Control, resistance and the battle of time in the Swedish home care service: The presence of digital apps in the daily work of assistant nurses
Author(s): Marita Flisbäck, Danka Miscevic
Wednesday 14 | 13:20-13:40
Room: TP43
Session: Behind the scenes of digital public services
The quality and cost of Swedish (tax-funded) home care service is a recurring theme in Swedish media and political debates. The work situation of the assistant nurses in municipal home care, is often described as stressful and time pressured. Care recipients are entitled to care input which is specified exactly and checked minute by minute. The same logic applies to the time, given for the changeover between the visits in the homes of the care recipients. A key tool for managing the time and the actual content of caring work is the several apps that the assistant nurses have access to on their service cellphone. However, what does it mean to "live" with these digital apps in the everyday of work? To what extent do the assistant nurses experience themselves guided, helped, or hindered by the apps? How do they navigate through and beyond the digital landscape presented by these apps? What attempts are made to conquer or challenge the digital control in favor of the assistant nurses own professional knowledge?
This paper is based on an ongoing qualitative case study of assistant nurses' and care recipients' experiences of home care in a medium-sized municipality in Sweden (funded by the Swedish Research Council for Health, Working Life). The study is inspired by Michael Burawoy's sociological methodology of connecting – and “extend” – close empirical descriptions of a lived everyday work life (at the societal micro level) with a more macro-oriented analysis. Through a co-productive research process, we investigate possibilities for a more sustainable organization of the home care service, together with those whose everyday life is most affected by the development. The empirical data consists of qualitative interviews, diary entries from assistant nurses of their everyday work, and observation sessions at meetings aimed at developing the quality and efficiency of the home care services.
In the paper, the focus is on the assistant nurses' stories of work practices and digital governance. However, as we will see, the assistant nurses are not merely analyzed as passive recipients, controlled, and monitored by the apps. The narratives of everyday work contain several examples of "clever" resistance and attempts to find "free zones" that the digital eye cannot register, or at least fully control. Moreover, the resistance may involve developing ways of working so that in practice the apps are rendered secondary, while one's own professional judgments of good care (adapted to the nurses' practical assessments of the care recipients' needs) play first fiddle.