When Paradoxes Hamper The Search For Meaning: The Psychodynamics of Work of Nurses in a Residential and Long-Term Care Facility
Bibliographic record
Abstract
Abstract This article seeks to analyze the effects of changes in the organization of work performed by nurses on long-term care wards in a residential and long-term care facility (centre d’hebergement et de soins de longue duree, CHSLD) in Quebec. The changes involved are 1) the introduction of a modular care system, a “living environment” approach and a computerized client-information system specifically for residential and long-term care centres (SICHELD). Problem: The changes have been implemented in most of Quebec’s CHSLDs but have not been evaluated. Theoretical Framework: The theoretical approach used here is that of the psychodynamics of work, which was developed in France by C. Dejours and adopted in Quebec by M-C. Carpentier-Roy and others. Method: The investigative methodology of the psychodynamics of work is fundamental to the examination. Study groups formed of nurses who volunteered to participate comprised 26 (out of a possible 76) nurses representing all the wards and all the shifts in the CHSLD. Results: Major sources of suffering take the form of paradoxes and undermine the meaning of work. The suffering the participants experience is evidenced by their resorting to a wide range of defensive strategies. Implications: Various considerations related to the structure and organization of work raise important questions about the nurses’ role. The discussion expands on the issues of role conflict, the ambiguous exercise of power and a broad search for identity; the situation is marked by an identity crisis and an impasse in action
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.024 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.011 | 0.026 |
| Scholarly communication | 0.008 | 0.003 |
| Open science | 0.002 | 0.007 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".