Look who's talking: Long term care from the standpoint of the nursing assistant, a feminist analysis
Date
1993
Authors
Aitken, Minna Uldall
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Abstract
This research presents a feminist analysis of the work carried out by Nursing Assistants in the context of facility based extended care for elderly people within the current, rapidly evolving long term care system in British Columbia.
Institutional ethnography, a non positivist method, is used to examine the problem of rigid and routine methods associated with Nursing Assistants' work. Management and professional staff have criticized Nursing Assistants for adhering to inflexible care giving routines which impede quality nursing care.
The starting point for exploring this problem is the everyday work experience of Nursing Assistants. A typical day is described based on the researcher and participants experiences. The study proposes that inflexibility is organized into Nursing Assistants' work through methods designed by management and professional staff to standardize the work and thereby assure a high quality of care. Further, it is argued that the top down approach to planning and organizing the work creates contradictions in the quality of the care. Nursing Assistants are expected to follow the standard directives of their superiors while feeling the pressure to offer the individual care which residents indicate they need. This study shows that Nursing Assistants succeed in offering flexible resident care; however, their lack of authority and heavy workload presents them with many challenges in doing so.
The author contends that the top down manner of arranging Nursing Assistants' work contributes to lack of understanding between management and professional staff at the top of the organization and Nursing Assistants located at the bottom. The contribution Nursing Assistants' knowledge and experience makes to the facility remains undervalued and invisible. The invisible and skilled aspects of Nursing Assistants' work are illuminated as are emerging pressures they must cope with related to the changing long term care environment.