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When Lakshmi Ramarajan worked for a non-profit organization several years ago, she noticed a high turnover rate among the employees. It wasn’t because of the work itself, but because of the organization’s management. “Employees were passionate about their jobs, but felt disrespected by their managers,” says Ramarajan. “The employees were belittled and patronized, and often publicly chastised for challenging the status-quo.” Complaints about the negative work environment “were met with inertia or rejected out of hand. Eventually a lot of employees left.”
That experience led to a research paper co-authored by Ramarajan, now a doctoral student in the Wharton management department, and Wharton management professor Sigal Barsade titled, “What Makes the Job Tough? The Influence of Organizational Respect on Burnout in Human Services.”
According to Barsade, “One of the biggest complaints employees have is they are not sufficiently recognized by their organizations for the work that they do. Respect is a component of recognition. When employees don’t feel that the organization respects and values them, they tend to experience higher levels of burnout.”
Or, as Ramarajan puts it, “it is often not the job that burns you out, but the organization.”
A Sense of Identification
While the researchers’ paper focuses on the health care industry — specifically on certified nursing assistants (CNAs) in a large, long-term care facility — their findings apply to a broader range of industries and individuals. Barsade, for example, cites a project she did for the real estate, accounting and legal departments of a large financial services agency. “The people in these departments were known as ‘non producers.’ That wasn’t their formal title, but it was what they were called because they were not revenue generators. Not only did they did not have as much power as the people who brought in the money,” but their contributions in terms of helping streamline and improve the company’s operations were not acknowledged. “This does not suggest a culture of respect,” Barsade says.
She also cites physicians allied with HMOs who are often told how many patients they must see each day, how long they can spend with the patients, and what diagnostic questions they must ask. “Doctors can’t offer customized care under these circumstances. They feel disrespected and are more prone to burnout” than doctors who work more autonomously, she suggests.
A company’s culture — which, for the purposes of the study, is defined as “the unwritten norms and values surrounding how employees are valued as individuals” — plays an important role in burnout, the researchers say. “We know that employees start identifying with an organization as soon as they join it,” says Ramarajan. “The more they feel respected as a member of the group, the more likely they are to have that sense of identification. Respect is a way in which employees get entrenched into the workplace and feel that what they do is meaningful. Conversely, if they observe that people around them are disrespected, they come to a consensus that the organization doesn’t treat people well.”
The researchers cite several ways in which the perception of organizational respect or disrespect can influence employee burnout. For example, “in situations where employees perceive that the organization does not treat employees with respect or dignity, burnout can occur from employee demoralization. Disrespected employees may need to mask their true emotional reaction regarding how their organization treats them while they assist their clients. This masking and suppressing could increase emotional exhaustion, a major component of burnout studied in the human services industry.”
Conversely, the researchers say, “individuals who feel respected by their organizations are more likely to expend effort on behalf of the organization” and are thus less likely to experience burnout.
Barsade and Ramarajan were especially interested in health care because many of the lower-level jobs in that industry tend to be difficult, and because a lot of research has been done on the industry’s burnout rate, says Barsade. “In the existing literature, there are two factors that have predicted burnout and why it occurs. The first factor is the job itself. The second is the personality of the employees, and the presence of ‘negative affectivity’ — someone’s propensity to be high energy in their negative emotions, such as anger, irritability, anxiety or frustration. It’s not that people are always feeling that way, but that they are feeling that way more so than people who have less negative affectivity. We focused on those two factors.”
Within health care, Barsade adds, the CNA job was especially interesting because the work is so hard. “There are tough physical components involved in helping patients, such as lifting them, bathing and feeding them, cleaning up after them and so forth. And there are also emotionally taxing components, such as when the CNA gets attached to a patient who dies, or when patients demand constant attention and care. So what better place to see what impact the organization has on the burnout levels of its employees and what they can do about it?” In addition, she says, burnout can affect the quality of patient care.
One approach an organization can take to try and decrease burnout and reduce turnover is to hire people who aren’t going to be stressed out by the job. That, of course, is not only difficult to predict with complete accuracy, but is often not feasible given the labor market supply. Organizations can also try to change the job to make it less demanding; but, at least in the case of CNA positions, the ability to do that is limited because of the nature of the job. A third approach — one not addressed by the existing research on burnout — is to consider the organizational culture of the company, says Barsade. “Can the values of the company — including whether you treat employees with respect or with disrespect — influence how people do their work and whether or not they will feel burned out?” Although burnout can lead to higher turnover costs in any industry, health care is especially interesting because the nature of its work is more likely to result in burnout. “As our country ages, this will become a bigger and bigger issue,” Barsade says.
In conducting their study — which looked at CNAs from 13 units across three sites of a long-term care facility during two different time periods, 2003 and 2005 — the researchers measured several aspects of participants’ jobs. Under the heading “organizational respect,” for example, participants were asked to rank how characteristic, or how uncharacteristic, the following five statements were of their organization: “Staff members respect each other;” “Staff members are treated with dignity;” “Cultural diversity of the staff is valued;” “Supervisors pay attention to staff members’ ideas,” and “Staff members are encouraged to be creative when solving problems.” These were the characteristics that a committee of senior managers and employees thought best illustrated how organizational respect would be demonstrated in their organization.
Under the heading of “autonomy,” participants were asked to respond to the following statements: “In general, how much say or influence do you feel you have in what goes on in your unit?” “Do you feel that you can influence decision-making … regarding things about which you are concerned?” “Does your supervisor ask your opinion when a problem comes up which involves your work?”
Under the heading “trait negative affectivity,” employees rated their general tendency to feel irritable, upset, nervous, afraid and guilty. “Burnout” was measured by participants’ reactions to four statements: “I feel emotionally drained from my work;” “I feel used up at the end of the workday;” “I feel fatigued when I get up in the morning and have to face another day on the job,” and “I feel burned out from my work.”
Among the study’s findings:
- Organizational respect influences burnout above and beyond the effects of job demands and negative affectivity. Because existing studies conceptualize burnout as stemming from the job or the individual, rather than the organization, “the ‘problem’ from a managerial perspective is the person,” the authors note. “Succumbing to burnout becomes a private affair of the employee, and not something of concern to the organization as a whole….This ignores the contextual sources of the problem.”
Furthermore, the researchers say, “by conceptualizing job demands as a primary cause of emotional exhaustion,” the nature of the work is seen as the culprit, rather than “the multiple sources of an employees’ work experience.” Human service jobs — such as caring for elderly sick patients or working with mentally ill individuals — may be difficult, the researchers add, but the “presumption that the demands are due to client interaction means that very little can be done about changing the negative parts of the experience.” In fact, the researchers suggest, companies can take a number of steps to change the organizational culture.
- The impact of organizational respect on burnout is felt most strongly when job autonomy is low. This finding confirms the researchers’ hypothesis going into the study about the importance of autonomy, which they define as “the discretion that one has to determine the processes and schedules involved in completing a task.” Autonomy, the researchers note, can act as a buffer on stress — and actually decrease job burnout — if autonomy is high, but not if it is low.
- The respect with which an organization treats its employees “is a pervasive organizational-level phenomenon that employees can recognize and agree upon,” the researchers note.
In addition, “respect can be a powerful signal to individuals regarding their standing not only as employees but as people…. As information comes from a variety of sources, one’s perceptions of respect and disrespect are not only based on how one views one’s own treatment, but also by how others are treated. For example, when team members see someone else on the team being treated unfairly, they alter their own perceptions of the fairness of the team. Likewise, the extent to which others, not just the self, are treated … can influence an individual’s own perceptions of respect.”
Ramarajan and Barsade carry this point further: Given the increasing importance of health care providers in aging societies, one aspect of burnout is especially crucial — the phenomenon of human service workers mentally “turning over” but remaining physically present. “In our study we found that being a longer-tenured employee was significantly correlated with higher burnout. From a managerial perspective, withdrawal behaviors are perhaps more important to human service organizations than turnover because withdrawal may be the response taken by employees who do not have high quality job alternatives,” they write.
In the worst case scenario, the researchers add, “disrespectful organizations can be left with neglected and neglectful individuals who have figured out how to cope or survive by mentally turning over while those with better job alternatives — or more commitment to their professions rather than the organization — end up leaving.”
Putting Work in a Broader Context
The authors’ research has a number of implications for managers. While it is likely, the authors note, “that disrespect is experienced across industries, disrespect for individuals may be particularly problematic in the helping professions where concern for individuals is supposedly paramount.” Because it is not just the demands of the job, or the personality of the employee, that drive burnout in human services jobs, but is also the organizational environment, “then there is a point of entry for human resource management. Good versus poor management, in the form of organizational respect, may therefore have a clear and critical role in stemming burnout in human service organizations.”
For example, Barsade suggests that HR departments make it clear they respect and value the work employees do, and recognize the difficulty of that work. “Employees understand that internally their work is very significant to how well the organization achieves its goals.” Companies like Mary Kay Inc. are based on the idea of “rewarding people to success,” she says. “Mary Kay rewards for everything. It uses respect as a powerful motivator for its sales force of independent contractors.”
Employers can also highlight to their employees how important their work is to society as a whole, Barsade adds. “Very often, caretaking work is not all that valued, but if employees in a daycare center, for example, understand that they are involved in early childhood education,” this puts their work in a broader context. In addition, she suggests that for people in jobs that don’t pay very well (and won’t in the future), managers can at least compliment employees, hold awards dinners and so forth, “just so long as these shows of respect are authentic.”
This doesn’t mean that managers “can’t look at employees’ performance, or can’t disagree with suggestions and demands that employees might put forward,” Ramarajan adds. “It just means that everything is done with an attitude of respect.” This approach won’t just make employees feel better. “It will help them stay with the organization and do a better job. So it’s not just about keeping your employees happy, but actually doing the job the organization exists to do.”
Does Ramarajan think employees would be surprised to learn that job burnout is not always “their fault,” but can also reflect the way the organization treats them? “I don’t think employees would be surprised, but I do think managers and/or corporate executives might be. And I think employees would be surprised to find out how widely shared this experience is.”