Negotiating the role of expert carers on an adult hospital ward

Abstract

Owing to a combination of economic, demographic and ideological factors, the last 20 years has witnessed the ‘rediscovery’ of family care (Nolan et al. 1996). Apart from notable exceptions, such as Sweden (Hokenstad and Johansson 1990; cited by Zarit et al. 1993), contemporary systems of welfare are increasingly underpinned by the assumption that families or significant others should care for their dependent relatives. There has been a concomitant explosion of research into caring over the past decade. We now have a better understanding of the incidence, patterns and experience of family caregivers (Twigg and Atkin 1994), the sorts of help carers say they need and the temporal elements of the care-giving career (Taraborrelli 1994; Nolan et al. 1996). Much less is known, however, about how carers fit into the service system. The aim of this chapter is to begin to address this gap in the literature by exploring the ways in which staff on an adult medical ward negotiated the caring division of labour with established family carers. I refer to this group as expert carers and argue for their analytic distinction from other family members or significant others who may have been implicated in the ward caring division of labour in some way. The argument presented here is that in terms of our understanding of the negotiation of the caring division of labour in the hospital context expert carers constitute a special case because of the challenge they pose to fundamental features of the social organisation of work on the wards.