Introduction

This introductory chapter provides a background of Forest Grove Elder Services and its nurse practitioners (NPs). It advances the notion of clinic work to illustrate the ways in which the Grove's NPs brought care work into the medical encounter. The term “clinic work” reflects the reality that the NPs' work was different in both form and content from the medical work of their physician colleagues. It also underlines the ways in which the NPs' work invoked a different form of relationality—it was in deep relationship with the organization or clinic in which it was located. Forest Grove Elder Services is not an ordinary outpatient clinic. It is a federally backed policy experiment to evaluate whether a comprehensive care model could ameliorate the state's economic burdens for long-term care. In some ways, the Grove's experimental objective was to figure out how to deliver care work under the aegis of medical care. Thus, the Grove's NPs were not simply performing an expansive form of work on behalf of their patients; they were also providing an expansive form of organizational care work for their employer. The chapter then considers the utility of NPs under state retrenchment.