized resource

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What is Social Capital?

• Nature and Accessibility of Resources Embedded in
  Relationships
• Multi-Faceted Construct
• Structural (pattern of connections)
• Relational (quality of relationships, e.g.,
  trust)
• Cognitive (shared meanings and goals)
• Multi-Level Theorizing
• Categorical (attributes of/effects on individual)
• Compositional (attributes of/effects on
  collective)

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What Makes Work Sustainable?

• Sustainability for the Individual Worker
• Living wage and benefits
• Personal meaning and efficacy
• Growth and development
• Sustainability for the Organization
• Performance
• Efficient and effective use of resources
• Sustainability for the Larger Society
• Human capital development
• Social capital development
• Economic development

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Recent and On-Going Projects

• Work process and quality of care in early
  childhood education. Academy of Management
  Journal, 2009 (with Eileen Appelbaum Iryna
  Shevchuk).
• Crafting work in context Social and structural
  moderators of task context on role performance
  among special education teachers. 2010 (with
  Brenda Ghitulescu).
• Applying organizational research to public school
  reform The effects of teacher human and social
  capital on student performance. Academy of
  Management Journal, 2009 (with Frits Pil) and
  on-going work.
• A dual driver model of retention and turnover in
  the direct care workforce. The Gerontologist,
  2010 (with Vikas Mittal Jules Rosen) and
  on-going work.

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Childcare Work

• Critical to economic and societal sustainability
• As currently organized in the US, childcare
  system is not sustainable
• For Individual Workers
• Low pay low status poor coordination
• For Organizations Providing Childcare Services
• Increased regulatory oversight but with little
  attention to the uniqueness of the work (K-5
  dream)
• Improving teacher human capital may not be enough
• For Society
• Spotty access and quality, despite clear evidence
  of benefits

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Building Social Capital Through Job Crafting

• Job crafting is the active role that individuals
  play in altering the boundaries of their jobs
  shaping work practice
• Employee (vs. management) initiated
• Informal (vs. part of formal job description)
• Reflects employees efforts to make the job a
  better fit to her own preferences and
  competencies
• Individual Job Crafting Individual making
  changes
• Collaborative Job Crafting Working together to
  make changes (e.g., communities of practice)
• Effects on performance and work outcomes?
• Task/process dependent

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Methods

• 79 Childcare Centers in PA and NJ
• 32 for-profit 11 Head Start
• 80 state subsidized for low-income children
• 232 Classroom Staff (146 teachers 86 teacher
  aides)
• On-site surveys in 3- 4-yr. old classrooms
• 95 women ave. age38 ave. exp.4.8 yrs.
• Parallel survey measures of individual
  collaborative crafting
• Outside performance assessment by trained
  observers

With Eileen Appelbaum Iryna Shevchuk
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Predictors of Job Crafting

• Individual job crafting
• () Discretion
• () Career orientation
• () Status

• Collaborative job crafting
• () Discretion
• () Interdependence
• () Supportive supervision
• () Social ties with peers

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Job Crafting and Work Outcomes

• For Workers
• Job satisfaction
• () Wages
• () Collaborative crafting
  (1 sd 13 rise)
• (-) Individual job crafting
• Organizational Commitment
• () Wages
• () Collaborative crafting (1 sd 21 rise)

• For Organizations
• Performance
• () Wages
• () Collaborative crafting
• Experience x collaborative crafting
• Turnover intentions
• (-) Wages
• (-) Collaborative crafting
• Quality of care x collaborative crafting

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Joint Effects of Teacher Experience and
Collaborative Job Crafting on Quality of Childcare
17 increase
7 increase
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Joint Effects of Quality of Childcare and
Collaborative Job Crafting on Turnover Intentions
14 decrease
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How can childcare work be better managed?

• Regulatory oversight must consider uniqueness of
  the work (and NOT assume K-5 education model will
  fit)
• Collaborative job crafting changes work process
  and job boundaries
• Essential to quality of care and maintaining
  quality workers
• Deliberately informal and invisible
• Better performance, stronger commitment
• Dilemma How to manage the invisible?

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Work as a Teacher in Urban Public Schools

• Critical to economic and societal sustainability
• As currently organized in the US, public school
  system is not sustainable
• For Teachers
• Low morale poor collaboration stressful work
• For Schools
• Strong public oversight but with little attention
  to the relational aspects of the work
• Improving teacher human capital will not be
  enough
• For Society
• Poor quality (by 5th grade, 40 of children lack
  basic proficiency 50 dont graduate high school
  with cohort)

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Explanations for Success/ Failure in Public
Schools

• Structural explanation Poverty
• Process explanations
• Why are some teachers better than others?
• Human Capital Superior skill, training, and
  professional development of teachers lead to
  better student outcomes
• Social Capital Individual connections to others
  lead to better outcomes
• Why are some schools better than others?
• Human Capital Unique skill bundles and
  contextualized learning lead to better
  performance
• Social Capital
• Information exchange, trust, and common goals
  facilitate coordinated action, resource
  accumulation and positive risk taking

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Linking Teacher Human and Social Capital in
Schools
Human Capital
Low
High
Limited capacity to absorb or exchange knowledge (low learning condition) Knowledge absorbed but not exchanged
Knowledge exchanged but of low or uneven quality Knowledge absorbed and exchanged (high learning condition)
Low
Social Capital
High
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Methods

• Nested Data Structure
• 24,187 student (4th 5th grade)
• 1,013 teachers (4th 5th grade)
• 239 teacher teams (4th 5th grade)
• Human Capital Measures
• Experience
• Ability to teach math (measures by Ball, et al.)
• Social Capital Measures
• Horizontal Ties strength of ties with peers
  (frequency closeness)
• Vertical Ties Strength of ties with Principal
• Instrumental Ties (Who do you talk to about
  math?)
• Outcome Measures
• Change in student achievement scores in math

With Frits Pil
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Human Capital Measures Assessment of Teachers
Ability to Teach Math

• SAMPLE ITEM
• Takeems teacher asks him to make a drawing to
  compare 3/4 and 5/6. He draws the following
• and claims that 3/4 and 5/6 are the same amount.
  
• What is the most likely explanation for Takeems
  answer? (Mark ONE.)
• Takeem is noticing that each figure leaves one
  square unshaded.
• Takeem has not yet learned the procedure for
  finding common denominators.
• Takeem is adding 2 to both the numerator and
  denominator of 3/4, and he sees that that equals
  5/6 .
• All of the above are equally likely.

Based on University of Michigan Learning Math
for Teaching Project (Hill, Shilling Ball,
2004)
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Summary of Significant Predictors of Growth in
Math Achievement
Student
Performance in previous year
Special Ed. Enrollment -
Low SES -
Student Attendance
Teacher
Human Capital Experience
Human Capital Ability
Team
Social Capital Horizontal Ties
Social Capital Vertical Ties
Cross-Level Teacher x Team Interactions
Teacher Ability x Team Horizontal Ties
Teacher Ability x Team Vertical Ties -
Student Characteristics
Teacher Human Capital
Team Social Capital
Teacher Human Capital Combined With Team Social
Capital
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Joint Effects of Teacher Ability and Team
Horizontal Ties
Highest payoff on horizontal social capital
Teachers with strong human capital
Teacher Human Capital
Gains in Student Achievement in Math
Ties Among Teachers in Team
Horizontal Social Capital
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Joint Effects of Teacher Ability and Team
Vertical Ties
Teacher Human Capital
Gains in Student Achievement in Math
Highest payoff on vertical social capital
Teachers with weak human capital
Team Ties with Principal
Vertical Social Capital
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How Can Public Schools be Better Managed?

• Team Context Matters
• For high-ability teachers, strong team
  interaction results in higher student achievement
  gains in math.
• For low-ability teachers, interaction between
  team members and principal results in higher
  student achievement gains in math.
• Conclusions
• Talk must be centered on teaching math
• Interaction must be both frequent and close
• Principal should concentrate their interactions
  on low-ability teachers (and leave high-ability
  teachers alone).
• BUT high-ability teachers need to be in teams
  with time and space to interact to be most
  effective.

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Work as a nursing aide

• Critical to economic and societal sustainability
• As currently organized in the US, eldercare
  system is not sustainable
• For Individual Workers
• Low pay low status poor collaboration
  stressful work
• For Organizations Providing Services
• Strong regulatory oversight but with little
  attention to the relational aspects of the work
• Improving worker human capital will not be enough
• For Society
• Poor quality and unstable workforce

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Building Social Capital Through Client
Relationships

• Why do people stay in such difficult jobs?
• Collaborative job crafting and social capital
• But with clients/patients rather than peers
• Patient advocates
• Close bonds
• Sense of calling
• Shared religiosity/spirituality
• Shared identity

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Methods

• Data Collection
• Observation
• Focus groups
• Intensive interviews
• Analyses
• Qualitative analysis of transcripts
• Quantitative stance analysis (looking for
  emotional hot spots)
• Demographics
• Gender almost all female
• Ethnicity 60 White 34 African-American
• Age 65 40 years
• Family status 69 Single 40 dependent children
• Education 22 high school grads 62 some
  post-HS training 13 college grads
• Work Experience
• 83 work in nursing homes
• 83 work full-time
• 93 certified in field (e.g., CNA)

With Jules Rosen, Vikas Mittal Emily Stiehl
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Findings Why do people leave these jobs?

• Because of the lack of respect for their work
• By management and other staff
• By the larger society
• Because the work is managed so poorly
• Because they are given too much work

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Why do People Leave?

• Lack of respect
• Administrators were very rude to the aides.
  They treated us horribly.
• Id like it if there was more respect for aides.
  Doctors and nurses should treat us like a partner
  and rely upon our knowledge of the patients.
• Theres not really shame in it, but a lot of
  peoplewhen you say what you dotheyre like,
  Oh, you wipe butts for a living. Youre a
  professional butt wiper. Thats how people look
  at it.
• Bad management
• They would hire anybody to be a manager.
• I worked in assisted living . . .that place was
  so chaotic no one would come in and run it. One
  time we came in there was all workers, wasnt no
  administrators in there. I mean, it was really
  bad for the residents.
• Over-work
• I feel like Im doing two peoples work.
• I struggled to give good care to my patients. I
  was just given too many patients.

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More Intriguing FindingsWhy do people stay in
these jobs?

• Because they are called to help others
• Because they are advocates for patients
• Because they have close personal relationships
  with residents and families
• Because of they share religion/spirituality with
  patients
• Because they can relate to patients hardship

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Why do people Stay?

• Being called
• I get a lot of satisfaction from my work and a
  lot of peace knowing that Im doing good for
  others.
• I really appreciate the thank yous, the I
  love yous and the gratitude. I feel like Ive
  really contributed and accomplished something.
• Well, Ive come out of the job actually very sad
  at times and wanting to leave and thinking its
  too much. But then I go back because I have so
  much in common with them and I feel that Im
  really good for patients.
• Patient advocacy
• Pretty soon, youre part of the residents
  lives, and you dont want to stay for overtime
  when youre mandated, but you do because whos
  going to take care of them?
• When someone dies, youre their last support.
  Patients shouldnt die alone. There should be
  more support.
• A lot of people dont respect the elderly. My
  residents deserve respect.

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Why do People Stay?

• Relationships with residents
• I enjoy taking care of elderly that doesnt have
  family, and you get involved in them. You do
  start after a while, you start loving them.
• I want to be the one thats interacting with the
  residents and, you know, being able to come in
  their room and make them smile and make them
  happy.
• Shared religion/spirituality
• You go in and pray with these people and talk
  more openly about spiritual things . . . Theyre
  more open to it at that point, and I enjoy that.
• I pray a lot. Through my job, as well as
  otherwise. . . it gets me through the night
  shift.
• A strong faith and my Christian background is
  absolutely essential.
• Shared identity of hardship
• When I go to work Im actually in a better mood
  than I am at home because I have to be. I mean
  theres days I dont want to go home.
• Im humbled by my job when I see my patients go
  through very difficult things. It helps me deal
  with my own life.

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Other Intriguing Findings

• 1. High turnover workers engage in more
• Depersonalization
• Some people, those people vs. my residents
• Polarization
• Lazy nurses, bad administrators, whining
  residents
• Credential comparisons
• Frequent reference to titles
• Tendency to talk about nursing as a possible job
  while at the same time expressing resentment of
  nurses

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Other Intriguing Findings

• 2. Aides informally customize their work Both
  expanding and contracting job scope

Expanding Scope of Job Contracting
Scope of Job
Job Facet
Enhanced medical care (LPN work) Cleaning rooms, linens, etc. Work arounds lifting alone Shortcuts bathing hand washing
Extra touching hugging holding hands Respect Distancing emotionally from residents Answering patient needs only not patient wants
Reframing Were the real experts Recalibrating work is special selfless Refocusing Actively downplay negative and emphasize positive
Seeing oneself as family member Providing spiritual counseling Me vs. them (nurses administrators residents)
Tasks Emotions Cognitions Relationships
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Collaborative Job Crafting

• Ive changed everything for myself. But when the
  supervisor finds out who trained me, they frown
  upon it. But its like, mines more efficient,
  but theyre not willing to change.
• When the state comes aroundyou know how you
  cant mix food, but some residents wont eat
  unless some stuffs mixed. We have a women who
  wont eat her food without something sweet in
  it. Yep, if theres no ice cream in that, like,
  pureed meat, she wont touch it. But you cant
  do that. Thatd break the rules. So, but thats
  not the only thing thats modified usually, Id
  imagine. I know Im not the only one that does
  it.

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Other Intriguing Findings

• 3. Do we take advantage of people conditioned to
  hardship by encouraging them to play the role of
  Super-woman?
• Isnt it amazing, you know, as women, what we can
  deal with on a day-to-day basis?
• Ive never left a job without a job because Ive
  always had to be the responsible one because Im
  the one that takes care of everything.
• I have three kids. I sleep when theyre at
  school.
• My son calls me at 1015 and tells me, . . . Im
  moving to Florida on the first of June. So
  then, you know, you go to work at 11 oclock,
  youve been crying for 45 minutes. . . and you
  have to walk in the door and act like nothings
  going on.
• After my son died when I first went back to
  work, I wanted to quit. I hated it because you
  cant go through something like that and then try
  to go take care of older people. That dont
  make sense when youve lost somebody young and
  healthy. And then my husband said, No, dont
  quit, just give it some time. And I did.

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How can Health Aide Work be Better Managed?

• Management and regulatory oversight should
  consider relational aspects of the work (NOT
  assume medical outcomes are the only important
  ones)
• Dignity
• Essential to staunching turnover
• Social capital/ Collaborative crafting
• Essential to retention
• Quality care means relational care
• Dilemma Multi-level change

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What Have We Learned About Social Capital and
Sustainable Work?

• In Nursery School collaborative job crafting
• In Public Schools team collaboration
• In Nursing Homes collaborative client care
• Overall
• Organizational effectiveness is not attained
  through human capital alone
• Policy-makers and practitioners continue to
  under-value social capital
• Systems to manage critical societal functions
  (e.g., education, eldercare) continue to be
  unsustainable

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What Is To Be Done?

• Valuing the work and its larger contribution to
  society
• Public subsidies
• Higher standards
• Enhanced status
• Building more effective models of work
  organization
• Human capital
• Social capital
• Work design and coordination

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Integrated (and Mutually Reinforcing) Change