Nursing in times of neoliberal change: An ethnographic study of nurses' experiences of work intensification

Abstract

Through an ethnographic study of nurses' experiences of work intensification, this article shows how nurses respond to and act upon neoliberal transformations of work. The article identifies and explores those transformations considered by the informants, nurses working in public sector hospital wards, as central to changing conditions of work and experiences of work intensifications. It further analyzes nurses' responses toward these transformations and locates these responses within a particular form of femininity evolving from rationalities of care, nurses' conditions within the organization, and classed and gendered experiences of care work. The article illustrates that in times of neoliberal change and public sector resource depletion, nurses respond to women's traditional caring responsibilities as well as to professional commitments and cover for the organization. Maintaining the level of frontline service is contingent on increased exploitation and performance control of ward nurses, and their ability and willingness to sacrifice their own time and health for the sake of their patients. The article argues that in the case of ward nurses in the Swedish public sector, work intensification is a multilayered process propelled by three intersecting forces: austerity ideology linked to the neoliberal transformation of the welfare state and public sector retrenchment; explicit care rationalities impelled by aspirations of the nursing profession to establish, render visible, and expand the nursing field both in relation to the medical profession and in relation to so-called unskilled care work performed by assistant nurses and auxiliaries; and the progressive aspect of New Public Management, which challenges the power and authority of the professions and contributes to strengthening the positions of clients and patients.