Nurses and Their Work in Hospitals: Ruled by Embedded Ideologies and Moving Discourses

Abstract

Nursing originates from societal beliefs about women‟s roles of self-sacrifice and obedience situated within a history of patriarchal control. Unfortunately, these ideologies continue to influence and shape nurses‟ work in hospitals. Within the literature, several dominant discourses construct hospitals and nurses‟ work in hospitals as chaotic and challenging while nurses are conceptualized as stressed and fatigued. Overcrowding, increasing patient acuity, budget constraint, and chronic understaffing are only some of the issues nurses face in their every day and night work. Because of these problems, nurses are expected to care for patients in the hallways; manage with minimal staffing; and simply absorb the work associated with acutely ill patients. Nurses actively participate and take up these discourses as their work. Patriarchal assumptions and nurses‟ endless compromise and accommodation have resulted in the normalization of hospital problems as just part of nurses‟ work. Prevailing ideologies and institutional discourses make invisible, and taken-for-granted, how this work contributes to sustaining the hospital‟s power. External relations contribute to influencing and organizing nurses and their work. Using institutional ethnography and a poststructuralist perspective; this research relies on my experience, historical research, participant observation and interviews to reveal how institutional discourses have framed nurses‟ work in hospitals and how nurses actively participate in perpetuating and vivifying them.