ABSTRACT
Introduction Legislation and organisational procedures regarding social and health care define the responsibilities of health and welfare workers. For example, decisions on hospital admissions are carried out by the psychiatrist in charge of the client, placements for supported housing are ultimately approved by the municipal commissioner, and everyday face-to-face contact with the client is maintained by the support worker. Despite these official and apparently clearcut duties, the operation of mundane care work often gives workers uncertainty regarding their roles and expectations (Thompson and Dowding 2001; Tainio and Wrede 2008). For example, Iqbal et al. (2014) report many unresolved debates on how mental health workers should proceed with their clients. Therefore, often responsibilities are ultimately shaped in everyday negotiations that Håland (2012: 768) characterises as “interactions that are not fixed and predetermined but that are dependent upon interpretations, discussions and contexts”. Slembrouck and Hall (2014: 64) note that negotiations on boundaries of responsibilities take place in professional interaction where participants are sorting out “who will do what” and “who is, or should be, responsible for what”. Scourfield (2015) calls this “negotiated reality”, which refers to the ambiguity regarding who is responsible for making, implementing and checking up on various care decisions. Responsibilities among welfare workers are complex within the fragmented service system (Clarke 2004; Möttönen and Kettunen 2014). Hence, it is likely that professional responsibilities may be differently defined and understood, resulting in negotiations between the different stakeholders. The notion of boundaries is useful in studying the division of responsibilities because it focuses on how social actors construct groups as similar and different and how boundaries shape their understanding of responsibilities (Lamont and Molnár 2002). In other words, as workers discuss their responsibilities, they come to define their own scope of practice in relation to those of others, and to set boundaries between “our” tasks and expertise and those of “others”. For example, Atkinson (2004) notes how physicians discursively construct their and “others’ ” competence and responsibility in medical collegial talk.
