This purpose of this study is to describe how nursing assistants make sense of organizational experience in a nursing home. This study will examine how nursing assistants in a nursing home understand, interpret, and describe their work. Caring for the elderly exists on a spectrum from informal care (family care) to formal care (nursing home care). The formal care for the elderly is provided mostly by nursing assistants in nursing homes. The occupation of nursing assistants consists of mostly women (91 percent), a disproportionate number of minority groups (30 percent are African American, and 55 percent are white), and in 2000, were paid an average annual income of $15,751 (Montgomery et al., 2005). Due to the demanding nature of the work (physically and emotionally), odd and long hours, and an unattractive salary, it is not a surprise that high levels of stress, burnout, and turnover is common among nursing assistants. As an organization, the nursing home has bureaucratic requirements reward and penalize nursing assistants for certain behavior. This study specifically analyzes nursing assistants experience as a worker in a nursing home, and how they interpret their occupation.
Research questions
RQ1: How do nursing assistants make sense of their work experience?
RQ2: How do nursing assistants make sense of their occupation?
Proposed sites and artifacts
Golden Living is a for-profit nursing home in Moorhead, MN, and is the proposed site for this study. The research participants for this study will be the nursing assistants who work there and their reflections on their work experience will be the basis for analysis.
Method
Semi-structured, in-depth interviews with 10 nursing assistants will be used to collect data. Interview questions will be probed based on broad categories (i.e., resistance and control, feminine and masculine roles, sexism in the workplace, social and economic class, and emotion). Probing questions that address the broad categories will be determined later in the research process. Follow-up questions will be asked during the interview based on how participants respond to the broad categories. Once the interviews have been transcribed, data will be analyzed using thematic analysis.
Contribution
A recent study funded by the National Institute of Health found a significant difference in the quality of care provided to the elderly between for-profit nursing homes and non-profit nursing homes, with non-profit nursing homes provided better care. The quality of care, or output of a nursing assistant’s care, is the primary attention of health researchers. Therefore, by interviewing the people who provide care in a for-profit nursing home, this study is an opportunity for nursing assistants to reflect on their work experience without taking in account their quality of care.
Annotated Bibliography
1) Aronson, J. & Neysmith, S. M. (1996). ‘You’re not just in there to do the work’: Depersonalizing policies and the exploitation of home care workers’ labor. Gender & Society, 10, 59-77.
This study depicts the care for the elderly workforce as a low-status, and exploited group of workers. This research will be used to describe work for the elderly.
2) Lopez, S. H. (2006). Emotional labor and organized emotional care. Work and Occupations, 33, 133-160.
This study is an exemplary qualitative study done at three nursing homes, and describes emotional labor in a care organization. This study will be used to define a care organization and will be used to describe the method section.
3) Jervis, J. L. (2002). Working in and around the ‘chain of command’: Power relations among nursing staff in an urban nursing. Nursing Inquiry, 9, 12-23.
This research focused on the power relations among the nurses and nursing assistants in a nursing home. It used ethnographic methods to uncover class conflict and power struggles in the work environment. The study will be used as a potential direction for my research study.
4) Stacey, C. L. (2005). Finding dignity in dirty work: The constraints and rewards of low-wage home care labour. Sociology of Health & Illness, 27, 831-854.
This qualitative research study used interviews to uncover how home care workers found their work with the elderly as both demanding and rewarding. The study will be used in the method section to show how qualitative interviews can uncover information about the work experience. It will also be used to show the abundance of research on home care workers, and the lack of research on nursing assistants.
5) Mumby, D. K. (2005). Theorizing resistance in organizations. Management Communication Quarterly, 19, 19-44.
In this article, Mumby reviews and critiques resistance in the workplace. He promotes a dialectical approach to research control and resistance in an organizational setting describes. Control and resistance is a potential direction for my study.
6) Buzzanell (1994). Gaining a voice: Feminist organizational communication theorizing. Management Communication Quarterly, 7, 339-383.
In this article, Buzzanell promotes for, outlines and describes how the use of feminist theories can be used in organizational research. The theoretical lens she provides is a potential perspective to take in my research.
7) Mumby, D. K. and Ashcraft, K. L. (2006). Organizational communication studies and gendered organization: A response to Martin and Collinson. Gender, Work and Organization, 13, 68-90.
Mumby and Ashcraft argue gender in organizational communication “is enacted in a complex field of discursive and nondiscursive relations of power, accommodation and resistance” (p. 75). This article is a possible direction for the analysis of my research.
8) Foner, N. (1994). The caregiving dilemma: Work in an American nursing home. Berkely, CA: Unversity of California Press.
Foner’s ethnographic research study provides a detailed description of a nursing assistant’s place within a regulated and bureaucratic organization. Her work will be used to describe the work, and organizational experience of nursing assistants.
9) Farmer, B. C. (1996). A nursing home and its organizational climate. Westpoint, CT: Greenwood Publishing Group.
Farmer describes the organizational climate in a nursing home in her ethnography. Her historical overview of the nursing home in the United States and her description of the nursing home as an organization will be used in this study.
10) Diamond, T. (1992). Making gray gold. Chicago: The University of Chicago Press.
This ethnographic study describes the work of nursing assistants, and depicts how their work is situated in a political, economic, and cultural context. His description will provide an overview of nursing assistants’ work. The theoretical perspective he uses may be used for this study.
11) Preidt, R. (2009, August 5). Not-for-profit nursing homes fare better in studies. Retrieved September 10, 2009 from the National Instituted of Health website, http://www.nlm.nih.gov/medlineplus/news/fullstory_87774.html
This study funded by the NIH compared the quality of care between for-profit and not for-profit nursing homes. The article will be used to justify the use of qualitative methods in nursing homes.
12) Ashcraft, K.L. (2004) Gender, discourse, and organizations: Framing a shifting relationship. In Grant, D., Hardy, C., Oswick, C., Phillips, N. and Putnam, L.L. (eds), Handbook of Organizational Discourse, pp. 275–98. Thousand Oaks, CA: Sage.
Ashcraft describes how discourse analysis can be used in organizational research. This is a potential methodological approach to the research study.
13) Ashcraft, K.L. and Mumby, D.K. (2004) Reworking Gender: A Feminist Communicology of Organization. Thousand Oaks, CA: Sage.
This article promotes a framework to researching gender in organizations. This is a potential area to focus on and framework for my research study.
14) Oglensky, B.D. (2008). The ambivalent dynamics of loyalty in mentorship. Human Relations, 61, 419-448.
This article uses a dialectical approach to studying mentoring. Dialectics, specifically resistance and control, is a potential area of research in this study.
15) Ashcraft, K. L. (2005). Resistance through consent? Management Communication Quarterly, 19, 67-90.
This article describes how resistance and power are played out in an organizational setting. Again, this is a potential area of research in this study and would be used in the methodology section.
16) Ashcraft, K. L. (2007). Appreciating the ‘work’ of discourse: Occupational identity and difference as organizing mechanisms in the case of commercial airline pilots. Discourse & Communication, 1, 9-36.
Ashcraft provides a feminist and critical perspective on the airline pilot occupation. Her theoretical perspective is a potential theory that could be used to interpret data in my research study.
17) Montgomery, R., Holley, L., Deichert, J., and Kosloski, K. (2005). A profile of home care workers from the 2000 census: How it changes what we know. The Gerontologist, 45, 593-600.
This article provides a nice overview of working with the elderly. It will be used to describe the nursing assistant profession.
18) Gass, T. E. (2004). Nobody’s Home. Ithica, NY: Cornell University Press.
Gass provides a rich description of the care giving provided in a for-profit nursing home. His experience of working in a nursing home will be used to describe the demanding, and sometimes downright gross, work provided by nursing assistants in nursing homes.
19) Anderson, R. A., Ammarrell, N., Bailey Jr., D., Colon-Emeric, C. Corazzini, K. N., Lillie, M., Piven, M. L. S., Utley-Smith, Q., McDaniel Jr. R. R. (2005). Nurse assistant mental models, sensemaking, care actions, and consequences for nursing home residents. Qualitative Health Research, 15, 1006-1021.
This qualitative research study analyzed observation and interview data to describe two mental models of nurses in a nursing home. The study will be used in the method section to show how interview techniques has been used to examine work experience in nursing homes.
20) Mumby, D. K. (2001). Power and politics. In F. M. Jablin and L. L. Putnam The New Handbook of Organizational Communication, pp. 585-623. Thousand Oaks, CA: Sage.
Mumby outlines methodological implications for researching power in organizations. This is a potential area in my research study, and his suggestions for methodology may be used in the methodology section.
