Estrés relacionado con el trabajo y exposición laboral en enfermeras de la Comunidad de Castilla y León

The missing two Cs – commodity and critique: Obscuring the political economy of the ‘gift’ of nursing

This discussion paper argues for understanding nursing care as a commodity within capitalist relations of production, ultimately as a product of labour, whose use value far exceeds its exchange value and price. This under-recognised commodification of care work obscures the social relationships involved in the contribution to the social reproduction of labour and to capital accumulation by nursing care work. This matters, because many care workers give of themselves and their unpaid overtime to provide care as if in a ‘gift economy’, but in doing so find themselves in subordinate subject positions as a part of the social reproduction of labour in a ‘commodity economy’. Thus they are caught in the contradiction between the ‘appearance’ and reality. A focus on the individual moral character of nurses (e.g. the UK’s 6Cs), may operate as a screen deflecting understanding of the reality of the lived experiences of thousands of care workers and supports the discourse of ‘care as a gift’. The commodification of care work also undermines social reproduction itself. Many nurses will not have tools of analysis to critique their subject positioning by power elites and have thus been largely ineffectual in creating change to the neoliberalist and managerialist contexts that characterise many healthcare and other public sector organisations. The implications of this analysis for healthcare policy and nursing practice is the need for a critical praxis (an ‘action nursing’) by nurses and nursing bodies, along with their allies, which may include patient groups, to put care in all its guises and consequences central to the political agenda.

Psychological harassment in the nursing workplace: an observational study

Psychological harassment in the workplace involves disrespectful or humiliating behavior to workers. Nurses make up one of the groups that are most exposed to these behaviors. This descriptive study investigated the most common types of psychological harassment in the nursing workplace and their relationship with sociodemographic variables among 285 nurses in Spain. Findings indicate differences in the prevalence of psychological harassment depending on the criterion that was used. Psychological harassment is positively correlated with a desire to abandon the profession and negatively with participation in decision making. The results suggest combining different measures to evaluate psychological harassment in the workplace and zero-tolerance polices for psychological abuse.

[Continuous care, one more cardiovascular risk factor to consider?]

OBJECTIVE

To assess blood pressure (BP) in Primary Care (PC) professionals while working extra shifts and its relationship with the professional role, anxiety level and social support.

METHOD

Descriptive,, cross-sectional, multicentre and prospective study.

POPULATION

PC health workers from Toledo Health Area who work on-call shifts.

EXCLUSION CRITERIA

diagnosed hypertension, African origin, cardiovascular disease or chronic treatment. Voluntary sampling.

VARIABLES

sociodemographic, occupational and STAI questionnaire (anxiety state/feature); ISTAS21 questionnaire (psychosocial risks at work), and Ambulatory BP Monitoring with a Holter for two days, 48h: one of them during the shift and the other one during a day without being on-call.

RESULTS

The BP monitor showed significant differences in daytime systolic BP: rest day115.9±8,3mmHg/ Shift mean: 120.2±8,1 (t=4.319; P<0.001); daytime diastolic: rest day 73.3±5.9mmHg/Shift 77.9±6.1 (t=6.555; P<0.001); night systolic: rest day 106.8±8.3mmHg/shift 111.6±9.5 (t=3.4; P<0.001); night diastolic: rest day 65.1±5.6mmHg/Shift 69.1±6.9 (t=4.14; P<0.0001). We found no relationship between variations in the BP, the category or role. The ISTAS dimensions (health situation status) and the anxiety level (average of 5/10 during the shift) are not related with the BP either.

CONCLUSIONS

There are significant changes in the BP of the professional during the extra shifts, independently of professional role, anxiety level or psychosocial risk. Studies need to be conducted on the demonstrated variation in BP working extra shifts to assess its impact on health.