Nurses' Borderwork between Caring, Professional Prestige, and Servitude in a Hospital Cardiology Unit

• In Event: 091 - Regular Session. Patient-Provider Interaction

Abstract

In this paper, I analyze social processes through which the nursing staff of a hospital Cardiology Unit experienced institutionalized coercion to care. This paper is based on three years of participant observation and contributes to scholarship on how race, class, and gender are constituted through care and structures of feeling. It also contributes to research on the social processes of healthcare delivery. In the hospital I studied, customer service policies disciplined nurses to care. However, both RNs (Registered Nurses) and CNAs (Certified Nursing Assistants) faced the threat of internalized coercion, because institutional forces disciplined by colonizing their capacities for compassion. In response to these forces, they used several emotionally-charged semiotic codes to define the behaviors, feelings, and subjectivities that signified acceptable care. RNs defined caring as basic stuff to set limits on their emotional labor and level of effort, thus mitigating coercion. These processes involved borderwork between subjectivities of caring and servitude. RNs claimed the moral virtue of caring even as they distanced themselves from the devalued labor it entailed by delegating tasks associated with servitude to CNAs. These processes reproduced racialized hierarchies among the nursing staff and further devalued care work.

Author

• John William Kaiser, University of California-Berkeley