Title of ArticleTacit practice in care homes
Type of ArticleSpecial issue article
Author/sAnne Marie Sandvoll
ReferenceVolume 7, Special Issue on Enhancing wellbeing: practice and politics, Article 6
Date of PublicationSeptember 2017
Keywordsaversion, care home, ethnography, habitus, nursing practice, older people, tacit

Background: Care home practice has been described as complex, even though it might comprise common everyday activities. Research has indicated that nursing staff consider assisting care home residents to be demanding work, much of which remains tacit or is taken for granted. The tacit knowledge that lies behind nurses’ work is an important issue to explore and describe.

Aims: To describe tacit care practices and understand the complexity of nursing practice in care homes.

Methods: An ethnographic study was used to gain an in-depth understanding of nursing practice in care homes in a Nordic context.

Findings: Nursing staff appeared to be committed to daily work routines but also reported having to deal with a number of unexpected events each day, some of which were particularly challenging. Dealing with some residents’ behaviours could evoke difficult emotions among staff, such as irritation and aversion – emotions that could be difficult to admit to. Despite this, staff seemed to believe they had to manage their responses and offer good care to all residents. Synthesising these findings led to the theme of ‘tacit care home practice’. Examples of such tacit practice are described in this article.

Discussion: Staff develop a common habitus of caring, including dealing with unexpected events and behaviours that are sometimes regarded as unpleasant. This habitus is often taken for granted and therefore needs to be explicated and discussed.

Conclusions and implications for practice:

  • The statement ‘we just do it’ suitably describes nursing staff’s habitus of caring, which includes dealing with unexpected events and unpleasant behaviours
  • Describing these tacit aspects of care can extend our understanding of some previously unarticulated aspects of care home practice
  • These findings suggest a need for greater awareness, better communication and reflection in relation to these tacit elements of practice. This could contribute to improved nursing practice in care homes

This article by Anne Marie Sandvoll is licensed under a Creative Commons Attribution Non-Commercial 3.0 License.

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