Labour, Work, Action

Although the descriptor often carries negative connotations, rationing is, depending on how it is defined, neither ‘good’ nor ‘bad’ in itself. Indeed, if we suppose that rationing describes the controlled or managed allocation of scarce resources, and/or if it designates means or methods of constructing, restricting and channelling demand then – arguably – absent unlimited resources, it is an ever present and inescapable part of everyday real-world decision making. Rationing can be justified on rational, practical, and ethical grounds. And the question is not then ‘do nurses ration care? Rather, it is, ‘do nurses ration care well?’
The IPONS 2018 conference theme speaks about rationing in relation to a dearth of decision making frameworks. No doubt frameworks can be useful, they may help structure and formalise rationing. However, technical solutions (i.e. the use of these sorts of tool) cannot absolve practitioners from making judgements. Determining whether rationing is done well or not thus involves judgement, and judgements are unavoidably contestable. How then should nurses think about the judgements that are involved in rationing decisions? What needs to be considered?
We might note the political nature of rationing judgements (and political questions are not, I would stress, synonymous with ethical questions). Or, we could step back and think about the nature of nursing in relation to complex problems of the sort thrown out by rationing. Taking this more abstract line, this presentation introduces aspects of the work of Hanna Arendt and, in particular, her writings on Labour, Work, and Action in The Human Condition. It is proposed that the valorisation of labour (practice) over contemplative (theoretical) activities hampers (by undermining) inquiries of the sort that are the focus of this conference.