Understanding telecare construction work An ethnography of nursing practices

Telecare, a broad set of technologies used in home-based care, is expected to reduce the rising costs of care in an aging society on both national and European levels. The increasing use of telecare will profoundly change nursing care, in both expected and unexpected ways. The obvious difference is that care professionals will not physically be with patients when care is given at a distance. But there are also more subtle changes, like patients who use the technology on their own terms, and nurses’ improvised solutions to work around hindrances. All of these adjustments turn telecare practices into construction sites, where nurses and patients work to achieve good care. Annemarie van Hout conducted ethnographic research in two field sites: at-home palliative nursing and at-home long-term mental health care. Nurses care at a distance by starting to draw from their daily repertoire, basing their actions on their regular working methods. When nurses encounter hindrances that they have to deal with, they extend their repertoires. This research finds that lessons learned tend to stay within the practice where they are learned. To avoid this pitfall, Annemarie calls for nurses and scholars to work together. When nurses and researchers work together, detecting and articulating changes, sharing and theorizing them, they can tell a new story, a nursing story of telecare, one that can counter the policy stories this thesis begins with. Hopes for and fears of telecare are bad predictors. Let nurses, researchers and policymakers instead listen to and learn from actual practice.