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Einleitung
Pflege in Deutschland befindet sich in einem Veränderungsprozess. Die politisch forcierte Zuwanderung von Pflegekräften sowie die Akademisierung führen zu einem enormen Anpassungsdruck bei allen Beteiligten. Wie wirkt sich dies auf den Arbeitsalltag aus?
Methoden
Die qualitative Datenbasis umfasst bisher 36 Tage Teilnehmende Beobachtung, 17 Themenzentrierte Leitfadeninterviews sowie vier Gruppendiskussionen in vier Pflegeteams zweier Krankenhäuser. Die Analyse erfolgt mit der Dokumentarischen Methode.
Ergebnisse
Am Beispiel der Grundpflege (u. A. dem „Waschen“) wird deutlich, wie die Pflegeteams ihren Arbeitsalltag neu aushandeln. Die Teams mit einer hohen migrationsbezogenen Diversität argumentieren eher, dass die Aufgaben der Grund- und Behandlungspflege entsprechend der Qualifikation als Hilfs- oder Fachkraft erledigt werden sollen. Hier treten stereotype (kulturalisierende) Zuschreibungen in den Hintergrund. Demgegenüber berufen sich Pflegeteams mit einer niedrigen migrationsbezogenen Diversität eher darauf, dass die Grundpflege in Deutschland – anders als in anderen Ländern – zu den Aufgaben einer examinierten Pflegefachkraft zählt. Kolleg*innen aus dem Ausland wird die pflegerische Kompetenz daher eher abgesprochen.
Schlussfolgerung
Die Frage nach der Aufteilung von Grund- und Behandlungspflege, ist auf allen Stationen virulent. Die Teams entwickeln jedoch in Abhängigkeit von ihrer spezifischen Heterogenität unterschiedliche Umgangsweisen. Demzufolge sollte sich Personal- und Organisationsentwicklung insbesondere an den Pflegeteams orientieren.
In a recent article in this journal, Ahrne, Brunsson, and Seidl (2016) suggest a definition of organization as a ‘decided social order’ composed of five elements (membership, rules, hierarchies, monitoring, and sanctions) which rest on decisions. ‘Partial organization’ uses only one or a few of these decidable elements while ‘complete organization’ uses them all. Such decided orders may also occur outside formal organizations, as the authors observe. Although we appreciate the idea of improving our understanding of organization(s) in modern society, we believe that Ahrne, Brunsson, and Seidl's suggestion jeopardizes the concept of organization by blurring its specific meaning. As the authors already draw on the work of Niklas Luhmann, we propose taking this exploration a step further and the potential of systems theory more seriously. Organizational analysis would then be able to retain a distinctive notion of formal organization on the one hand while benefiting from an encompassing theory of modern society on the other. With this extended conceptual framework, we would expect to gain a deeper understanding of how organizations implement and shape different societal realms as well as mediate between their particular logics, and, not least, how they are related to non-organizational social forms (e.g. families).
In a comparison of three human service organisations in which the human body plays a key role, we examine how organisations regulate religious body practices. We concentrate on Muslim norms of dressing and undressing as a potential focal point of cultural and religious diversity. Inspired by Ray’s (2019) idea of racialized organizations, we assume that state-run organizations in Germany are characterized by a strong commitment to religious tolerance and non-discrimination but also marked by anti- Muslim sentiment prevalent among the German population. Our study looks for mechanism that explain how Human Service Organizations accommodate Muslim body practices. It draws on qualitative empirical data collected in state-run hospitals, schools and swimming pools in Germany. Our analyses show that the organizations draw on formal and informal rules at the organizational level to accommodate Islam. We identify five general organizational mechanisms that may hinder Muslim accommodation in human service organizations. In particular, we see a risk of decoupling between the expectation of religious tolerance and processes that lead to informal discrimination, driven mainly by the difficulty of controlling group dynamics among users.
Einleitung
(2021)
Background:
Like most countries, Germany is currently recruiting international nurses due to staff shortages. While these are mostly academic, the academisation of nursing in Germany has only just begun. This allows for a broader look at the participation of migrant nurses: How do care teams deal with the fact that immigrant colleagues are theoretically more highly qualified than long-established colleagues?
Methods:
Case studies were conducted in four inpatient care teams of two hospitals in 2022. Qualitative data include 26 observation protocols, 4 group discussions and 17 guided interviews. These were analysed using the documentary method and validated intersubjectively.
Results:
Due to current academisation efforts in Germany and the immigration of academised nursing staff from abroad, the areas of activity and responsibility of nursing in Germany are under negotiating pressure. This concerns basic care for example, which in Germany is provided by skilled workers, but in other countries is mostly provided by assistants or relatives. The question of who should provide basic care, whether all nurses or only nursing assistants, documents the struggle between an established and a new understanding of care. In this context, the knowledge and skills of migrant and academicised care workers become a crucial aspect in the struggle for a new professional identity for care in Germany.
Conclusions:
The specific situation in Germany makes it possible to show the potential for change that international care migration can constitute for destination countries. The far-reaching process of change of German nursing is given a further dimension not only by its academization, but by the immigration of international and academically trained nursing staff, where inclusive or exclusive effects can already be observed.
Key messages: The increasing proportion of migrant nurses accelerates the current discussion on nursing in Germany. Conflict areas show up in everyday work of care teams and must be addressed there.