Med avstegen som arbetsplats – En etnografisk studie av hälso- och sjukvårdskuratorns arbete

Abstract

ABSTRACT Title: Out of line as workplace – An ethnographic study of health social work Author: Elisabet Sernbo Keywords: health social work, ethnography, queer phenomenology, reorienting work, jurisdictional work, professional self-image, professional-patient relations, interprofessional relations Distribution: University of Gothenburg, Department of Social work, Box 720, S-405 30 Göteborg ISBN: 978-91-88267-09-2 ISSN: 1401-5781 E-publishing: http://hdl.handle.net/2077/59806 The aim of this thesis is to analyse what characterizes everyday health social work, focusing on the interplay between health social workers, patients and other health care professionals, and on the professional self-image of health social workers. The approach is ethnographic and the study is based on shadowing and focus group interviews. The overarching theoretical concepts are inspired by queer phenomenology. The analysis shows that in the main, health social work is not characterized by the exercise of public authority or redistribution of resources. It is therefore analysed as reorienting work – affecting how people understand themselves and direct their attention as well as what objects become reachable. Health social workers help patients as well other staff members and teams to cope with difficulties and contribute to maintaining organizational efficiency and specialization by offloading other staff members and enhancing patient compliance. They position themselves, and are positioned, in many and contrasting ways. This results in multifaceted everyday work directed at individual patients as well as other health care professionals, in which the health social workers become a conditioned part of several constellations of ‘we’. These ambivalent loyalties are balanced using strategies that allow them to be perceived as parts of the institutions and also as unattached. This makes them flexible in organizing their work but also dependent on cultivating and maintaining personal relationships, resulting in a high degree of temporality in their jurisdictional work. Health social workers hold a professional self-image of valuing loyalty with patients, but this ideal is difficult to observe in practice. They often intend to function as extended arms for patients, but sometimes they rather become extended arms of the organizations.