Academic journal article Nordic Journal of Working Life Studies

How Do Restructuring Processes Influence Low- and Unskilled Immigrant and Nonimmigrant Workers and Their Managers in a Norwegian Hospital?

Academic journal article Nordic Journal of Working Life Studies

How Do Restructuring Processes Influence Low- and Unskilled Immigrant and Nonimmigrant Workers and Their Managers in a Norwegian Hospital?

Article excerpt


A vast amount of international research has documented that workplace restructuring, and mergers and acquisitions can have undesirable effects on the psychosocial work environment, individual health, and sick leave listing (see reviews in, e.g., Bambra et al., 2007; Egan et al., 2007; Enehaug and Thune, 2007), and several have studied the relationship between these factors among medical staff at hospitals (Bernstrøm, 2014; Burke, 2002; Mamelund et al., 2014). Prior research has also documented that low and unskilled workers and immigrants are at a higher risk of experiencing negative health consequences of restructuring than nonimmigrants and higher socioeconomic status groups. One reason for this may be that low and unskilled workers and immigrants may be more prone than nonimmigrants and higher skilled workers to apply for-and remain in-jobs where there is a higher risk of reorganization. Furthermore, they often tend to hold jobs where the risk of detrimental health consequences because of restructuring is higher (selection). Another reason may be that the lower socioeconomic status group for various reasons may be less able to cope with the stress associated with restructuring-that may lead to ill health-than the higher socioeconomic status group (causation) (Gamperiene, 2008). Prior studies have indicated that poor Norwegian language skills among immigrants may be an additional risk factor for adverse health effects associated with reorganizations (see, e.g., Enehaug, 2008; Enehaug and Widding, 2011, 2013). However, no attention has been given to the adverse health effects of work environments characterized by a climate of constant restructuring, a multicultural staff, and a strong socioeconomic occupational hierarchy. Here we study a large Norwegian hospital that displays all of these features. We use a case-study approach to analyze qualitative interview data with 23 workers and 7 managers coming from three nonmedical departments at the hospital.

The aim of the present paper is twofold: First, we examine the restructuring process among low/unskilled workers and their managers at a large Norwegian hospital in Norway, and study whether these experiences are different for immigrant workers than for nonimmigrant workers. We also study whether potential differences can be explained by poor knowledge of the Norwegian language among the immigrants, and to what extent language skills may influence the experience of the restructuring itself. By doing this we extend prior literature by studying other occupational groups working at a hospital than highly skilled doctors and nurses. Second, we investigate how the restructuring processes affect the work environment, subjective health, and sickness absence of these groups. Our qualitative data will not allow a disentangling of effects of selection from effects of causation. Based on prior studies of restructuring and health, and studies of immigrant workers' work environment, we hypothesize that work environment variables such as social support, participation, and control over work, manager availability, and communication issues may be seen as indicators of a healthy restructuring process. For analytical purposes we have included additional factors from research which documented that awareness among managers of diversity, local norms, availability, constructive conflicts, and early role clarification is important in order to create healthy organizational change processes (Saksvik and Finne, 2009; Saksvik et al., 2007).

This paper is structured in the following way. First, we present prior research on three fronts: 1) reorganizations and health outcomes; 2) indicators of a healthy restructuring process; 3) employment status and the work environment of immigrants and lowskilled workers in the Norwegian labor market. In the second part, we present our data and methods. We finally present and analyze the results before we conclude.

Prior Studies

Reorganizations and health outcomes

Research on organizational change often emphasizes the distinction between the content, the process, and the context and outcome variables (Armenakis and Bedeian, 1999), but it is also mentioned that these factors need to be seen in connection with each other (Self et al. …

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