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- Author or Editor: Carsten Juul Jensen x
Over the last few decades, nurses have had to do the necessary, and sometimes life-saving, care work at hospitals under genuinely changing political and organisational conditions. Following the regimes of New Public Management (NPM), new managerial discourses have been set up in Scandinavia, as well as in many other OECD countries, which have placed ever-increasing pressure on health-care workers (Malmmose, 2009; Centeno and Cohen, 2012). Managerial regimes have been implemented, partly to encourage efficiency through standardisation of care, but also to ensure commitment to the marketisation discourse and make ‘health care services’ more consumer-oriented and open, to meet the consumer’s ‘right to choose’ between different service providers. The arrival of these new regimes and discourses have been followed by policy instructions to take up a more service-minded approach, displayed through the slogan, ‘We are here for you’, advertising the Regional Health Service on the website (Region Sjælland, 2016). This is part of a policy regime, aiming to address the needs of patients-as-customers and announcing the political and organisational concern, not only for consumer choices, but also for their safety – as a first priority. While it could in fact be seen as a commitment to address citizens’ and patients’ needs, we will discuss a different and more complex reality. The focus of this chapter is on the consequences of the current transformations of these governing regimes – here based on the recorded experiences of newly educated nurses from different medical wards in Region Zealand, Denmark.
The work of nurses has, since the beginning of the 21st century, been deeply influenced by international discourses of safety programmes; especially as outlined in the World Health Organisation’s (WHO) conceptualisation of ‘patient safety friendly hospitals’ (WHO, 2016).
Care research does not take place in a vacuum, especially in the context of a global pandemic that has magnified the care crisis dynamics discussed in this book. Perhaps the COVID-19 crisis will actually give impetus to a more enduring, transformative restructuring of care and justice. And yet there is only limited room to reflect on these developments in the format of academic book chapters written mainly in the pre-COVID-19 period. How then can we make sure to position this book in its time, so that you, the reader engaging with our discussions, get a sense of the unsettling, disruptive context in which it has been finalised?
This postscript brings together a range of vignettes by some of the book’s contributors on dimensions of COVID-19-related developments in their respective context. Taking the care crisis concept as reference point, each vignette describes a concrete moment, development or process that offers reflections on the discussions in the book within the COVID-19 context. Carsten Juul Jensen provides a glimpse from the perspective of a practitioner of care. Birgitte Ljunggren highlights the ambiguities of the impact of policy reactions to COVID-19, where unintended consequences have indeed shown what early childhood care could look like if there was sufficient political will. Carsten Juul Jensen’s poetic rendering of an interview with a nurse volunteering for the COVID-19 unit conveys a feeling of how mundane and at the same time existential hospital care is, on so many levels. Finally, in a reflection on what it means to write and edit a book on the care crisis, Laura Horn highlights the disruptive context of academic work in the time of COVID-19.