The NP: Medical Work, Gender, & Social Inequality

In this project, I investigate contemporary transformations in medical work through the introduction of the nurse practitioner into the medical encounter. As nurses, NPs belong to a predominately female group of workers. I argue that to pay attention to the NP is to consider deeply the ways in which the terrain of medical work is being differently gendered, not just in terms of the social characteristics of those performing the work, but in how the work is constituted, the expertise that is assumed to be required, and the professional identities of the workers who do the work.

I also examine the case of the NP to understand the connection between these changes and the social reproduction of inequality. The NP is typically understood as a policy fix for the ostensibly neutral numerical problems of cost and personnel. However, I argue that it is impossible to understand the creation of NPs without placing them within the context of what the state has decided not to do in other realms. The federal government has largely withdrawn itself as a payer for the problems of poverty even as its financing of medical care has soared. In showing the impact of these choices at the micro-level of an organization, my analysis illustrates that the transformation of the clinic encounter is more than changes in “who does what,” but is the working out of much deeper shifts in what these problems are considered to be and who we believe is responsible for solving them.

Work from this project appears in my book More than Medicine and in several other academic publications. I have also had the pleasure of writing a piece based on the book for the 2021 spring issue of AFT Health Care.

New Forms of Home, New Forms of Care: Work, Responsibility, and Relationships in Older Adult Care

This project examines the emergence of nursing home alternatives for older adults such as assisted living facilities, adult day care centers, and senior only retirement communities. Unlike nursing homes, these institutional forms are not expressly medical institutions; however, they remain sites of routinized medical work and care work. Through a comparative ethnographic analysis, this project investigates the organizational logics through which conceptions of work, identity, and responsibility are being reconstituted.