Care Descriptions at Work
Textual Technologies from the Standpoint of Care Workers
Keywords:care work, professional discretion, accountability, textual technologies, institutional ethnography
Forms and documents play significant roles in the context of care work for older people. One type of form that care workers use on a daily basis is individual care descriptions (ICDs). An ICD is a text that is written on a piece of paper or on a computer, and specifies the care tasks to be carried out. How do ICDs operate in local settings of care work for older people? Anchored in insights from institutional ethnography, I investigate care work practices from the standpoint of care workers in care settings in Norway. In the empirical analysis, I identify and pay attention to two particular ICDs and how they enter the everyday care work practices. The findings indicate that ICDs contribute to standardizing care work practices that are related to changes in the cultural and institutional foundations of the welfare state. Furthermore, ICDs coordinate practices in different ways, and promote several forms of coordination. Hence, when analysing care descriptions at work, awareness of contextual sensitivity is called for. This paper contributes to research on management and power relationships in home care and nursing care work by illustrating different dimensions of textually based coordination.
Barnes, M. (2012). Care in Everyday Life: An Ethic of Care in Practice. Bristol: University of Bristol. https://doi.org/10.2307/j.ctt9qgvc9
Bode, I., Gardin, L., & Nyssens, M. (2011). Quasi-marketisation in domiciliary care: Varied patterns, similar problems?, International Journal of Sociology and Social Policy, 31(3-4), 225-235. https://doi.org/10.1108/01443331111120654
Breimo, J.P., Normann, T., Sandvin, J. T., & Tommesen, H. (2015). Individuell Plan: Samspill og unoter [Individual Plan: Interaction and bad habits]. Oslo: Gyldendal Akademisk.
Campbell, M. L. (2001). Textual accounts, ruling action: The intersection of knowledge and power in the routine conduct of community nursing work, Studies in Cultures, Organizations and Societies, 7(2), 231-250. https://doi.org/10.1080/10245280108523559
Campbell, M. L., & Gregor, F. M. (2004). Mapping Social Relations: A Primer in Doing Institutional Ethnography. Lanham: AltaMira Press.
Christensen, K. (2012). Towards a mixed economy of long-term care in Norway? Critical Social Policy, 32(4), 577-596. https://doi.org/10.1177/0261018311435028
Devault, M. L. (2006). Introduction: What is institutional ethnography? Social Problems, 53(3), 294-298. https://doi.org/10.1525/sp.2006.53.3.294
Devault, M. L. (2008). People at Work: Life, Power, and Social Inclusion in the New Economy. New York: New York University Press.
Fisher, J. A. (2006). Coordinating ‘ethical’ clinical trials: The role of research coordinators in the contract research industry, Sociology of Health and Illness, 28(6), 678-694. https://doi.org/10.1111/j.1467-9566.2006.00536.x
Foucault, M. (1972). Power/Knowledge: Selected Interviews and Other Writings. New York: Pantheon Books.
Garfinkel, H. (1967). Studies in Ethnomethodology. Cambridge: Prentice-Hall.
Grace, L. (2014). Accountability circuits in vocational education and training. In A. I. Griffith & D. E. Smith (Eds.), Under New Public Management: Institutional Ethnographies of Changing Front-Line Work. Toronto: University of Toronto Press.
Griffith, A. I., & Smith, D. E. (2014). Under New Public Management: Institutional Ethnographies of Changing Front-Line Work. Toronto: University of Toronto Press. https://doi.org/10.3138/9781442619463
Hansen, A. M. (2016). Rehabilitative bodywork: Cleaning up the dirt work of homecare, Sociology of Health and Illness, 38(7), 1092-1105. https://doi.org/10.1111/1467-9566.12435
Haraway, D. (1988). Situated knowledges: The science question in feminism and the privilege of partial perspective, Feminist Studies, 14(3), 575-599. https://doi.org/10.2307/3178066
Hart, R. J., & McKinnon, A. (2010). Sociological epistemology: Durkheim’s paradox and Dorothy E. Smith’s actuality, Sociology, 44(6), 1038-1054. https://doi.org/10.1177/0038038510381609
Hirvonen, H., & Husso, M. (2012). Living on a knife’s edge: Temporal conflicts in welfare service work, Time and Society, 21(3), 351-370. https://doi.org/10.1177/0961463X12454382
James, N. (1992). Care = organisation + physical labour + emotional labour, Sociology of Health and Illness, 14(4), 488-509. https://doi.org/10.1111/1467-9566.ep10493127
Jensen, P.H., & Lolle, H. (2013). The fragmented welfare state: Explaining local variations in services for older people, Journal of Social Policy, 42(2), 349-370. https://doi.org/10.1017/S0047279412001006
Latour, B. (2005). Reassembling the Social: An Introduction to Actor-Network-Theory. Oxford: Oxford University Press.
Mykhalovskiy, E. (2001). Troubled hearts, care pathways and hospital restructuring: Exploring health services research as active knowledge, Studies in Cultures, Organizations and Societies, 7(2), 269-296. https://doi.org/10.1080/10245280108523561
Norstedt, M., & Breimo, J. P. (2016). Moving Beyond Everyday Life in Institutional ethnographies: Methodological challenges and ethical dilemmas, Forum: Qualitative Social Research, 17(2). https://doi.org/10.17169/fqs-17.2.2539
Quinlan, E. (2009). The ‘actualities’ of knowledge work: An institutional ethnography of multi‐disciplinary primary health care teams, Sociology of Health and Illness, 31(5), 625-641. https://doi.org/10.1111/j.1467-9566.2009.01167.x
Rankin, J. (2001). Texts in action: How nurses are doing the fiscal work of health care reform, Studies in Cultures, Organizations and Societies, 7(2), 251-267. https://doi.org/10.1080/10245280108523560
Rankin, J. M., & Campbell, M. L. (2006). Managing to Nurse: Inside Canada's Health Care Reform. Toronto: University of Toronto Press.
Smith, D. E. (1987). The Everyday World as Problematic: A Feminist Sociology. Boston: Northeastern University Press.
Smith, D. E. (2001). Texts and the ontology of organizations and institutions, Culture and Organization, 7(2), 159-198. https://doi.org/10.1080/10245280108523557
Smith, D. E. (2005). Institutional Ethnography: A Sociology for People. Lanham: AltaMira Press.
Smith, D. E. (2006). Introduction. In D. E. Smith (Ed.), Institutional Ethnography as Practice. Lanham: Rowman and Littlefield.
Smith, D. E., & Turner, S. M. (2014). Incorporating Texts into Institutional Ethnographies. Toronto: University of Toronto Press. https://doi.org/10.3138/9781442667082
Spradley, J. P. (1979). The Ethnographic Interview. Wadsworth: Cengage Learning.
Szebehely, M., & Meagher, G. (2013). Four Nordic countries – four responses to the international trend of marketization. In G. Meagher & M. Szebehely (Eds.), Marketisation in Nordic Eldercare: A Research Report on Legislation, Oversight, Extent and Consequences. Stockholm Studies in Social Work 30. Stockholm: University of Stockholm.
Thompson, T. L., & Pinsent-Johnson, C. (2011). Institutional Ethnography and Actor Network Theory: The Possibilities and Challenges of Exploring the Relational in Adult Education Research. Paper presented at Canadian Association for the Study of Adult Education Conference. Toronto, Canada.
Timmermans, S., & Epstein, S. (2010). A world of standards but not a standard world: Toward a sociology of standards and standardization, Annual Review of Sociology, 36(1), 69-89. https://doi.org/012809.102629
Trydegård, G. B., & Thorslund, M. (2010). One uniform welfare state or a multitude of welfare municipalities? The evolution of local variation in Swedish elder care, Social Policy and Administration, 44(4), 495-511. https://doi.org/10.1111/j.1467-9515.2010.00725.x
United Nations, Department of Economic and Social Affairs, Population Division (2013). World Population Ageing 2013. ST/ESA/SER.A/348. New York: United Nations. https://doi.org/10.18356/22e83351-en
Vaboe, M. (2009). Home care in transition: The complex dynamic of competing drivers of change in Norway, Journal of Health Organization and Management, 23(3), 346-358. https://doi.org/10.1108/14777260910966762
Vaboe, M. (2011). Changing governance, changing needs interpretations: Implications for universalism, International Journal of Sociology and Social Policy, 31(3-4), 197-208. https://doi.org/10.1108/01443331111120618
Vaboe, M. (2012). Norwegian home care in transition – heading for accountability, off‐loading responsibilities, Health and Social Care in the Community, 20(3), 283-291. https://doi.org/10.1111/j.1365-2524.2012.01058.x
Vaboe, M., & Szebehely, M. (2012). A caring state for all older people? In A. Anttonen, L. Häikiö & K. Stefánsson (Eds.), Welfare State, Universalism and Diversity. Cheltenham: Edward Elgar.
Waerness, K. (1984). The rationality of caring, Economic and Industrial Democracy, 5(2), 185-211. https://doi.org/10.1177/0143831X8452003
Øydgard, G. W. (2018). Forhandlinger I omsorg: En institusjonell etnografi om pårørendes omsorgsarbeid og tilgang til helse- og omsorgstjenester [Negotiations in care: An Institutional Ethnography about family carers’ care work and access to health and care services]. PHD-avhandling. Bodø: Nord Universitet