ISTR Sixth International Conference Toronto, Canada / July 11-14, 2004 Contesting Citizenship and Civil Society in a Divided World

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	Abstracts

The division of labour among paid adn volutneer caregivers in home-care: the case of the Victorian Order of Nurses in Nova Scotia
by
Judy Haiven
Saint Mary's University
Coauthors: Larry Haiven (Saint Mary's University)

In Canada, more and more of the human and healthcare services that the state once provided are being delivered by charities, nonprofit and even for-profit organizations.

The Victorian Order of Nurses (VON) is a charitable organization which offers health services to clients/patients in a home care setting as well as other health-related services to the community. Some of these services are contracted out on a fee-for-service basis to governmental or quasi-governmental organizations; some are delivered privately on a fee-for-service basis; still others are delivered as a nonprofit activity to the community.

To deliver these services, the VON deals with two types of service providers, paid staff and volunteers. The work of these two types of caregivers intersects with a third group - informal caregivers. These are family members and friends of the patients/clients, who provide a range of services to the client/patient. The VON does not at present directly supervise or train informal caregivers but the employees and volunteers the organization manages are definitely affected by and sometimes work with these people and thus they form an important part of the care and care management equation. Some VON branches are contemplating involvement in the organization and nurturing of informal caregivers.

This paper is about the intersection of the first two types of caregivers. Several issues arise.

First, how can traditional human resource management techniques address these two tiers of caregivers? Should paid staff and volunteers be managed in the same way? Is the division of labour between paid staff and volunteers fixed or porous?

Second, often there is a hierarchy involved when there is paid staff versus volunteer staff. How is this handled and if conflict arises how can it be dealt with?

Third, the VON offers extensive training to the first two groups of caregivers. What does this training consist of and what are the common elements and differences among the groups? Clearly the paid staff includes professionals such as nurses; do these people need even more training? What kind of training should be given to the informal caregiver? Because of the nature of their commitment, the volunteer might be only short term caregivers. How does a nonprofit organization justify spending training budget on care providers who may stay only until a paying job comes along?

This paper will look at the intersection of paid and volunteer caregivers. It will also compare the Webbs' stepladder model of social welfare - that the state should provide all the basics of care while the charitable sector should be used to merely top up these benefits - to where we are headed today.

Date received: September 26, 2003