Caring Connections - Compassionate mutuality in the organizational life of a nursing home

Research output: ThesisDoctoral ThesisMonograph


Connections with others make up the fabric of daily life within organizations. Caregiving – understood broadly – takes place on a daily basis. Engagement in such caring situations has been found to be highly beneficial for both the caregiver and the cared-for. A nursing home is an especially good place to study caregiving. Accordingly, the data for this dissertation consists of semi-structured interviews with 26 nurses, five residents, and nine head nurses (altogether 27 hours, transcribed over 400 pages), as well as 13 days of participant observation. In addition, I presented my results to the research subjects in order to receive their feedback as a form of validation. The data was analyzed using a grounded theorizing approach. My first empirical finding is that in caring situations, both participants can choose to either be emotionally engaged or disengaged. This gives rise to four different types of caring situations: 1) Instrumental caretaking, in which some need is taken care of without either person being engaged in the situation, 2) unmet call for caring, in which the cared-for reaches out to form a connection with the caregiver who remains emotionally detached from the situation, 3) one-sided caregiving, in which the caregiver engages with the cared-for in a warm and tender way but the recipient of care remains disengaged, and 4) caring connection, in which both participants engage emotionally with each other, thus allowing for the formation of a reciprocal, high-quality connection between them. Focusing on caring connections in particular, I argue that they are composed of six elements that both participants need to display: mutual validation of the distinct worth of the other, being present in the now-moment, opening up towards the other, establishing a shared space, heightened flow of affectivity, and acts of caregiving and displays of gratitude. The connection between the participants is deep and operates to a significant degree through channels related to non-verbal attunement and sensitivities. This work also makes a few more theoretical contributions. In discussing the ways to improve the possibilities for caring connections, it employs insights from systems intelligence to come up with nine ways through which the nurse can increase the occurence of caring connections. Methodologically, the dissertation makes a contribution by taking a research approach strongly inspired by pragmatist philosophy, and applying it to research in social sciences. All in all, by emphasizing intersubjectivity and the active contribution of the cared for to the mutually generated encounter, this dissertation contributes equally to two different research traditions: firstly, organizational research and especially positive relationships at work, and secondly, nursing research and especially gerontological nursing.
Translated title of the contributionHoivayhteys – keskeinen inhimillinen voimavara kahdenkeskisessä hoivatyössä
Original languageEnglish
QualificationDoctor's degree
Awarding Institution
  • Aalto University
  • Saarinen, Esa, Supervising Professor
Print ISBNs978-952-60-4847-5
Electronic ISBNs978-952-60-4848-2
Publication statusPublished - 2012
MoE publication typeG4 Doctoral dissertation (monograph)


  • caring
  • caregiving
  • compassion
  • intersubjectivity
  • relationality
  • nursing
  • positive relationships


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