The hidden injuries of bureaucracy: work in an American nursing home

This article analyzes the tensions and contradictions in nursing home bureaucracies. Bureaucratic rules are essential for administrative efficiency and to reduce the potential for neglect and abuse of patients. These are especially critical given the complex requirements of modern medical care and state regulations. At the same time, as my field research reveals, bureaucratic rules can interfere with a key goal of nursing homes as they stand in the way of aides' ability to provide compassionate and supportive care. Key words: bureaucracy, nursing home, USA, New York