The Nurse Who Never Clocks Out: Kin‐Directed Care Coordination, Filial Obligation and Invisible Work in the Care Economy

AIM(S): To examine the unpaid advisory, navigational and hands-on health work that nurses perform for relatives, friends and neighbours and conceptualise it as kin-directed care coordination. DESIGN: Position paper. METHODS: A critical discussion drawing on feminist scholarship on care work, filial piety and gendered family care, double-duty caregiving, work-family boundaries and recovery, professional regulation and nurse retention. RESULTS: Feminist scholarship has shown that unpaid care work sustains economies and falls mainly on women. Double-duty caregiving research has described nurses advising relatives, but not the standing role in which a nurse becomes health adviser and navigator for a whole kin network. Filial piety and gender may shape who is asked and how hard refusal is. We describe five practices: interpreting, triaging and advising, brokering access, hands-on care and bearing accountability. It crosses the work-home boundary, may erode recovery, carries professional obligations and is absent from workload measures, workforce surveys and care-economy accounts. Health systems with weak primary care may rely on this work without counting it. CONCLUSION: Kin-directed care coordination can be understood as a distinct, culturally shaped, probably gendered, and unmeasured form of nurses' unpaid care work that warrants recognition in research, regulation, and policy. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Nurse managers, educators, regulators, and researchers can name and measure this work and address it in retention strategies, professional guidance, and ethics education. IMPACT: This paper addresses the absence of a defined concept, and of any measure, for nurses' health work for their wider kin and social networks. It proposes a concept, five practices and a measurement agenda. It will inform nurse leaders, educators, regulators and workforce planners. REPORTING METHOD: Not applicable to this position paper. PATIENT OR PUBLIC CONTRIBUTION: This study did not include patient or public involvement in its design, conduct, or reporting.