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Professional Talk: How Middle Managers Frame Care Workers as Professionals

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Abstract

This paper examines how middle managers in the long term care sector use the discourse of professionalism to create ‘appropriate’ work conduct of care workers. Using Watson’s concept of professional talk, we study how managers in their daily work talk about professionalism of vocationally skilled care workers. Based on observations and recordings of mundane conversations by middle managers, we found four different professional talks that co-exist: (1) appropriate looks and conduct, (2) reflectivity about personal values and ‘good’ care, (3) methodical work methods, (4) competencies. Jointly, these professional talks constitute an important discursive resource for middle managers to facilitate change on the work floor. Change involves the reconfiguration of care work and different managerial-worker relations. Middle managers use professional talks in both enabling and disenabling ways vis-à-vis care workers. Based on these findings, we suggest a more nuanced portrayal of the relationship between managers and professionals. Rather than being based on an intrinsic opposition, i.e. ‘managers versus professionals’, this relationship is flexibly reconstructed via professional talk.

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Notes

  1. Professionalism in everyday speech can for example refer to ‘paid services’ as opposed to doing something for pleasure, but is also used by people to imply that they are competent in their occupation or that they run someone else’s enterprise rather than one’s own [59].

  2. In a very insightful article on varieties of discourse, [3] make a distinction between different forms of discourses, varying from a micro textual analysis to grand Discourses on a macro level that constitute the social world. Our perspective on discourse can be placed in the middle range theories of discourse, which assume that there is a loose connection between talk and the framing of action.

  3. In Dutch: Regionale Opleidingscentra (ROC’s).

  4. Only the very first day of observations was not recorded due to the absence of an appropriate recording device.

  5. As opposed to hospital settings, in the Dutch long term care sector the use of uniforms is less common. Especially in small-scale living facilities, formal attire of care workers is rare since the goal of these domestic living arrangements is to let clients live their life as ‘normally’ as possible.

  6. The terminology differs slightly per sector. In the disability sector, the term ‘Support Plan’ is used, whereas in the elderly sector the term ‘Care Living Plan’ is more common, see [54]. Notwithstanding these differences, the Plans are based on the same principles of self-determination and client choice.

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  1. Institute of Health Policy and Management, Erasmus University, J-gebouw, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands

    Lieke Oldenhof, Annemiek Stoopendaal & Kim Putters

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  1. Lieke Oldenhof
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Correspondence to Lieke Oldenhof.

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Oldenhof, L., Stoopendaal, A. & Putters, K. Professional Talk: How Middle Managers Frame Care Workers as Professionals. Health Care Anal 24, 47–70 (2016). https://doi.org/10.1007/s10728-013-0269-9

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