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Not Merely TLC: Nurses’ Caring Revisited

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Abstract

The profession and practice of nursing has been studied from quite diverse scholarly perspectives in the United States and abroad. Feminist critiques focus on the gendering of caring and its knowledge/skill features, while professionalization advocates view emotive caring as secondary to other critical activities necessary for the occupational advancement of nursing. Based on ethnographic observations 30 in-depth, semi-structured interviews with nurses across different units working at a large urban hospital, this paper examines how nurses define caring as knowledge-based, skilled work. Specifically, nurses described four types of skills—observational, analytical, interactional, and comforting—that they deploy in the accomplishment of caring work at the bedside. My findings go beyond previous literature in this area by showing how nurses think of caring work in line with occupational strategies that emphasize their biomedical knowledge and diagnostic skills and uphold an advocacy or intermediary role in health care. I argue that while this ideological work may reassure nurses of their professional identity and critical role in health care, it may also reinforce the dilemma of nurse professionalization by obscuring the organizational nature of caring, as it remains an unsupported dimension of their work.

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Notes

  1. For an example of how “eye contact” relates to power differentials, see Razack 1994, 1998; for an example of how “eye contact” is cultural, see Anderson 1992, 1999.

  2. On the prevalence of nurse frustration with their jobs, see turn-over and burn-out rates and common reasons for dissatisfaction in The Registered Nurse Population 2010.

  3. See the recent U.S. Veterans Administration scandal (Griffin and General 2014), or the critical Francis Report on England’s National Health System (Francis, Robert 2013).

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Acknowledgments

I would like to thank Dr. Charles S. Varano and Dr. Judith C. Barker for their invaluable conceptual assistance during the various stages of manuscript development. I also would like to thank Sydney Lopez for providing support during manuscript preparation.

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    Ester Carolina Apesoa-Varano

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Apesoa-Varano, E.C. Not Merely TLC: Nurses’ Caring Revisited. Qual Sociol 39, 27–47 (2016). https://doi.org/10.1007/s11133-015-9322-3

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