Valerie Adams

The Economics of Nursing: Articulating Care

Abstract Nurses in many industrialized countries are under pressure to prove that the care they provide is cost effective and an appropriate use of scarce healthcare funding. Attempts to describe what nursing care involves, however, have not yet resulted in a generally accepted articulation that is fully up to this task. This essay analyzes how Cartesian dualisms of mind versus body and knowledge versus virtue have contributed to the inadequacy of many current descriptions of nursing. The authors explore how a non-dualistic, practice-enhancing rhetoric might be developed, particularly in light of healthcare finance issues affecting college-educated nurses in the United States, Australia, Canada, and the United Kingdom. The authors present a diagram as a suggested tool for thinking that may help bring attention to neglected and undervalued aspects of nursing care. Special challenges in geriatric care are discussed.

Laughing It Off: Uncovering the Everyday Work Experience of Nurses

During research towards her doctoral dissertation, the author noticed that nurses understated the conditions in which they worked. Seeking to understand how nursing culture shapes how nurses describe their work, she developed a “toolbox” of reflexive methods. She used metaphors of nursing and emotion expressed as laughter to identify aspects of nursing culture in semistructured interviews with nurses working in Australian residential aged care facilities. She also incorporated autoethnography, as she had worked as a registered nurse while studying economics. The inclusion of her voice in the data illustrates the difference between nursing culture and another worldview. These pluralist methods made explicit some of the effects of gendered socialization, such as understatement and self-consciousness, and demonstrate how they are embedded in nursing culture. Awareness of such norms is important for understanding marketized caring labor. This combination of methods has significance for uncovering workplace culture in other forms of marketized caring.

Financial abuse of older people by a family member: a difficult terrain for service providers in Australia

Financial abuse by a family member is the most common form of abuse experienced by older Australians, and early intervention is required. National online surveys of 228 chief executive officers and 214 aged care service providers found that, while they were well placed to recognize financial abuse, it was often difficult to intervene successfully. Problems providers encountered included difficulties in detecting abuse, the need for consent before they could take action, the risk that the abusive family member would withdraw the client from the service, and a lack of resources to deal with the complexities inherent in situations of financial abuse.

Reciprocity in Caring Labor: Nurses’ Work in Residential Aged Care in Australia

Feminist economists identify reciprocity as a motivation for both paid and unpaid caring work. In general, reciprocity describes people responding to each other in similar ways, either benevolently or harmfully. The quality of care is potentially increased when care relationships are motivated by positive and generalized forms of reciprocity and decreased with negative forms of reciprocity. This study draws on nursing literature and two qualitative studies in Australian residential aged care facilities, conducted in 2002–3 and 2009, to identify a new form called “professional reciprocity.” This form of reciprocity involves deliberate and skilled relational work by nurses to facilitate mutual and interdependent exchanges with care recipients that are beneficial to both care recipients and nurses. This study argues that professional reciprocity, as a skill that can be taught, is important for achieving quality care and workers’ job satisfaction.

Financial abuse of older people: A case study

This article presents a case study to illustrate the complexities of financial abuse of older people by their family members. It provides insights into why older people and social care professionals may not detect or define family member’s behaviour as abuse or feel discomfort in talking about it. The authors argue case studies can lead to new understandings about financial abuse that move beyond operational definitions to theoretical explanations that consider practices and outcomes of ageism and gender relations.

Mixed-methods research: What’s in it for economists?

Empirical studies in economics traditionally use a limited range of methods, usually based on particular types of regression analysis. Increasingly, sophisticated regression techniques require the availability of appropriate data sets, often longitudinal and typically collected at a national level. This raises challenges for researchers seeking to investigate issues requiring data that are not typically included in regular large-scale data. It also raises questions of the adequacy of relying mainly or solely on regression analysis for investigating key issues of economic theory and policy. One way of addressing these issues is to employ a mixed-methods research framework to investigate important research questions. In this article, we provide an example of applying a mixed-methods design to investigate the employment decisions of mature age women working in the aged care sector. We outline the use of a coherent and robust framework to allow the integrated collection and analysis of quantitative and qualitative data. Drawing on particular examples from our analysis, we show how a mixed-methods approach facilitates richer insights, more finely grained understandings of causal relationships and identification of emergent issues. We conclude that mixed-methods research has the capacity to provide surprises and generate new insights through detailed exploratory data analysis.