The boundaries of care
The boundaries of care

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The boundaries of care

1.6 Unofficial work cultures

The whole issue of bodily care and bodily functions tends to be driven underground and then emerges in jokes or crudeness. Picture this scene, a few months after Marie has started, when she has become more settled within the care team.

It was quite late on a Saturday night and a group of the younger staff were sitting in the staff room waiting for Jenny's boyfriend. He was going to give some of them a lift to the pub and the plan was for them to meet up with friends for a few drinks and then go for a curry. Marie was a bit late because she had been getting Richard ready for bed and he had had an ‘accident’ so she had to wash him and change his pyjamas. She rushed in after the others had already finished their handover meeting with the night staff. When she came in and mumbled about having to change Richard's pyjamas, Jenny started giggling and said it must have taken ages because he was so ‘well hung’. Everybody laughed. If you had played back a video of the scene you would have seen that Marie froze for almost half a minute before she started laughing as well.

Activity 5 Joking apart…

0 hours 10 minutes

What do you think was going through Marie's mind in that 30 seconds? Draw some thought balloons to script what she might have been saying to herself.

Discussion

I think Marie might have had quite a struggle because my guess is that she disapproves of this kind of language. She may also have felt disloyal to Richard as a person she respects, and have felt uncomfortable about what could be racist undertones because Richard is black. But perhaps she also found it quite a relief to get some of her feelings out of her system before she went home. Perhaps it helped her to put work, with its peculiar rules and relationships, out of her mind so she could go back to an ordinary Saturday night out with her mates.

My first reaction to Marie and her friends was very disapproving but then I thought that maybe laughing was therapeutic. You have probably heard of ‘a Freudian slip’. Although we try constantly to censor what we say, forbidden thoughts and secrets tend to leak out in the form of jokes, mistakes or slips.

Another reaction I had was to think how difficult it would have been for Marie not to laugh. Getting on well at work depends on going along with what other people do and fitting into the ‘culture’ of the place. Different workplaces develop their own jokes and jargon. Perhaps laughing about people's bodies and sexuality is one way Marie and her colleagues ‘let off steam’ about being exposed to the intimacy of people's bodies.

Isabel Menzies carried Freud's thinking a bit further in a classic piece of work on nursing practice called The Functioning of Social Systems as a Defence Against Anxiety (Menzies, 1970). She said that it was not only individuals who have an ‘unconscious’, but organisations and whole professions. The informal culture (the jokes, the language and also the way jobs are set up) is partly a consequence of the need to be defended from some of the things they are dealing with. For example, if you were an undertaker you couldn't get upset about every individual whose funeral you arranged. For your own sanity you'd have to distance yourself. Probably there are all kinds of ‘corpse jokes’ which take the sting out of the work.

A nurse I know who works on an oncology ward told me the joke about cancer being safe from ‘cut-backs’ in her hospital because it was a ‘growth area’. Lawler relates an interview with a nurse who, with her fellow trainee, became ‘hysterical with laughter’ when she encountered her first death, but who then became ‘sad because we hadn't witnessed anything like this before’.

Perhaps once you start making jokes you can't draw a neat line which stops you from passing on some of the cruelty to those receiving care.

Key points

  • Jokes may be used as a way of ‘letting off steam’ about the strains of care work.

  • Aspects of the work which are not publicly acknowledged tend to get dealt with in the informal culture of the establishment or work group: open supervision or discussion may avoid this.

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