Study Asks ‘What Is Nursing Work?’—And It’s A Lot

A study asking a seemingly simple question—“what is nursing work?”—yielded a complex answer: there are multiple types of labor involved, which “may be hidden and taken for granted,” according to the researchers.

The study authors conducted a meta-narrative review of research published from 1953 to the present. The review was guided by four questions: “What has been the historical understanding of nursing work and how has it changed over time?,” “What research methods and paradigms were present in this narrative?,” “Were there shifts in the meta-narrative of nursing work, and if so, what drove these changes and when?,” and “What are the implications of this meta-narrative review for understanding nursing work?”

Of 585 total articles identified, 121 were included in the final analysis. Four labor narratives were identified: physical, emotional, cognitive, and organizational.

Each labor narrative also included subthemes. One subtheme of physical labor was harms associated with physical work.

“Nurses’ physical labor is incredibly demanding, requiring long hours of standing, lifting, and walking long distances,” the researchers said. “Nurses’ roles place them at high risk for negative physical outcomes.”

Researchers described the central subtheme of emotional labor as “emotional labor is central to nurses’ work, and helps nurses focus on people, not tasks.” And yet, “Despite the emphasis on emotional labor as an essential part of nursing work, it often goes unrecognized and unsupported. Nursing students struggle to learn emotional labor norms, citing a lack of support for developing positive emotional labor strategies.”

Regarding cognitive labor, the researchers described “learning while working” as one subtheme. “Nursing could be taught in a classroom and learned through experience,” they wrote.

Organizational labor tends to go unrecognized by others but even by nurses themselves. In fact, the authors found that oftentimes in research, organizational labor is not investigated “as a legitimate facet of nursing labor.”

“Researchers consistently report that nurses spend more time on arranging and documenting care than interacting with patients. For example, Westbrook et al. (2011) reported that nurses spend 37% of their time with patients, with the reminder of their time being used for professional communication, indirect care, and medication preparation. However, this work is not reported as essential nursing work, but rather a distraction from nurses’ other roles,” the researchers observed.

The review was published in the International Journal of Nursing Studies.

“It is important to appreciate the breadth of nursing work and its demands, to plan workforce policies, and defend nurses against implicit judgements about nursing work. Nurses can argue for tertiary education and adequate resources based on the complexity of their work, and their need for appropriate recognition and monetary compensation,” the researchers concluded.