Tides of Enforcement: Rules and Realities in an American Nursing Home
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2004
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ndltd-OhioLink-oai-etd.ohiolink.edu-osu13808996892021-08-03T06:19:53Z Tides of Enforcement: Rules and Realities in an American Nursing Home Thomas, Michele Sociology Recent ethnographies analyzing the structure of work in nursing homes have notsufficiently explored the gap between official rules and actual organizational practices.In this paper, I argue that caregivers must systematically bend or break many workplacerules in order to protect their employment, avoid supervisory wrath, meet (or appear tomeet)unrealistic job expectations, and to provide compassionate care not included in theirjob descriptions. I identify three distinct types of routine rule breaking, and I show thatmanagement's rule enforcement is selective and cyclical. Further, I show the relationshipbetween rules and practices is complex and based upon a changing, interactiverelationship between management, employees, and residents. Workers desire to performtheir jobs in a manner consistent with rules and regulations they understand the necessityfor, but they also find themselves in search of ways to protect morale, control their workload when the demands are greater than what is possible, and find ways to break rules ina way that would not compromise care in a manner detrimental to the immediate healthneeds of the residents. However, I did not find they often considered the long termeffects of continuous systematic rule breaking. Results from this research indicate thatworkers do care about the quality of care they give, but their own most pressing needssuch as maintaining employment play a significant role in determining how they carryout their work.ii 2004 English text The Ohio State University / OhioLINK http://rave.ohiolink.edu/etdc/view?acc_num=osu1380899689 http://rave.ohiolink.edu/etdc/view?acc_num=osu1380899689 unrestricted This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws. |
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NDLTD |
| language |
English |
| sources |
NDLTD |
| topic |
Sociology |
| spellingShingle |
Sociology Thomas, Michele Tides of Enforcement: Rules and Realities in an American Nursing Home |
| author |
Thomas, Michele |
| author_facet |
Thomas, Michele |
| author_sort |
Thomas, Michele |
| title |
Tides of Enforcement: Rules and Realities in an American Nursing Home |
| title_short |
Tides of Enforcement: Rules and Realities in an American Nursing Home |
| title_full |
Tides of Enforcement: Rules and Realities in an American Nursing Home |
| title_fullStr |
Tides of Enforcement: Rules and Realities in an American Nursing Home |
| title_full_unstemmed |
Tides of Enforcement: Rules and Realities in an American Nursing Home |
| title_sort |
tides of enforcement: rules and realities in an american nursing home |
| publisher |
The Ohio State University / OhioLINK |
| publishDate |
2004 |
| url |
http://rave.ohiolink.edu/etdc/view?acc_num=osu1380899689 |
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AT thomasmichele tidesofenforcementrulesandrealitiesinanamericannursinghome |
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