Chapter eight: Safeguarding through work arounds: Socio-materiality and the organising of care in a private hospital

Abstract

The growth of the private hospital sector in Australia has implications for the provision of nursing care, for nursing work differs in each sector. How nurses work in the private sector is shaped by stakeholder and economic imperatives, and even the spatial organisation of care is changed by the differing imperatives shaping nursing work. This chapter provides an analysis of work and its organisation in an Australian acute care private hospital. Taking a socio-materiality approach, we examine how nursing staff employ various strategies to navigate the physical space while providing care to patients and meeting the changed demands of work in the private environment. Changes to the funding allocations in private hospitals have altered how Registered Nurses (RNs) navigate ward spaces and the allocation of staff. RNs’ practices in a private healthcare context thus become focused on the relational maintenance of appearances of private hospital care, with a focus on public relations, fiscal responsibility and occupancy rates. The practices that emerge signal values integral to private healthcare, safeguarding quality and the hospital’s reputation. Such safeguarding practices carry and sustain RNs’ valuing of private care, despite the potential for contestation and conflict.