Surveillance Dynamics in Long-Term Care: A Qualitative Study of the Nursing Workplace

In recent years, the growing demands of an aging population and market forces have led to an increase in nursing staff, including nurses and nursing aides. This expansion necessitates the surveillance of nursing activities to ensure the quality and efficiency of care. However, there is still a limited understanding of surveillance dynamics in long-term care (LTC) and their implications. This qualitative study explored the surveillance dynamics affecting nurses and nurse aides in LTC facilities. The research used semi-structured interviews to describe how surveillance affected LTC work and care quality. In total, 14 registered nurses and 18 nurse aides were interviewed. Analysis indicated three themes. Vertical surveillance involves oversight by higher management and families, as well as patient complaints and camera recordings. Horizontal surveillance includes peer monitoring and gossip, creating an informal oversight system. Finally, patients' body surveillance consists of monitoring patient health and hygiene, and nurse aides' compliance with regulations. The study found that these surveillance practices were described as only partly effective. Although they aimed to improve safety and compliance, they often resulted in heightened stress, diminished autonomy, and lower care standards. The results and implications are discussed.