Chugging along, going with the flow, collegiality and chaos: A micro-political essay on interpersonal troubles within care situations in Sweden

Abstract: A lot of time and care have been put into exploring and explaining the power relations between nurses and nursing assistants, the emotional investment appropriate in care work, different views on leisure time for staff in this context (Warming, 2019; Habel, 2021; Jervis, 2002; Crocker, 2019). Less work has been done in exploring the complex relationships care workers have with their patients and how staff navigate troubling situations that arise in these relationships as well as how staff feel when these troubling situations occur. The purpose of this study is thus to highlight and explore how care workers in different care institutions navigate troubling interactions with their patients. Eight care workers were interviewed from four different care institutions in Sweden using semi structured interviews. Three full days of overt participant observations were implemented at a daily activities facility. The daily activities facility had patients of all genders at the ages of 18-65. Concepts and theoretical reasonings were borrowed from Robert M. Emerson (2015, 1962) and his studies of interpersonal troubles. Patterns that cut across both interviews and fieldnotes are a number of different strategies that seemed to be commonly used to resolve challenging interactions with patients emerged when the material was analyzed. These methods included (a) ignoring the troubling behavior, (b) distracting the patient and thereby interrupting the troubling behavior, (c) asking colleagues for help and lastly (d) involving a formal third party. The power relations visible in the material were also significant, suggesting that the power balance between staff and patient might shift and twist a great deal without necessarily changing fundamentally. Through the analysis of the empirical material three traces emerged: (I) Chugging along/going with the flow, (II) Collegiality, (III) Chaos and last resort. The informants also described feeling a variety of emotions when dealing with challenging interactions with their patients: insecurity, shame and fear. The study points to the importance of exploring and noticing the patterns in interpersonal conflict related by care workers to further the field of conflict sociology.