Professional discretion and length of work experience: what findings from focus groups with care managers in elder care suggest

Abstract

Research has explored how care managers in elder care -who often function as 'street-level bureaucrats' -regard professional discretion. The way in which length of work experience affects care managers' use of professional discretion remains, however, unexplored. This article present findings from 12 focus groups with 60 care managers. By bringing attention to how care managers experience the needs assessment process, this article sheds light on how these 'street-level bureaucrats' struggle when they try to balance their clients' needs against institutional frameworks and local guidelines. Length of work experience seems to play a role in how care managers claim to use professional discretion. Experienced care managers describe how they deviate from the guidelines at times in order to create an increased scope of action in their decision-making process. Those with less time in the profession describe greater difficulties in this respect. Findings suggest that research should explore if length of work experience plays a role in the actual way in which care managers assess needs and make decisions. As such, they contribute to our understanding of how needs assessment processes are navigated by professionals while also pointing towards the nature of professional discretion in gerontological social work.

Lederskjønnets utfordringer i kommunalt barnevern: Om spenninger mellom faglig skjønn og lederskjønn

“…Det finnes studier som utforsker ledelse innen sosialt arbeid (Colby Peters, 2018;Fisher, 2009;Peters, 2017;Rank & Hutchison, 2000), men disse berører i liten grad ledernes skjønnsbruk. Til tross for at skjønn har fått økende oppmerksomhet i ledelsessammenheng (Hagebakken & Nilsen, 2017, s. 95;Olaison et al, 2018), er den forskningsmessige kunnskapen om lederskjønn i barnevernet begrenset (Kirkhaug, 2017).…”

Skjønn i praktisk barnevernledelse;Kollektiv prosess med organisatoriske begrensninger

“…I ledelseslitteraturen understrekes skjønn som en viktig egenskap ved ledelse, og det å utøve ledelse innebaerer bruk av lederskjønn (Evans, 2011;Hutzschenreuter & Kleindienst, 2013;Kakabadse et al, 2009;Kirkhaug, 2017;Shotter & Tsoukas, 2014). Som følge av økende krav om endring, sterke innslag av uforutsigbarhet, kompleksitet og dilemmaer, samt uklare referanser for beslutningene, har skjønn fått økende oppmerksomhet i lederskapssammenheng (Hagebakken & Nilsen, 2017, s. 95;Olaison et al, 2018). Ledere bruker skjønn for å ta beslutninger og for å handle i ulike organisatoriske kontekster.…”

“…Ledere med liten erfaring kan ofte oppleve at handlingsrommet er mindre enn ledere med lang erfaring (Olaison et al, 2018). Dette ser ikke ut til å stemme for barnevernslederen.…”

Assessing individual needs in Swedish elderly home care services: care managers’ argumentation in relation to the needs of migrant customers

“…The inclusion criteria for the target group then becomes unclear. Care managers with limited time for the assessment showed more insecurity and difficulties in reconciling the client's needs with the local guidelines (Olaison, Torres, and Forssell 2018).…”