Enacting efficient care within a context of rationalisation

Abstract

Scholars have described how care cannot be completely commodified or withdrawn because it is a disposition anchored in the commitment to the needs of others. This article advances the literature on care ethics and inequality by examining how care workers resist and negotiate the rationalisation of care work. Building on ethnographic fieldwork on auxiliary nurses in Norwegian nursing homes, the study shows that despite care workers facing increasingly rationalised forms of control, they continue to act out of the caring self, which centres on the desire to give meaningful care. However, by addressing how power differences and ethnic stratification between workers influence their strategies of coping and resistance, the findings also illustrate how the most vulnerable care workers respond to rationalisation by providing efficient care – that is, careless care – to their patients. Drawing from alternative perspectives on care work as ambivalent work, the study’s main theoretical contribution is to offer insight into how precarious work contexts may pose a threat to the caring self, especially when inequalities exist between care workers.

‘It's always a battle against time’. Experiencing and handling temporal conditions in homecare work

“…In contrast to previous studies (Doniol‐Shaw & Lada, 2011; Orupabo, 2022), the workers in this study do not seem to engage in any particular form of resistance. Even though resistance – in the form of, for example, speaking up – is considered the best way of achieving organisational change, it can be a confrontational and risky strategy not available to all categories of workers.…”

“…Unsurprisingly, recent transformations in the eldercare sector have affected the time available for care, increasing time pressure in work performance. Several studies have reported on time in social and eldercare work, for example in Ireland (McDonald et al, 2019), England (Hayes & Moore, 2017; Leverton et al, 2021; Rubery et al, 2015), France (Doniol‐Shaw & Lada, 2011), Canada (Sims‐Gould & Martin‐Matthews, 2010), Finland (Hirvonen & Husso, 2012; Leinonen, 2020), Denmark (Tufte, 2013; Tufte & Dahl, 2016), Norway (Bergschöld, 2018; Orupabo, 2022) and Sweden (Andersson, 2007; Strandell & Stranz, 2022). In addition to focusing on temporal dilemmas, scarcity of time, and staff experiences of time pressure, some of these studies have also been concerned with the psychosocial consequences of time constraints.…”

“…Although recent changes in the eldercare sector have reduced homecare workers' autonomy in relation to time allocation (Rubery et al, 2015; Strandell, 2020; Tufte, 2013), under certain conditions, care staff manages to create room for manoeuvre within the constraints of standardisation and rationalisation. International studies have shown that care workers adopt various strategies to cope with problematic temporal conditions, including, for example, working unpaid hours, reorganising work tasks, calling for assistance, bending rules, speaking up and defying management (Bergschöld, 2018; Doniol‐Shaw & Lada, 2011; Orupabo, 2022; Tufte & Dahl, 2016).…”

Is Nordic elder care facing a (new) collaborative turn?

“…Numerous studies, representing different research disciplines such as social policy (e.g., Anttonen & Karsio, 2017;Burau et al, 2017;Szebehely & Meagher, 2018) and the sociology of work (Kamp & Hvid, 2012;Orupabo, 2022) have assessed and explained changes in the eldercare sector as consequences of NPM reforms.…”

“…Numerous studies, representing different research disciplines such as social policy (e.g., Anttonen & Karsio, 2017; Burau et al, 2017; Szebehely & Meagher, 2018) and the sociology of work (Kamp & Hvid, 2012; Orupabo, 2022) have assessed and explained changes in the eldercare sector as consequences of NPM reforms. Researchers have typically focused on topics such as contract and control practices related to competitive tendering (Almquist, 2004; Szebehely & Meagher, 2013), free choice models (Rostgaard, 2011), performance and quality management (Hoppania et al, 2021; Vabø, 2012).…”