Joy, sorrow and invisible work and theoretical inconveniences in the labour process of community nurses

This paper uses data from an ethnographic study of a group of NHS community nurses in England, to analyse their work using labour process theory. A theory influenced by Marxist thinking, which is concerned with the examination of the labour process. This study of the nurses' work provides insights into their labour process, as well as proposing theoretical development relating to labour process theory.

The paper has been developed using data from an ethnographically oriented study of a group of community nurses. Data was produced from 140 h of field observations and also semi-structured interviews with six, community nurses. The data produced from field observations and interview transcripts were analysed thematically and theory building was developed inductively.

The analysis within this paper highlights two areas of the nurses' work and both illustrate the theoretical difficulties raised, when using labour process as a tool for analysis, as well as its usefulness. These two areas of work are aspects of invisible work and feelings of joy and sorrow; analysis of both these areas supports a theorising of a distinct relationship between nurse and patient. That is, a relationship between worker and human product, which the paper argues should be accommodated within labour process theory.

More research is required to understand the nature of the proposed social relation in production, particularly with reference to other types of worker, in other caregiving settings. As the demands on healthcare workers and other public sector workers are likely to remain consistently high, improved analytical tools to support research into the nature of caregiving work seem both prudent and timely.

Labour process theory is a useful (but often under-used and rather unfashionable) tool in the analysis of service-based, public sector work. This paper proposes a theoretical development within labour process theory, which would recognise a social relation in production between a worker and their human product, based on empirical data from a study of community nurses. This theoretical development has the potential to improve the usefulness of labour process theory in the analysis of caregiving labour.