Recognizing the power in ‘the little things’: a secondary analysis using critical discourse analysis of home care nurses’ emotional work
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Date
2021
Authors
Teetaert, Courtney
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Abstract
Home care has been significantly impacted by the healthcare reforms. Guided by the application of industrialized models intended to improve efficiencies in care, home care nursing has been defined as tasks to be delivered within an allotted time frame. When care is defined as such, nurses emotional work, the emotional aspect of providing care, is minimized. The purpose of this study was study was to critically examine how home care nurses described their emotional work, using a secondary qualitative dataset collected as part of a larger study on excellence in intimate care delivery (Thompson et al., 2014).
Methods
Fairclough’s framework of Critical Discourse Analysis (CDA) was used for the secondary analysis that consisted of interview data (n = 15) from nurses in the home care setting collected from nine direct care/ frontline nurses, five middle-management (Resource Co-ordinator/ Case-Coordinator, Scheduler), and one upper-manager (Team Manager).
Results
The study revealed that home care nurses were able to identify and describe their emotional work as an intrinsic part of providing quality care. This work was positive for nurses; it was the lack of recognition and time for the work that resulted in negative descriptions of providing care. Nurse’s descriptions of their relational work, how they built connections to their clients and their colleagues, was significant in that nurses continued to connect, even when those connections were not supported by the healthcare system.
Significance
This study draws attention to how emotional work in nursing is undermined by patriarchal views that assume that technical skills hold more value than the ability to connect to others and create healthy care relationships. Emotional work cannot be quantified or commodified; therefore, it cannot be touched by the task-based approach of the healthcare reforms. We see this in nurses’ descriptions of how they continued to connect with others. This insistence on carrying out emotional work as part of care is a form of resistance. If nurses can harness this power of connection, they can create a new movement, one that is free of the constraints placed upon nurses by the current healthcare system.
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Keywords
Emotional work, Emotional labour, Home care nursing, Winnipeg, Resilience, Power, Healthcare system, Critical discourse analysis, Healthcare reforms, Connection, Care, Relational care, Change, Resistance, Task nursing, Time, Patriarchy, Lack of resources