The Social Relations of Home Care Nursing Work




Sanders, Tanya

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There is an increasing need for home care in Canada; however, there is little evidence about the everyday nursing work in home care and the institutional influences that impact this work. As nurses are the largest professional care providers in home care and given the increasing demands for home care services, there is a need to understand the work of nurses, specifically to identify the social organization of this work. As a part of a larger Canadian study on home care systems, this institutional ethnography focused on home care nurses in one health authority in Western Canada. The standpoint of nurses was explored through interviews, observations, and collected texts used to explicate the social relations coordinating home care nursing work. The results of this inquiry show that nurses’ work is coordinated through texts and electronic health documentation systems. Safety, measurement, and efficiency are shown to influence nurses’ work. Alongside the discursive arrangements, increasingly nurses’ time coordinating their work and client care is expanding, with less time for direct client care. To meet the increasing demand for home care, insight is needed to improve access and care. Understanding the invisible but dominant ruling relations organizing influencing, and at times disorganizing, the everyday work of nurses is a vital first step in creating change for home care nursing.



Home care, Home care nursing, Institutional Ethnography, Community health nursing, Nursing