Old Folks and Dirty Work: The Social Conditions for Patient Abuse in a Nursing Home

This analysis, using data gathered by participant observation, examines patient abuse in a nursing home. It tries to show how the everyday conditions of work there keep the nurses from seeing or hearing about patient abuse. These conditions also provide the nurses with routine ways to deny its occurrence when such a claim is made. The conditions are: the invisibility of aide-patient interaction, the gap of hostility, and suspicion that separates the nurses from the rest of the employees, and the character and behavior of the personnel and patients which provide the nurses with “accounts” that deny its existence when allegations of abuse are made. In the conclusion, it is argued that similar conditions and processes may exist in other types of organizations.