Reproducing Care: Changing Geographies of Nursing Work in the United States

Nurses provide essential care to people in their most vulnerable times and perform myriad tasks that support the healthcare system as a whole. In spite of their essential role, nurses in the United States have been subject to devaluation individually and systemically, through underinvestment in nurse training, understaffing of facilities, and a lack of recognition for the work that they do. This dissertation is a qualitative study of nursing work in the US, focusing on nursesâ experiences of their jobs since the 2008 financial crisis until 2014. I base my argument on interviews I conducted with 37 nurses working in New York City and St Louis, Missouri. I also analyzed a variety of texts including media stories, union publications, and discussion boards, as a complement to nursesâ own stories. I examine three means of managing nursing work: the restructuring of the built environment of health services, the lengthening of the working day, and the changing modes of measuring and counting nursing work. I demonstrate different ways and scales at which nursesâ work and working conditions are changing during a dynamic period of restructuring in US health care. By drawing on interviews with nurses working in the New York and St Louis metropolitan regions, complemented with secondary textual analyses, I examine how broader changes to the political economy of health care, specifically the built environment, shift length, and ways of measuring work, impact the mundane and everyday aspects of the nursing job. Through these three means of governing nursing work, I add texture to theories of social reproduction. Social reproduction, or the reproduction of people and of everyday life and institutions, includes historically feminized work that sustains life, such as nursing work. Health and health care work, however, are under-theorized in the social reproduction literature. This dissertation contributes to feminist geography by foregrounding nursing work and the workplace of the hospital. While there is a rich literature in geography on the global migration of nurses and on the gendered dynamics of work, few scholars have engaged with the everyday experiences of nurses in their most common worksite. Furthermore, health geography has paid scant attention to the crucial roles that health care workers play in the making of health. Therefore, in this dissertation, I contribute to these literatures by focusing on the workers, how they and their work are regulated, and their subjectivities in relation to their work as it is restructured.Ph.D