Nursing casualization and communication: a critical ethnography.
OBJECTIVE
The aim was to explore the relationship between nursing casualization and the culture of communication for nurses in a healthcare facility.


BACKGROUND
Casualization, or non-standard work, is the use of temporary, contract, part-time and casual labour. An increase in casual labour has been part of a global shift in work organization aimed at creating a more flexible and cheaper workforce. It has been argued that flexibility of labour has enabled nurses to manage both non-work related needs and an increasingly complex work environment. Yet no research has explored casualization and how it impacts on the communication culture for nurses in a healthcare facility.


METHODS
Critical ethnography.


METHODS
Methods included observation, field notes, formal interviews and focus groups. Data collection was undertaken over the 2 years 2008-2009.


RESULTS
The concepts of knowing and belonging were perceived as important to nursing teamwork and yet the traditional time/task work model, designed for a full-time workforce, marginalized non-standard workers. The combination of medical dominance and traditional stereotyping of the nurse and work as full-time shaped the behaviours of nurses and situated casual workers on the periphery. The overall finding was that entrenched systemic structures and processes shaped the physical and cultural dimensions of a contemporary work environment and contributed to an ineffective communication culture.


CONCLUSIONS
Flexible work is an important feature of contemporary nursing. Traditional work models and nurse attitudes and practices have not progressed and are discordant with a contemporary approach to nursing labour management.
Department of Infectious Diseases, Royal Brisbane and Womens Hospital, Queensland, Australia.
Mary
M
Batch
Carol
C
Windsor
D000328:Adult; D000884:Anthropology, Cultural; D001291:Attitude of Health Personnel; D001315:Australia; D003142:Communication; D003284:Contract Services / Q000458:organization & administration*; D004651:Employment / Q000145:classification; D005260:Female; D017144:Focus Groups; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000458:organization & administration* / Q000523:psychology*; D015279:Organizational Culture; D010348:Patient Care Team / Q000458:organization & administration*; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D013240:Stereotyping; D017132:Workplace / Q000523:psychology*; D055815:Young Adult
casualization; communication; critical ethnography; culture; healthcare organizations; marginalization; nursing