Individuals performed low-level jobs (that is, jobs with low prestige, low salaries, and a narrow range of required skills and duties), on the other hand, are generally not satisfied with their jobs and would welcome an increased range of responsibilities. Thus the concept of an universal healthcare worker is especially relevant in a medical context in which a very high degree of the care is provided by personnel who are neither doctors or nurses. Such a locale that is ideal for the insertion of a universal healthcare worker is a long-term care facility.

Increasing the job satisfaction of workers in long-term care facilities is especially important because such facilities experience very high turnover rates. This is expensive for the institution, stressful on the workers, and traumatic for the patients.

While some assisted living facilities still operate within this model the industry as a whole is moving toward a more "holistic" approach to care in which the "universal worker" attends to all the daily living needs of their residents: assistance with ADLs, meal service, light housekeeping, laundry, programming, etc. Rather than dealing with four or five different people to have their needs met, residents are able to relate to one or two staff members who actually know them and are familiar with their needs, their routines, their likes and dislikes. The result is care that is more personal, customized and consistent.

The "universal worker" approach also seems to enhance job satisfaction. In Manor HealthCare's Arden Courts: Alzheimer's Assisted Living facilities, we've had feedback from staff who tell us that they enjoy the feeling of being responsible for the resident "as a whole" rather than for only one aspect of their care. It is a feeling that undoubtedly enhances the caregiver's sense of "job importance." Whether this greater job satisfaction leads to reduced turnover remains to be seen. (Widdes, 1996)

The above paints a very rosy set of consequences for the introduction of the universal worker into healthcare settings....

However, there are also serious criticisms of this movement, which tends to question the motivation of healthcare organizations toward this shift.
Criticism of the model

Assigning an increased number of tasks to the workers in an organization who are paid the least, such critics argue, is a recipe for a degradation of patient care with increased worker frustration (as they have to try to accomplish jobs for which they are not trained). The following summarizes this line of criticism:

In homelike culture change models, the universal worker has basic dietary, nursing, housekeeping, and activity responsibilities. Despite its unflattering "jack of all trades" moniker, the job class in theory creates consistent assignment, meaning residents see the same caregiver every day because that person is doing everything.

"I fear that we will abolish the field of therapeutic activities and recreation in long-term care based on the assumption that uncertified, unqualified individuals can facilitate meaningful activities," Grandal said in an interview with a fellow Long-Term Living blogger. (Kolus, 2010)

Both viewpoints have merit: There is no reason that workers in healthcare settings such as long-term care facilities cannot take on additional facilities in some cases. But this is the case only if all of the workers -- both those who are universal workers and everyone else in the same workplace -- are properly educated and trained for their new positions. There must also be safeguards put into place so that there is no possibility that the workers who are provided with the least compensation are not exploited.