Nursing casualization and communication: a critical ethnography

This is the authors' abstract. We don't add key points for this paper.

AIM: The aim was to explore the relationship between nursing casualization and the culture of communication for nurses in a healthcare facility. BACKGROUND: Casualization, or non-standard work, is the use of temporary, contract, part-time and casual labour. An increase in casual labour has been part of a global shift in work organization aimed at creating a more flexible and cheaper workforce. It has been argued that flexibility of labour has enabled nurses to manage both non-work related needs and an increasingly complex work environment. Yet no research has explored casualization and how it impacts on the communication culture for nurses in a healthcare facility. DESIGN: Critical ethnography. METHODS: Methods included observation, field notes, formal interviews and focus groups. Data collection was undertaken over the 2 years 2008-2009. RESULTS: The concepts of knowing and belonging were perceived as important to nursing teamwork and yet the traditional time/task work model, designed for a full-time workforce, marginalized non-standard workers. The combination of medical dominance and traditional stereotyping of the nurse and work as full-time shaped the behaviours of nurses and situated casual workers on the periphery. The overall finding was that entrenched systemic structures and processes shaped the physical and cultural dimensions of a contemporary work environment and contributed to an ineffective communication culture. CONCLUSION: Flexible work is an important feature of contemporary nursing. Traditional work models and nurse attitudes and practices have not progressed and are discordant with a contemporary approach to nursing labour management.