Supervisors as Aids and Obstacles to Upward Mobility in the Healthcare Sector

In this dissertation, I examine how supervisors affect the mobility prospects of frontline workers in the healthcare industry. Using data from interviews and focus groups conducted in the late 2000s with 77 supervisors in seven hospital sites in the United States, I look at how supervisors responded to a workforce development program aimed at helping low-wage, frontline workers gain job skills and opportunities for career advancement. I found that some supervisors praised the program and aided workers who participated, while others criticized the program and gave little help to workers who participated. I explain this difference by reference to supervisors' desires to protect their feelings of job-related competence. When the workforce development program involved supervisors in the planning phase, when it did not strain their already limited resources, and when it gave them roles as teachers, mentors, and coaches, they felt more competent as supervisors and supported the program. When the program excluded supervisors during the planning phase, when it reduced their staff resources and made it harder to meet productivity demands, and when it gave them no clear roles to play, their feelings of job-related competence were threatened and they did not support the program. I also examine how supervisors accounted for the failures of their workers to perform well and to succeed in the workforce development program. I show how supervisors drew on cultural discourses of colorblind racism and neoliberalism to deflect blame from economic and organizational structures onto workers. This study adds to our understanding of how self-concept motives matter for acceptance of and resistance to organizational change, and of how these motives are implicated in behaviors that can affect the mobility prospects of low-wage workers.