Labor conditions and the meanings of nursing work in Barcelona

ABSTRACT Objective: to analyze the relationship between the quantitative assessment of working conditions and the qualitative perception of one’s own work experience. Method: a sample of 1,760 nursing professionals from Barcelona answered a questionnaire assessing their working conditions and summarized their own current work experience in five key words. Results: the textual corpus of the meanings of nursing work included 8043 lexical forms, which were categorized and codified. Respondents who rated their work conditions the highest expressed a vision of their work in terms of autonomy, achievement and well-being, while those who rated their work conditions the lowest talked mostly of exhaustion, depersonalization and negative climate. A correspondence analysis showed a close relationship between the quantitative assessments of working conditions and the verbal codes of the meaning of work. Conclusions: the meanings given to work were not only consistent with the numerical evaluations of the working conditions but also made them more understandable. The information obtained poses challenges for reflection and indicates ways to promote the positive aspects and prevent the negative conditions of nursing work.


Introduction
The working conditions of health professionals, and particularly those of nursing professionals, have undergone profound changes in light of the general changes in the world of work. The scientific literature has analyzed the impact of working conditions on wellbeing and professional performance, as well as their multiple side effects on occupational health and the quality of the service provided. These effects appear as a negative spiral of care pressure, staff shortage, task overload, time deficit to execute everything and to do so well, distress and burnout, absenteeism and presentism, rotation and abandonment of the workplace and profession (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11) . The role of moderating variables in some of these effects, such as control of process and work content, horizontal and vertical social support, degree of adjustment between demands and labor resources, and the work-family balance or emotional load, has also been studied (12)(13)(14)(15) . Some research reports the economic and human cost of the lack of prevention of psychosocial risks in work in general and particularly in health care services (16)(17)(18) .
Another important topic of contemporary research in this field is the dynamics by which people give meaning and significance to their work in different sociocultural and organizational contexts and the role these cognitive processes play not only in shaping work experience but also in how professional practice is carried out (19)(20)(21)(22)(23) .
In this regard, psycho-sociological theories about the meaning of working argue that the meanings that people ascribe to their work do not derive only from immediate situations, contexts and conjunctures but also from a complex construction process involving values, ideals, goals, norms, rhetoric, strategies, beliefs, aspirations and sociocultural and personal expectations about work, profession and career.
In recent decades, the development of the nursing profession has followed a paradoxical development at and Doctorate) of nursing as an autonomous discipline and the development of the profession in the areas of assistance, teaching, research and management (24) .
In contrast to this positive trend, the conditions of application of this work potential evolved in the opposite direction in a series of organizational aspects. The initial situation was marked by a high ratio of patients per professional, well above the European average, which already entails a high care pressure. On this basis, a new organization and business management of health care work was implemented in recent decades, reinforced by certain policies to cope with the recent economic crisis.
In this context, the imposition of measures to reduce the public deficit, especially the health budget, entailed reduced staffing levels and increased annual work  In Table 2
While the numbers presented indicate the relative levels of satisfaction for the conditions of nursing work in the social and organizational environment studied, the codes of meaning associated with them give names to the aspects of those conditions that need to be strengthened and those that need to be modified.
Overall, the study contains some notable weaknesses and strengths. Among its methodological limitations is the use of self-report measures within the framework of a cross-sectional design, which in turn did not allow for causal inferences. However, none of these characteristics hampered the achievement of