The following three chapters, constituting the Danish section of this book, are examples of research into care as work and working life from the perspective of practice and the subjectiv-ity of the care worker. This has been part of qualitative learn-ing research into changes in the welfare-creatlearn-ing sectors and occupations that has been carried out at Roskilde University over the last 15 years. The three contributions conceptualise
learning as an integral part of the working of the individual, and of the collective working environment. The concept of learning connects the experiences of the worker as a learner with her expectations for the future, both as an individual and as a member of a collective group of workers/professionals. A horizon of expectations is created from experience. The artic-ulation and activation of this horizon enables specifi c steps in learning. However, the possibilities for such articulation and activation are dependent on the historical and cultural context and the specifi c learning space occupied by the work-er. The learning space is actively created through a process of framing. Framing is shaped by power structures, but also by the activity of the agents/learners. The learning concept has its roots in the concept of subjective and collective horizons of experiences and learning (Ziehe 1998) that suggest differ-ent forms of learning, understanding and action.
The three chapters aim at creating knowledge about the practices and practitioners in care from a psycho-societal per-spective in order to analyse the impediments to and possibili-ties of learning and becoming active agents of change in care.
Chapter One by Betina Dybbroe focuses on processes of oc-cupational identifi cation and learning in nursing and points out how these are framed through a process involving politi-cal, social and structural factors. Placing the spotlight on the experiences of three nurses, Dybbroe argues that paradoxes in work in the health sector create paradoxes of learning that dismantle learning spaces within work.
In Chapter Two Anne Liveng analyses everyday interactions in elderly care from the perspective of social and health care helpers. The analysis demonstrates that subjective meaning in care is a prerequisite for not only quality in care, but also the willingness and the ability of care workers to stay in care work. Liveng shows how impediments to creating meaning and strong occupational identifi cations in work are related to hierarchical structures framing care work.
Chapter Three is by Helle Krogh Hansen who considers the space for self-refl ection and learning in elderly care in all three
occupational groups found in Danish elderly care: social and health care helpers, assistants and nurses. Through the per-spective of experiential learning and practice-based knowl-edge, Krogh Hansen probes into the possibilities of learning in care work, arguing that such possibilities are presently unused and downplayed. Thus Krogh Hansen illuminates how the occupational groups might become agents of change in care through the organisation of the everyday practice of elderly care as a learning environment seen from a lifelong learning perspective.
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A Crisis of Learning,
Professional Knowledge and Welfare in Care
Betina Dybbroe
This chapter contributes to the understanding about the cri-sis in paid care work in the Nordic countries by highlighting the crisis of learning and professional knowledge in care in Denmark, here viewed as linked both to the critical conditions in and of care and to the crisis of recruitment. The theme of crisis of learning and professional knowledge concerns all four countries, as the ideology of New Public Management in its different versions has been universally implemented. In all of the Nordic countries, this meant taking practical steps towards creating an ‘economy of health’, in which strategies to improve and widen qualifi cations in health care are seen mainly as costs and not investments in the future welfare state. All of the Nordic countries therefore experience aspects of dequalifi cation of the work force in the professional and semi-professional groups.
The dequalifi cation process has several implications, concern-ing the jobs themselves, the shortage of qualifi ed social- and health care workers as well as the failing recruitment strategies.
The key consequence in focus here is the short supply of qual-ity learning environments in the workplaces. The recruitment crisis in the Nordic countries is also linked to the creation of a health economy and dequalifi cation of work. Recruitment fail-ure is not an instrumental problem, but a symptom of more profound problems, such as the conditions society offers to the social and health care occupations, as well as a symptom of changes over time in the economic market.
The chapter builds on two recent research projects on nurs-ing (Andersen, Dybbroe & Bernurs-ing 2004, and Ahrenkiel, Dybbroe
& Sommer 2008) that shred light on the development of oc-cupational identity and learning closely linked to the changes in the conditions and the frames of the social and health care sectors. Here I explore the crisis empirically through subjective and intersubjective experiences and dynamics, relating these to the contextual and structural factors that actively contrib-ute to the framing of education and learning in care.
Before exploring the learning crisis, I shortly discuss the long-term crisis in recruitment facing the Danish care occupa-tions that has taken a turn during the last few years.