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Article Excerpt
THIS PAPER DESCRIBES THE CAREWORK performed by volunteers in four large teaching hospitals in Alberta, Canada. Carework encompasses and integrates "caring for" (instrumental tasks) and "caring about" (affective labour) (Abel and Nelson, 1990; Graham, 1983). Whether paid or unpaid, carework is mostly done by women. Many have argued that when carework is paid and bureaucratically organized, tensions arise for workers who try to integrate instrumental and affective dimensions of care (see Armstrong and Armstrong, 2003; Brannon, 1994; Browne, 2003a; 2003b; Campbell, 2000; Jones, 1998). For example, bureaucratic specifications requiring workers to perform many instrumental tasks within a short time make it difficult for them to have the flexibility required to attend to varying emotional needs. Like nurses, many volunteers provide both instrumental and affective care, though their work is unpaid and differs in skill level. Far less has been written, however, on how caregiving by volunteers may also be affected by bureaucratic expectations. This paper first considers expectations for volunteer work in hospitals and the constraints these institutions impose on volunteers. I then ask how volunteers manage to provide instrumental and affective care despite these constraints. To do this, I examine statistics on the gender of volunteers, the content of volunteer "job descriptions" and data from interviews with volunteers and volunteer coordinators. These data have been collected for a larger project on how volunteer work is gendered and how volunteers offer emotional labour.
Carework
The concept of carework has evolved to capture the complexity of women's experience as caregivers and overcome the bifurcation arising from a masculine model of work that separates instrumental and affective caring. "[C]aregiving involves a distinctive pattern of thought that can be learned and practiced, but which differs sharply from scientific rationality" (Abel and Nelson, 1990: 9). Caring is a complex activity involving dimensions such as time, effort, technique and social skills. Such work is closely tied to the concept of emotional labour (Hochschild, 1983) since it relies on "a sense of emotional attachment and connection to the person being cared for" (Badgett and Folbre, 2001: 328). Personal knowledge of the person being cared for facilitates the work of the caregiver. Caring labour is most effective when trust can develop between the caregiver and the individual receiving the care (Browne, 2003a). Time is also an important component of such work because it is required for trust to develop and because freedom to organize work time is necessary to tailor the work to the needs of the person receiving care.
Carework crosscuts paid and unpaid work. It encompasses the reproductive labour done by women in families as well as the paid work of service workers and pink collar professionals. It can also be applied to the work of volunteers, whether in formal organizations or informal neighbourly settings. Lan (2003) speaks of "the continuity of domestic labour" to emphasize women's multiple positions as caregivers across public and private domains. Carework is gendered because women do it more than men and because the content and organization of this activity are grounded in activities that are culturally defined as feminine: tending to small children, nursing the sick, comforting those who weep, and so on.
Carework is also shaped by class and race. This is highlighted in discussions of Filipina nannies and Black domestic workers employed by well-off White families (Lan, 2003; Nakano Glenn, 1992). Not only do children, the elderly and the infirm benefit from this labour, but so do able-bodied adults who have a cook or cleaner to attend to their needs or nannies to tend to their children. Carework in public institutions is also structured by gender, race and class. Sacks (1990: 188) asserts that health care is "an industry so visibly stratified by race and gender that the uniforms worn to distinguish the jobs and statuses of health care workers are largely redundant."
Volunteerism as Carework
Most descriptions of carework focus either on the labour that women perform for their own families (Abel and Nelson, 1990; Blair-Loy and Jacobs, 2003; Lan, 2003) or paid work. Paid carework has been discussed in relation to nurses (Reverby, 1990), social workers (Baines, 2004), teachers (Fisher, 1990), daycare workers (Enarson, 1990; Nelson, 1990) and domestic workers (Lan, 2003). Fewer authors discuss volunteers within this rubric. Prentice and Ferguson (2000) consider mothers who volunteer in daycare centres and how their caring labour structures their relation to paid workers and to the welfare state. Reitsma-Street and Neysmith (2000) look at volunteerism in community centres in impoverished urban neighbourhoods. Baines (2004) argues that due to the reorganization of welfare agencies, much caring labour formerly done as part of the job by social workers now happens outside of paid work hours, effectively becoming volunteer work. Abel and Nelson (1990: 22-23) briefly acknowledge the role of volunteers within "circles of care," although their discussion of this group is minimal compared to their discussions of care provided by family members or paid workers. Browne (2003b: 27) suggests that "informal and formal care are complementary rather than alternative forms of support." Browne explicitly uses informal care to refer to unpaid care provided by family and friends, although he also seems to place volunteers in this category.
In the past, volunteer work, like carework, has been identified as a female domain, with women outnumbering men as volunteers (Abrahams, 1996); however, in recent years in Canada, the proportions of women and men who volunteer are converging. In 2000, 28% of women and 25% of men volunteered, compared to 33% of women and 29% of men in 1997 (Statistics Canada, 2000: 34). These data come from the National Survey of Giving, Volunteering and Participating (NSGVP). The NSGVP does not provide the proportions of male and female volunteers in different institutions, but it does tell us that 27% of all volunteers are involved in "providing support or care." Other authors suggest that there are distinct patterns of gender segregation across organizations (Baldock, 1998; McPherson and Smith-Lovin, 1986; Popielarz, 1999; Rotolo and Wharton, 2003); for example, Baldock (1998) points out that women are more likely to volunteer in social welfare organizations, which entail a dimension of care, while men are more likely to volunteer in civic organizations such as sports clubs.
Carework in Health Care Institutions
Caring by family members in the home is based on long-term relationships, intimate knowledge between individuals, and relative freedom to decide on how and when care is provided. However, when carework becomes paid work and is situated within large institutions such as hospitals, tensions may arise among organizational constraints, managerial control, and the ethic of care that would otherwise guide such work. The particularity of caring fits uneasily within the standardized rules and impersonality of bureaucracy (Abel and Nelson, 1990: 22; Baines, 2004; Browne, 2003a; 2003b); caregivers must have some personal knowledge of those for whom they care...
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