We are at Full Capacity”: Social care workers persisting through work-related stress in a new immigrant settlement context in the United States

Abstract

Cities without a prior established history of Latina/o migration are experiencing the fastest rate of growth in new immigrants in the United States (Wainer, A tale of two cities (and a town): Immigrants in the Rust Belt, 2013; Lichter & Johnson, Immigrant gateways and Hispanic migration to new destinations. International Migration Review, 43, 496, 2009). These new immigrant settlement cities experience the challenge of adapting their social care context to become more responsive to the needs of immigrants. Yet as cities and social care organisations struggle to keep up with the “lag” time in the availability of culturally and linguistically responsive resources and services, social care providers often work in conditions of scarcity in a social care context that is often lacking in its ability to fully respond to the needs of immigrants. Literature indicates that such conditions of scarcity can lead to work related stress, burn-out, and can have a negative impact on the quality of services delivered by social care workers. Yet little is known regarding social care providers’ motivations and responses to work stress; and how providers may positively respond and persist in their jobs despite such stressors. This study conducted in the new immigrant settlement city of Baltimore from 2014 to 2016, utilises semi-structured interviews to qualitatively explore the personal motivational beliefs, workplace and demographic factors associated with buffering stress and frustration among social care workers in a new immigrant settlement city (N = 29). Findings highlight important motivational and work-related factors that appear to minimise the impact of stress and frustration for social care providers and can be used in the development of burn-out interventions as well as improving quality of services for vulnerable populations such as, immigrants, especially in low-resource new immigrant settlement contexts.

1 ∣. INTRODUCTION

In the United States, a trend in migration is emerging whereby cities without a prior established history of Latina/o migration are experiencing the fastest rate of growth in new immigrants (Lichter & Johnson, 2009; Wainer, 2013). Specifically, these non-traditional immigrant settlement cities or new immigrant destination cities have seen an average of 100% versus 32% growth in Latina/o population when compared to traditional immigrant destination cities (e.g., cities in California, Arizona, Texas; Johnson & Lichter, 2016). New immigrant settlement cities must then contend with keeping up with a changing social care dynamic that is responsive to the needs of an immigrant population. As cities and social care organisations struggle to keep up with the “lag” time in the availability of linguistically and culturally appropriate resources for their new immigrant population, social care providers often have to work under conditions of scarcity and a structure of social services that is lacking in its ability to fully respond to the social service needs of Latina/o immigrants (Negi, Maskell, Goodman, Hooper, & Roberts, 2017). Yet, in such new immigrant destination contexts, without an established community and network of immigrants, the role of social care workers is even more critical in providing support, and comfort as well as assisting recent immigrants’ navigation of complex American bureaucracy and available services (Negi, Cepeda, & Valdez, 2013). Multiple studies conducted in a variety of social care settings in the United States, United Kingdom and Australia indicate that conditions of scarcity can lead to work related stress, burn-out, and have a deleterious impact on the quality of services delivered by social care workers (Judd, Dorozenko, & Breen, 2017; Quevillon, Gray, Erickson, Gonzalez, & Jacobs, 2016; Teran, Fuentes, Atallah, & Yang, 2017; Verdinelli & Biever, 2009). Much of the literature has focused on examining the causes of work stress and burnout in social care (Ahern, Sadler, Lamb, & Gariglietti, 2017; Bowden, Smith, Worker, & Boxall, 2014; Tartakovsky & Walsh, 2016), however, few focus on social care providers’ motivations and responses to work stress; and how providers positively respond and persist in their jobs despite such stressors (Lloyd, King, & Chenoweth, 2002; Maslach, Schaufeli, & Leiter, 2001; Moore et al., 2017). This gap is especially significant as many social care workers not only persevere, but thrive in their work despite challenges (Mandell, Stalker, de Zeeuw, Wright, Frensch, & Harvey, 2013). Such strengths based information regarding the wide range of work-related stressors as well as associated coping responses among social care workers, particularly in new immigrant settlement cities, can then be instructive in promoting job satisfaction, decreasing burnout and ultimately, providing better care for recent immigrants (Dombo & Gray, 2013).

In Baltimore, a new immigrant destination city, the Latina/o population has more than doubled between 2000 and 2015 (U.S. Census Bureau, 2016). Latina/o immigrants are one of the only increasing demographic groups in a city that has experienced significant population loss—with rates recently hitting the lowest in a century (Sherman, 2017). While recent national political rhetoric has become increasingly anti-immigrant, Baltimore is a “welcoming city” for immigrants and has credited immigrants with assisting with the revitalisation of many of Baltimore's impoverished neighbourhoods (Wenger, 2016). Despite such actions by the city, the majority of Latina/o immigrants in the city continue to have limited access to social and health services. A survey conducted by the Baltimore City Health Department (2011; 2014) indicated that Latina/o respondents had a much higher risk of being uninsured compared to their White and Black counterparts. In fact, a Health of Latinos Survey conducted in Baltimore in 2011 indicated that as many as 75% of respondents did not have any health insurance in the last 12 months. Additionally, 84% of adult Latina/os in the city reported speaking only or mostly Spanish and 68% read only in Spanish, while as many as 41% reported not seeking health related services because providers do not speak Spanish (Baltimore City Health Department, 2011). This is compelling as bilingual service providers and Spanish written materials in Baltimore are sparse, much like in other new immigrant settlement cities, indicating not only a large gap in meeting the needs of the city's monolingual families but also the heavy client burden on the few existing Spanish-speaking providers who must take on the role of language and cultural brokers in the absence of a robust immigrant-responsive social care infrastructure (Negi et al., 2017). The current qualitative study aims to explore how social care providers in a new immigrant settlement city, Baltimore, persist and engage in their work in a constrained and under-resourced social care environment.

Bilingual social care providers have been found to experience, even within traditional immigrant settlement cities, additive and unique challenges in providing services to clients who have a native language other than English. Numerous studies have found bilingual social care providers experience higher workloads associated with their bilingual skills, their role as cultural brokers, and work to connect clients with existing and often sparse resources, and advocacy efforts to meet the linguistic and cultural needs of clients within their own organisations (Teran et al., 2017). Contributing factors of job stress for bilingual social care providers include extra work (such as, translating for other staff) due to lack of bilingual staff; supervisors’ pressure to serve as cultural brokers even when they may not have the same cultural background as clients; requests to provide Spanish-language services with very little guidance or support (Verdinelli & Biever, 2009). Studies suggest that low resources and the lack of an adequate social infrastructure to refer immigrant clients to can act as a source of stress, be emotionally taxing and lead to burnout and attrition (Jones et al., 2015). However, little is known regarding how social care workers in low-resource contexts may persist and thrive in their work.

Previous studies suggest that the stressors experienced in social care settings may be moderated by the rewards of work. A study of child protection workers in Colorado found that half of their sample (N = 363) reported very high to high levels of compassion fatigue, yet a majority reported low levels of burnout. The authors postulated that this lack of association could have been moderated by the protective effects of compassion satisfaction as 70% of their sample reported high levels of compassion satisfaction (Sorenson, Bolick, Wright, & Hamilton, 2016). Other studies have noted similar contradictions. Maslach et al. (2001) found that while relationships between social care providers and clients were often sources of occupational stress, they were also resources for coping with job stressors. While, a study of Canadian child welfare workers found that a subset of their sample was both highly emotionally exhausted and highly satisfied with their jobs (Mandell et al., 2013). In fact, workers with high emotional exhaustion and high job satisfaction were active in finding ways to cope with work challenges and finding positive meaning in their work. Another study found that the pride and connection experienced in conjunction with the awareness of meeting the linguistic and mental health needs of an underserved population may serve as a protective factor against burnout for Latina/o clinicians (Teran et al., 2017).

To this end, unlike other professions where workers may view their jobs predominately as a way to earn money (Williamson, 1996), social care providers may be driven by altruism or an orientation that derives coping resources and job satisfaction from unique factors related to the rewards of social care work. Smith and Shields (2013) proposed a conceptual framework, based on Herzberg's classic study The Motivation to Work (1959), on job satisfaction among social care providers. They postulate that social care workers are predisposed to an altruistic orientation as well as motivationalcharacteristics and workplacefactors which may be experienced uniquely across worker demographics and shape job satisfaction. Smith and Shields (2013) tested this framework quantitatively with social service workers in Missouri and found that variety and creativity (motivation factors) and experiences with supervisor (workplace factors) were significantly associated to job satisfaction. Graham and Shier (2014) further extended the literature by qualitatively elucidating the role of cognitive processes including meaning making or insight into the overall value of service to clients, in shaping the well-being of social care providers in Canada.

As the primary aim of this study is to better understand social care providers’ motivations to work through the challenges of a low resourced environment, we extend the aforementioned literature on social care providers by applying Smith and Shields’ (2013) framework to providers working with a marginalised population: Latina/o immigrants living in a new immigrant settlement city, Baltimore. Further, we apply the concept of meaning making and qualitatively explore the personal motivational beliefs, workplace and demographic factors associated with buffering stress and frustration among social care workers in Baltimore.

2 ∣. METHODS

2.1 ∣. Procedures

Convenience and snowball sampling were used to gather data from participants from 2014 to 2016. A comprehensive list of all Latina/o immigrant-serving organisations in Baltimore as well as individual Spanish-speaking providers who work with Latina/o immigrants was compiled through internet searches, phone calls and suggestions by key informants. Identified individuals were contacted via phone call and/or email and recruited if they met the eligibility criteria. Eligibility criteria included: those who met the following criteria: 18 years or older, worked at least 1 month with Latina/o immigrants in Baltimore, and served primarily Spanish-speaking clients. Identifying information of participants including the names of the organisations were kept confidential and participants could terminate the interview at any time. Participants were asked to refer other Latina/o immigrant serving social service providers to the study. All participants were given $20 as appreciation for their time. The Human Research Protection Office (Institutional Review Board) of the University of Maryland, Baltimore approved the study protocol for the current study.

Interviewers trained in open-ended interviewing techniques conducted in-depth qualitative interviews lasting 1–1.5 hr with each participant in private locations of convenience to them. A semi-structured interview questionnaire solicited providers’ general experiences, and the contextual factors they believed affected their service delivery to Latina/o immigrants. All interviews were audio-recorded and transcribed verbatim. A demographic survey was administered collecting quantitative data including participants’ age, race/ethnicity, gender, education level, license/credential, case-load size, role and length of time worked at agency, amount of time worked with Latina/os in Baltimore, and full-time or part-time work status at an agency or organisation.

2.2 ∣. Analysis

All interview transcriptions were uploaded into Dedoose, a mixed-methods data analysis program. Elements of Consensual Qualitative Research (CQR; Hill, Thompson, & Williams, 1997) were implemented which included team-based consensus building and the use of third party “auditors” serving as an additional check on the team findings (Hill et al., 1997). Multiple checks with the research team were used to confirm reliability, including independent analysis of data to decrease groupthink; further, consensus building; and, the use of third-party “auditors” (individuals outside of the primary data analytic research team who have an academic or professional background in social services) were used to serve as an additional check on the research team's findings (Hill et al., 1997).

Emergent themes were extracted by a team member based on a review of the first 10 transcripts. This was further refined through open coding with remaining transcripts with the following research question in mind: How do social care workers cope with lack of resources for Latina/o clients in Baltimore? Preliminary themes were reported and discussed with the research team familiar with the data, to discuss definitions of domains and example excerpts for each domain. Domains were refined based on team discussions and all transcripts were then read and open-coded based on these domains.

Next, the research team independently coded 10 transcripts and collectively discussed any emergent or redundant themes. Research team members independently coded remaining transcripts to check for stability of themes. Specifically, research team members reviewed domains for each transcript and argued over the validity of themes for transcripts until consensus was reached. Furthermore, based on discussion some themes were redefined, eliminated or added to create greater stability. An auditor, a social science researcher familiar with the literature, helped resolve cases where consensus was not reached.

Dedoose was then used to analyse the relationship between qualitative codes and quantitative demographic data (race/ethnicity, gender, age, education, licensure) as well as work-related characteristics (years worked at the agency, years worked with Latina/os in Baltimore, full-time or part-time employment status) to understand if there were any demographic trends in our qualitative findings. Once consensus on the stability of the qualitative domains was reached and finalised, Codes × Descriptor charts (Qual codes × quant) were examined on Dedoose which adjusts the relative frequency of domains for each group based on the relative number of participants in each sub-group. Findings were presented to the research team for discussion to aid in the interpretation of qualitative trends in the data (Creswell, Plano Clark, Gutmann, & Hanson, 2003).

3 ∣. FINDINGS

3.1 ∣. Characteristics of the sample

The sample was composed of 29 social service providers serving Latina/o immigrants in Baltimore. A majority of the sample was between 35 and 54 years of age (69%), of Latin American descent (62.1%), female (79.3%), and had a graduate or professional degree (55.2%). Participants were proficient in Spanish, with the exception of one who used translation and interpretation services in her work. Participants served in diverse roles: six of each worked as program directors, managers or coordinators; four were clinicians; and seven were case managers. Approximately 79% were employed full-time, while the remaining were employed part-time. Most participants (66%) worked with Latina/os in Baltimore for over 5-years, whereas 3% worked with Latina/os in Baltimore for less than 1-year (see Table 1).

TABLE 1.

Latina/o-serving social service provider demographics

Variable	%
Gender
Male	20.7
Female	79.3
Age
25–34 years old	17.2
35–44 years old	41.4
45–54 years old	27.6
55–64 years old	6.9
65–74 years old	6.9
Race/ethnicity
Latina/o	62.1
White/Caucasian	31.0
Black/African American	3.4
Asian American	3.4
Education
Some college	6.9
Completed Associate's Degree—2 years	6.9
Completed Bachelor's Degree—4 years	24.1
Some graduate or professional school	3.4
Completed graduate or professional school	55.2
M.D.	3.4

Note: N = 29.

Findings indicate that participants experienced frustration related to the context of service scarcity for Spanish-speaking Latina/o immigrants; however, this frustration was buffered by three altruistic, predisposing motivational characteristics (Sense of Duty, “Calling”, and Love for Service) and three work-related motivational factors (Inspired by Clients, Fruits of Labour and Meaning Making). Such factors enhanced acceptance of challenges and improved work satisfaction. In addition, colleauge and organisational sources of support helped ameliorate frustrations and stressors associated with lack of resources, onerous bureaucracy and lack of well-coordinated services (see Table 2).

TABLE 2.

Persisting through work-related stress in a new immigrant settlement context

Domains	Themes	Sub-Themes or Definition	Relation to Workplace Stressors
Frustration in a New Immigrant Context	Frustration due to:   Lack of resources   Onerous bureaucracy   Lack of well-coordinated services	Lack of resources for Spanish speaking clients led to frustration	Perceived inability to provide optimum services to Spanish speaking clients due to new immigrant context was a stressor
Motivational Factors	Predisposing Motivational Characteristics	Sense of Duty “Calling” Love for Service	These altruistic characteristics buffered stressors
	Work-Related Motivational Factors	Inspired by Clients’ Resilience Fruits of Labour Meaning Making	Noting positive client and work-related outcomes minimised impact of stress
Colleague and Organisational Sources of Support	Feeling valued	Experiencing support and appreciation from both colleagues and the organisation	Experiencing support from colleagues and the workplace itself helped to push through stressful conditions

3.2 ∣. Frustration in a new immigrant settlement context

Social care workers indicated that the lack of resources for Spanish-speaking clients in Baltimore was the most significant cause of frustration in their work. Many were motivated to enter the profession out of a compelling desire or stated need to serve Latina/os in Baltimore. Yet the inability to provide resources to their Spanish-speaking clients, thereby improving clients’ quality of life, was considered a major barrier and source of exasperation in their goals of serving Latina/os in the city. This was especially so when clients were uninsured or undocumented. A Latino provider discussed his frustration at not being able to provide therapy to those uninsured, “That's frustrating… I came into my profession 'cause I wanted to help people, I never thought that insurance would be the red light or the green light.” Many noted their frustration at the lack of culturally relevant services and the dearth of providers who spoke Spanish. Another Latino provider expressed:

Now, we wish there were more, for example, Spanish-speaking therapists, or Spanish speaking social workers. There are not many. It’s amazing, you know, and there’s such a need that the ones that are out there that are good, they’re already flooded.

Ultimately, participants who discussed frustration felt this in the context of limited resources to meet the needs of their clients, such as medical care and other supportive services. A Latina social care provider who worked with Latina/o children and families reported:

My frustration is just when, hitting the road block when you know that a family needs a service. Whether it’s family reunification or when a child needs a hearing test, or needs glasses and we’re not able to pay for those things in the school setting. And there are no agencies that fund that or not having the knowledge of the agencies that do fund it. It’s frustrating because you know that you want to help, but your hands are tied.

Social care workers indicated that complex rules for obtaining services for clients led to feelings of frustration at the bureaucracy. Existing rules and regulations made it difficult for participants to engage in the primary work they felt compelled to do: help clients get necessary resources. A White social care provider described:

There’s only so much you can do without approval or without the city, like there’s all those other red tape things that you have to go through …

Social care providers reported frustration due to a lack of well-co-ordinated services. One White male provider related his frustration at the constantly changing processes for connecting clients with services and unclear communication between different providers, yielding inadequate service provision.

There’s a lot of dysfunction and lack of communication and depending on who you talk to, five different ways to do one thing that should only have one way to do it, you know what I mean? So, just when you think you, okay, that’s how it’s supposed, that’s the process to submit this. And then, you find out it’s not, you’ve been told wrong, or it’s just changed and no one’s told you.

3.3 ∣. Motivational factors

3.3.1 ∣. Predisposing altruistic characteristics

Social care providers’ motivation to care for people, particularly Latina/o immigrants, was a major factor driving their ability to push through the frustrations of work. Participants shared a strong commitment to working with Latina/o immigrants in Baltimore driven by an altruistic orientation including factors they identified as a “calling,” sense of duty, and love for service. Distinctly, Latina/o social care providers often related they had an overwhelming sense that they were “called” to work with Latina/o clients. Providers who were not Latina/o felt a “calling” that emerged because of interactions with Latina/o cultures. A White female provider relayed that her experience of learning Spanish as a teenager set her on the path to working with Latina/os:

I learned Spanish in seventh and eighth grade and then when I hit ninth grade I started dreaming in Spanish…I don’t know why, you know, but that’s what it was. It was kind of a calling for me…

Alternatively, a Latino provider experienced a “calling” to serve Latinos because of the great need for mental health services for Latina/os in the city.

One of the reasons I became a social worker was there were not enough therapists here in Baltimore to refer Spanish speaking clients for services. Specifically, in areas of mental health and addiction… I really wanted to help, but I needed credentials. So, I went to school and got my credentials.

Many social care providers further elucidated a love for serving people or love for service as a positive incentive for them to work with Latina/os in Baltimore. A Latina provider stated, “I do love it and I do believe that what we do is improving lives of people. So, that has a lot of rewards.” This feeling of gratification from the ability to help clients access needed resources was a critical reward for many participants. Interestingly, many explicitly used the word, “love” to describe their work, and often paired it with the fact that their service was “so needed” to assist Latina/o immigrants. This sense of duty was particularly strong because many social care providers were concerned that their Latina/o clients may not otherwise be able to have their needs met. A Latina provider stated the following: “…you really have to care, ‘cause you will be doing things that's not your role or it's not why you were hired but you see the need.” Similarly, another Latina social care provider stated, “…you end up doing things, that it's not my role, but it's like because they need help and I cannot, just you know, [say] ‘sorry, I cannot help people deal with problems’.”

3.3.2 ∣. Work-related motivational factors

Inspired by resilience of clients

Many social care workers expressed their clients’ resilience through difficult times inspired and motivated them (social care workers) to continue working despite frustration with their work. A White provider stated,

By and large, these are people with big dreams and they work very, very, very hard to do whatever is best for their kids…You see people who come here and everything they went through to get here and there are moments when they are very inspiring.

A Latina social service provider noted: “In the process, I have to say, I had the amazing experience of witnessing how people learn how to live, and how to address their problems, how to solve their issues.” Another female White social care stated, “I always like to think that the people I am seeing are the most resilient people around cause, (a) they are looking for help and (b) they have made it here, which is really hard. They got here physically but then they have been able to get jobs or sustain themselves one way or the other. They're survivors.” Many participants echoed such sentiments, indicating their clients’ resilience sustained their own ability to persist through difficult and frustrating circumstances.

Fruits of labour

Being able to track successful outcomes from their work with Latina/o clients further motivated participants. Some expressed feelings of accomplishment after completing social care tasks culminating in clients achieving service goals. Other social care workers shared success stories describing clients achieving positive outcomes in life as a result of services received. A Latina social care worker reported the following about her sense of accomplishment when a program she implemented was well-attended:

Most of our participants in the programs are under-insured, so they may have something, but they may not be totally insured. So, for them, learning about how to prevent diseases is really helpful. And they were committed and they were coming. So it was really nice.

A Latino social worker illustrated a success story by sharing his pleasure of witnessing Latina clients become leaders in their community:

It is a lot of empowering work. And it’s phenomenal to see, because we’ve been doing this for 12 years with the Latino community. To see some of the ladies who went through all that now as leaders in their churches, in their communities. And wanting to give back, to help do outreach…

In spite of low resources for clients, having a sense of accomplishment or being able to witness success stories helped social care workers feel their goal of being able to provide needed services for Latina/os in Baltimore was being met.

3.3.3 ∣. Meaning making and acceptance

Some participants indicated they came to accept that their provision of social care services was vital yet constrained within larger structural factors such as their clients’ undocumented status, under or lack of insurance, and the city's scarcity of resources for Spanish speaking clients. A White female provider stated:

You’ve just got to do stuff with love. And that’s what I try to do every day, is just love my patients, do what I can, forget that, you know, a lot of what I try to work for is not gonna happen. And just realise that what I do matters to the people that I work with (clients).

Similarly, another Latina social care worker stated, “there are so many adverse circumstances and horrible stories that I listen to. But there is hope, no?” Accepting the limitations of their work was a means for some participants to thrive and persist in work they were motivated to do because of a “calling”, sense of duty and love for service. A positive regard for the client population allowed social care workers to engage in positive meaning making which, in turn, led to feelings of acceptance or feeling satisfied in their work.

3.4 ∣. Colleague and organisational support

Social care workers underscored the importance of support from their organisations and co-workers to help cope with the stressors of work. The presence of caring colleagues not only allowed for a positive work environment but one where workers felt valued. As one Latina provider who identifies as multiracial described, “Early this year, everyone here, because I had to take [husband] to radiation and chemo, everyone here donated sick days from their sick bank, so that I could still be paid while I was out.”

Participants spoke of the importance of a goodness of fit between personal values to assist vulnerable populations and organisational values. A White female provider shared:

It’s kind of nice to be associated with another group of people that’s providing healthcare for vulnerable people. ‘Cause it’s not just about Latinos, or anything like that, it’s more about people who truly are falling outside the networks of support. And the safety-nets that are supposed to be here.

Within the context of an under-resourced and challenging social service environment, the support of colleagues and organisations with shared goals and values buffered the stress associated to such frustrations within their work environment.

3.5 ∣. Demographic trends

Latina/o social care providers indicated greater amount of predisposing motivating factors that led them to serve Latina/os in Baltimore when compared to other racial/ethnic groups in the sample. Specifically, Latina/os in our sample more frequently reported that they were driven to work with Latinos due to a “calling” and “a sense of duty.” Furthermore, Latina/o social care providers more frequently discussed coping with the challenges of their work by observing successful outcomes.

In regards to age, while participants that were in the 35–44 years and 45–54 years categories relayed frustration at similar rates, those that were in the 45–54 years category also mentioned acceptance more than any other age category in the sample. Further, those that were in the highest age category in our sample (65–74 years) expressed calling and love for service more often. Older participant categories (55–64 years and 65–74 years) also relayed success stories as a workplace motivating factor more often than any other age category in our sample. In contrast, younger participants (25–34 years; 17.2% of the sample) reported much lower rates of frustration.

4 ∣. DISCUSSION

The findings highlight important motivational and work-related factors that appear to help buffer the impact of stress and frustration for social care providers working in a new immigrant settlement city. These contexts are characterised by a lack of available culturally and linguistically appropriate services for Latina/o immigrants due to a scarcity of resources and rapidly emerging local needs. Participants specifically expressed frustration with the limitation of resources, complex bureaucratic processes and lack of coordination of services. This frustration was especially impactful given that many participants reported feeling a “calling,” love for service and sense of duty, to serve the Latina/o population. Social care workers’ meaning making, or overall belief in the value and impact of their work, and prior success stories with clients helped push and sustain them in their work and ameliorate these feelings of frustration or stress. This is consistent with Bowden et al. (2014) who found that pride in service to a meaningful cause and valued client population can be its own reward. Being inspired by the resilience of clients, seeing observable successful outcomes or fruits of labour and work-related organisational and coworkers support, seemed to facilitate social care workers’ job satisfaction. These findings are also consistent with the broader social care literature, whereby intrinsic reward has been found to be associated with level of commitment and satisfaction with work (Balloch, Pahl, & McLean, 1998; Huxley, 2005; Papadaki & Papdaki, 2006).

Interestingly, Latina/o providers more frequently relayed the role of internal motivating factors associated with their work with Latina/os. Furthermore, they more frequently expressed that witnessing observable successful outcomes of their work allowed them to cope with challenges inherent in their work. This suggests that Latina/o providers may have a particularly acute sense of duty or calling to serve people of their own ethnic background. This is aligned to Teran et al.'s (2017) findings which noted that Latina/o providers serving underserved Latina/os often experience a sense of pride and connection with their clients which could then serve as a protective factor against burnout for Latina/o clinicians.

Younger (age 25–34 years) care workers expressed lower levels of frustration working in a low resource context compared with older care workers above the age of 35. There are a few possibilities that may explain this trend. First, it may be that older workers are more likely to have worked in the field longer and thus have had more opportunity to become more frustrated with the lack of resources present in a new immigrant settlement service delivery context. Second, it may be a limitation of the small sample, which only included five individuals in this younger age group (25–34 years).

Interestingly, increase in age was associated with greater reliance on motivational factors which could enhance coping skills associated with working in a low resource context. Older social care workers have been previously found to access greater use of coping skills to manage the stressors of social care work in a study of bilingual (English-Spanish) providers (Teran et al., 2017). These findings have a number of practical implications. Supportive organisations and senior co-workers can help provide an environment where social care workers can better cope with work stressors (Lamb & Cogan, 2016; Travis & Mor Barak, 2010; Verdinelli & Biever, 2009). While larger structural interventions that seek to change organisational culture are critical, they can be expensive and time intensive (Maslach et al., 2001). Mindfulness and positive reframing of events can further assist social care workers in positive meaning making of the influence of their work (Quevillon et al., 2016). However, interventions that incorporate both structural and individual interventions simultaneously are the most ideal as they can most effectively address both internal and external processes associated with burnout and stress (Morse, Salyers, Rollins, Monroe-DeVita, & Pfahler, 2012).

Although these findings shed light on key provider characteristics that help mitigate work-related stress, these results must be interpreted in light of study limitations. The results of this study are not generalisable beyond our sample of social care workers in Baltimore. Our mixed method (Qual codes × quant) findings should also be interpreted with caution as our findings are based on how often each demographic group (quant) expressed a Qualitative code. To this end, it is possible, for example, that younger participants may have similar levels of motivational factors as older participants but simply did not express this in our study. Moreover, this study emphasised social care providers’ coping responses at the individual level, limiting understanding of how providers cope with their work environment at an organisational or societal level such as advocating for better working conditions or collaborating with other providers for policy reform. Further research is needed to better understand how social care providers cope with lack of resources at mezzo and macro levels in new immigrant settlement cities. Such an analysis may be particularly compelling because as Lipsky's (1980) argues in his seminal study of the “street level bureaucrat” or frontline public service employees (which includes social care workers), high caseloads and low resource contexts may lead social care workers to microdecisions that impact and alter organisational policies. Specifically, social care work in low resource contexts has been found to lead to resourcefulness and innovation (Negi & Furman, 2009; Negi et al., 2017). It may be worthwhile to explore if such adaptation can ameliorate or exacerbate the stressors of working under conditions of scarcity.

As a whole, despite study limitations, this study highlights important implications for supporting frontline staff working in new immigrant cities with scant resources. Specifically, an intentional focus on the celebration of client success stories within an agency or organisation may help underscore social care workers’ fruits of labour and bolster their individual motivations, thereby reducing staff stress and turnover. Such organisational recognition of the work of social care providers through client success stories can also potentially serve as a motivating work factor (Huxley, 2005). Additionally, this study's elucidation of the important role of predisposing motivational characteristics (Sense of Duty, “Calling”, and Love for Service) and work-related motivational factors (Inspired by Clients, Fruits of Labour and Meaning Making) can move the needle forward in social care through the development of burn-out prevention interventions as well as the improvement of quality of services for vulnerable populations such as, immigrants in low-resource contexts and new immigrant settlement cities.

What is known

• The United States has experienced a new trend in migration whereby cities without a prior established history of Latina/o migration are experiencing the fastest rate of growth in new Latina/o immigrants.

• In new immigrant settlement cities, social care providers who work with immigrants often work under conditions of scarcity placing them at risk for burnout.

• The bulk of the literature has focused on examining the causes of work stress and burnout among social care providers.

What this study adds

• Findings provide an understanding of how social care providers may positively respond and persist in their jobs despite stressors associated to scarcity of resources.

• Findings highlight important motivational and work-related factors that appear to minimise the impact of stress and frustration for social care providers and can be used in the development of burn-out interventions as well as improving quality of services for vulnerable populations such as, immigrants, especially in low-resource new immigrant settlement contexts.