Hierarchical resistances to occupational health interventions: a case of the workers of a diurnal hospital of Montevideo

Abstract

Introduction: the topic of this research is the approach to the barriers for the implementation of an intervention to modify the behavior of workers in the outpatient Oncology Unit. At the request of the university authorities a study of the conditions and environment of the workplace was performed. Some of the issues found were as follows: a thermos and mate (herbal tea infusion typical of Uruguay) were found inside a laminar air flow chamber; there was a lack of signalization and emergency shower and eyewash station. There were no procedures protocols for the handling of cytostatic drugs, waste disposal, work accident response or the consumption of food. Objectives: To carry out a health education intervention to train workers on the proper handling of cytostatic drugs. Material and method: The proposal is to create an intervention program involving the workers with the aim of defining the needs perceived by workers, identify critical problems and design solutions. Results: From the interviews, the need for occupational health trainers, the creation of education material regarding good work place habits and improving the infrastructure of the Oncological outpatient unit, became evident. Permission to carry out the intervention was contingent upon the approval of the Director of oncology services. The approval was given and a coordinating delegate was named. The first intervention had three participants, the second, one participant, and the third was canceled. Conclusions: The research was not possible because the organization showed resistance of the participants and of the whole hierarchical line of the organization. Resistance to change was expressed in terms of communication difficulties. There was a lack of clear objectives and standards, skepticism about the possibility of changing workplace behavior, with strong inertia in behavior and discourses justifying inertia.