Omsorg i tanke och handling : En studie av kvinnors arbete i vården

Sammanfattning: This dissertation gives a picture of the everyday life of women who work as registered nurses (RNs), nursing assistants and nursing auxiliaries in the Swedish public health care system. The study attempts to take a comprehensive, holistic view of their care work. The point of departure for the study is paid care work, professional roles and the social structure around these roles. The empirical material was collected during 1989-1993. It consists of journal entries written during one month of participant observation at an emergency ward of a large hospital and at a long-term care ward at a smaller nursing home. In addition, interviews have been conducted with 34 women employed at these two wards. In my participant observations the women's thoughts were centred around the patients and on how to meet the multi-dimensional needs of the patients. This patient-oriented perspective came out even more clearly during the interviews. The thoughts expressed by the women did not, however, correlate with their actions in concrete situations. Their actions were rather characterised by a prioritising of routinized tasks and/or by social interaction with other colleagues. The over-arching aim of the study is to interpret this lack of correspondence between thought and action and to identify the social mechanisms that formed the everyday reality of the women. The analysis includes both the organisation of formal work and familial relations. The results show that a complex of social relations restricted a more patient-oriented action. The most important factors were the work organisation, the worker's relations with her colleagues and superiors, power and status differences between professional categories, the mixing of full and part-time workers and the gender division of labour within the family. Three concepts of care actions were developed: patient-orientation, colleague-orientation and family-orientation. Patient-oriented care action is directed towards weak and ill people, colleague-oriented care towards co-workers and family-oriented care is oriented towards family members. When the interest of these three groups collided the women were exposed to a threefold loyalty conflict which made it difficult for them to put their patient-oriented -thoughts into practice.