Tinkering with care values in public and private organizations

Abstract

Tinkering with care values in public and private organizations This special issue develops from discussions and papers presented at the Annual Ethnography Symposium in 2017 and aims to gather ethnographies on how care values intersect with service organizations, welfare policy and varying views of good professional practice in private and welfare institutions. It zooms in on the growing cross-disciplinary interest in the values of care for the ill, unwell and unhealthy or disabled in industrialized societies. The issue takes up the well-known but far from trivial debates about how bureaucrats, professionals, students, users and families often represent and face competing requirements and approaches to care in organizations informed by different values and ideologies. Yet, the ideological or value-laden underpinnings of care in organizations often remain less clear in organizational studies, nursing research and in social studies in medicine and social work. Questions of value lie at the heart of debates about the organization of current welfare systems, provision of care services and the architecture of future societies. This transpires, for example, in recent contributions to Journal of Organizational Ethnography on meaning making in acute nursing care practices (Lake et al., 2015), in studies of health care reform and patient and public involvement (PPI) (Glasdam and Oute, 2019) and in studies of volunteering and ethnographic conduct (Garthwaite, 2016). Values are embedded in the contemporary calculus of health and social care provision in many different forms (Rose, 1999, 2007): the financial value of contracts for health or social care services; consumerist values and the commercialization of help seekers (Mol, 2008; Mol et al., 2010), ethical values located in standards and guidelines which regulate clinical practice (Huniche, 2011), and moral values, through which dilemmas and discrepancies are experienced by professionals (Mattingly, 2014, 1998). Albeit invisible and/or taken-forgranted these kinds of different orders of worth are not only deeply rooted in the political requirements that underpin care in organizations, such orders also shape reform and the very organization of welfare services. Moreover, the entanglement of different sets of values also form a background for professional-user relations, recruitment of staff, care education and professionals' feelings and at times limit users' access to services at street level. In response, we need ethnographic work that disentangles what care values "do" in care organizations and bring to light how they are made to work, negotiated and resisted by actors in everyday practice. The issue thus aims to elucidate such themes that are often hidden in the intersections between ethnographic, organizational and health care journals. The issue focuses on the taken-for-granted values, ideals and ideologies located in the practical realities of care giving and receiving across a range of contexts. Organizational ethnographies on care values This issue features six in...

The Prosocial-Culture-Work Nexus: An Integrative Literature Review and Future Research Agenda

“…Emic organization culture research approaches are actor-centered, thickly described and context rich, reflecting ethnographic [ 25 , 26 ] and anthropological [ 27 ] perspectives and methods. They identify named and authentic actors and their own terms and experiences in a culture.…”

What are dually diagnosed patients’ problems represented to be in mental health? A WPR analysis of the multistability purpose of digital health records

“…Thus, the effects of the politically pre‐determined focus on determining risk factors, individualising illness management and the rhetorical and structural exclusion of patient experience in the records might impose a moral appeal for professionals to tinker actively with service construction. If so, it questions how professionals might deliberately ignore the political requirements of the records and systematically fail to document how they ‘go an extra mile’ to collaborate with users in the shadows of mental health in order to provide meaningful and adequate help to service users (Nygaard‐Christensen et al., 2018; Oute & Rudge, 2019).…”

Solidarity and polarisation regarding COVID-19 and related risks – A thematic analysis of comments from an international survey

“…This process of negotiation can be compared with the value of tinkering in relation to care. This refers to how different actors tinker with what needs to be done and what matters to them, with consideration taken to multiple sets of values including personal, professional, organisational and governmental ones, and how such processes of weighing up different kinds of value-informed care will colour service construction ( Oute & Rudge, 2019 ). Or in the present study, how such tinkering will or can colour the handling of daily life related to decrees, recommendations, risks, daily responsibilities and personal beliefs.…”