Hidden voices and deep meaning: An ethnography to reveal and render explicit health care assistants, porters and domestics experience and role in the social organisation of end of life care

Raftery, Anne-Marie

Abstract

Encounters with patients who are approaching end of life or dying can affect all staff. Yet health care support staff are rarely mentioned or included in service evaluation or research studies, with their roles often not easily visible, largely happening ‘behind the scenes’ or ‘backstage’. This ethnographic research study aims to reveal and render explicit health care assistants, porters and domestics experience and role in the social organisation of end of life care. Exploring their knowledge, attitudes, and beliefs - including any specific difficulties or barriers encountered to ensure support, training and educational offers relating to end of life care are considered and inclusive. This ethnographic study conducted at the height of the global COVID-19 pandemic uses a naturalistic approach - the primary data gathering method being participant observation, shadowing and following their everyday routines, with semi-structured interviews conducted across the staff groups. Insights from observational fieldwork and interviews, explored using tropes to ‘tell tales of the field’ preserved the integrity of the participants stories, which revealed many forms of invisible labour. Aspects such as tacit knowledge - that which is understood or implied without being stated, sensory elements, embodiment - sensory awareness at end of life, interaction order - unspoken language and meaning, transition points – that occurred ‘front’ and ‘back’ stage, architecture - their use of space and rituals or rhythms through custom and practice which had either not been noticed, fully recognised, or taken for granted. Using ethnography relating to end of life care in context, recognises their valuable experience and roles and should encompass inclusive support, training, and education.

• Thesis Type: Thesis
• Deposit Date: Dec 12, 2024
• Publicly Available Date: Jan 24, 2027
• Keywords: Ethnography, health care support staff, social organisation, end of life care
• Award Date: Jan 23, 2025