Affective Contextures of Collective Care: Nurse-To-Nurse Communication, Resilience, and Sustainability in Nursing Work

This paper examines how nurses in United States hospitals generate and rely on informal communication practices of collective care-what we call <i>affective contextures of care</i>-to sustain their work and well-being within an increasingly financialized healthcare system. This dynamic relational fabric weaves together the emotional, social, and material dimensions of collective care to compensate for insufficient state and organizational support. Drawing on a narrative case study based on interviews with hospital nurses, we argue that these institutionally invisible affective and informal practices of care among nurses are intertwined with and essential for organizational, institutional, and economic dimensions. Our analysis demonstrates how affective contextures of collective care play a crucial role in sustaining healthcare institutions. We critically examine how institutional discourses of resilience position nurses as personally responsible for their well-being while obscuring systemic issues. In contrast, the informal nurse-to-nurse resilience practices that nurses describe in this study reflect a form of solidarity that resists the extractive logic of neoliberal healthcare. Extending the communication theory of resilience, we argue that affective contextures of care enable a rhizomatic form of organizing resilience in the context of ongoing precarity. These practices of solidarity embody a dialectic in which the same resilience processes simultaneously help sustain the current financialized healthcare system and generate potential for transformation by reclaiming collective agency and envisioning more sustainable, humane systems of care work.