Care Descriptions at Work

Textual Technologies from the Standpoint of Care Workers


  • Kjetil G. Lundberg



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.

Author Biography

Kjetil G. Lundberg

Associate professor
Department of Welfare and Participation
Western Norwegian University of Applied Sciences


Allen, D. (2014). Lost in translation? ‘Evidence’ and the articulation of institutional logics in integrated care pathways: From positive to negative boundary object? Sociology of Health and Illness, 36(1)6, 807-822.

Barnes, M. (2012). Care in Everyday Life: An Ethic of Care in Practice. Bristol: University of Bristol.

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.

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.

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.

Devault, M. L. (2006). Introduction: What is institutional ethnography? Social Problems, 53(3), 294-298.

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.

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.

Hansen, A. M. (2016). Rehabilitative bodywork: Cleaning up the dirt work of homecare, Sociology of Health and Illness, 38(7), 1092-1105.

Haraway, D. (1988). Situated knowledges: The science question in feminism and the privilege of partial perspective, Feminist Studies, 14(3), 575-599.

Hart, R. J., & McKinnon, A. (2010). Sociological epistemology: Durkheim’s paradox and Dorothy E. Smith’s actuality, Sociology, 44(6), 1038-1054.

Hirvonen, H., & Husso, M. (2012). Living on a knife’s edge: Temporal conflicts in welfare service work, Time and Society, 21(3), 351-370.

James, N. (1992). Care = organisation + physical labour + emotional labour, Sociology of Health and Illness, 14(4), 488-509.

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.

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.

Norstedt, M., & Breimo, J. P. (2016). Moving Beyond Everyday Life in Institutional ethnographies: Methodological challenges and ethical dilemmas, Forum: Qualitative Social Research, 17(2).

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.

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.

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.

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.

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.

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.

United Nations, Department of Economic and Social Affairs, Population Division (2013). World Population Ageing 2013. ST/ESA/SER.A/348. New York: United Nations.

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.

Vaboe, M. (2011). Changing governance, changing needs interpretations: Implications for universalism, International Journal of Sociology and Social Policy, 31(3-4), 197-208.

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.

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.

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




How to Cite

Lundberg, K. G. (2019). Care Descriptions at Work: Textual Technologies from the Standpoint of Care Workers. Journal of Comparative Social Work, 14(2), 55–75.