Context and Work Organization in an Acute Health Care Setting

This chapter explores the influence of context in shaping the health care support worker in a hospital setting. Viewing context as constraining or facilitating the exercise of discretion or choice, the chapter examines such influences at different levels of a health care system: the national, the organizational, and the workplace. Drawing on material from four case study hospitals in National Health Service England, the chapter highlights the sensitivity of the support worker role to national and organizational policies and practices. However, the role is presented as particularly affected by workplace contingencies linked to clinical setting, work organization, and interpersonal relations on the ward. The result is a role that shares a job title but assumes a very different form, in terms of tasks performed between and especially within different hospitals.