Work Shifts

This chapter takes a closer look at caregiver/nurse interactions. It includes an analysis of the identities and emotional labor of home health nurses. As professionals who possess valuable disciplinary knowledge, how do they feel about transferring their skills to lay caregivers? Nurses' orientation to the labor and the effects on interactions with caregivers are key features in the labor transfer. Nurses were able to gradually transfer the skilled labor through strategies such as “gently encouraging” or “forcefully 'pushing' ”caregivers to learn, and “if the caring work appeared too difficult or technical, nurses simplified or 'downplayed' these aspects, or they would insist that the caregiver was 'smart enough' to learn.” Nurses often stated that the goal was to make patients and families “independent” in their care. Nurses thus draw heavily on the ability of home care to provide holistic nursing practices. Nurses' focus on patients' physical and emotional health refutes a vision of nurses as purely “ideological workers” — an image that implies an insensitive and coercive nature in the transfer of skills. The relationship between nurses and caregivers is critical for nurses, who identify heavily with the education component of their profession.