'Catching up': The significance of occupational communities for the delivery of high quality home care by community nurses

Health (London). 2013 Jul;17(4):422-38. doi: 10.1177/1363459312460703. Epub 2012 Oct 18.

Abstract

This article examines the importance of some informal work practices among community nurses during a period of significant organizational change. Ethnographic fieldwork in two purposively selected adult community nursing services in England comprised 79 hours of observation of routine practice, 21 interviews with staff and 23 interviews with patients. We identified the informal work practice of 'catching up', informal work conversations between immediate colleagues, as an important but often invisible aspect of satisfying work relationships and of the relational care of patients. Drawing on anthropological literatures on 'communities of practice' the article examines two central issues concerning the practices of 'catching up': (1) how informal learning processes shape community nursing work; (2) how this informal learning is shaped both in relation to the ideals of community nursing work and the wider political and organizational contexts of community nursing practice. Our findings highlight the distinctive value of informal workplace 'catch ups' for nurses to manage the inherent challenges of good home care for patients and to develop a shared ethic of care and professional identity. Our findings also indicate the decline of 'catching up' between nurses along with diminishing time and opportunity for staff to care holistically for patients in present service climates.

Keywords: Ethnography; health policy; organization of health services; patient–physician relationship.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Community Health Nursing / methods
  • Community Health Nursing / organization & administration
  • Community Health Nursing / standards
  • England
  • Home Health Nursing / methods*
  • Home Health Nursing / organization & administration
  • Home Health Nursing / standards
  • Humans
  • Interviews as Topic
  • Nurse-Patient Relations
  • Nursing Process
  • Quality of Health Care
  • Workplace / psychology