Being there or being competent? How co-worker support contributes to unit performance.

Abstract

In this dissertation, I address three gaps in the workplace social support literature that has demonstrated the consequential nature of perceived workplace support. First, a relationship between social support and organizational performance has been implied, but not directly tested. Second, it challenges an implicit and limiting assumption of this research stream that social support is important to the degree that it keeps a person in their work role (through reduced turnover), rather than by influencing how competently that person actually does their work. Finally, while there is evidence for the importance of perceptions that support is readily available within the workplace, researchers know little about the development of these perceptions. I address these gaps through two complementary research methods in the context of nursing homes. In the first study, I develop and test a resource and competence-based theoretical model of co-worker support and unit-level performance in long-term care organizations, which proposes that perceived co-worker support generates three key psychological, emotional, and social resources---namely, self-efficacy, gratitude, and trust---which in turn are positively related to competent work behaviors (perseverance and collaboration) that positively impact quality of care outcomes. I test this model using survey data from nurse aides and unit managers from 25 units in across 6 nursing homes and through a combination of structural equation modeling and means comparisons. These findings provide general support for the model, with all hypothesized relationships but the one between trust and collaboration supported. Through the ethnographic study, I both elaborate some of the constructs proposed in the theoretical model and provide a situated view of the development of perceived co-worker support. These ethnographic findings reveal a range of challenges facing nurse aides and the competence with which they are overcome. These findings also suggest that it is the support that the nurse aides provide each other in the face of resident death that may lead to general perceptions of support availability. Taken together, the findings of the survey and ethnography illuminate the antecedents and organizational performance implications of perceived co-worker support, as we'll as resource and competence mechanisms that link the two.