The construction of career aspirations amongst healthcare support workers: beyond the rational and the mundane?

• DOI: http://doi.org/10.1111/irj.12245
• Published date: 01 March 2019
• Author: Ian Kessler,Stephen Bach,Vandana Nath
• Date: 01 March 2019

The construction of career aspirations

amongst healthcare support workers:

beyond the rational and the mundane?

Ian Kessler, Stephen Bach and Vandana Nath

ABSTRACT

This articleengages with a literaturethat views the limitedcareer aspirationsof low-paid,

low-statusworkers as a reasonableresponse to materialand structural constraints. Based

on four hospital trust cases studies, the article contests this view, revealing how

healthcare support workers in NHS England have retained the cognitive capacity to

override such constraints to develop a strong and authentic career goal to become a

nurse. This goal is acknowledged by the healthcare support workers themselves as

unlikely to be achieved and is therefore presented as a flight from rationality. Its

emergenceis explained by workplaceinteractions thatallow such an ambitionto become

taken-for-granted. The article deepens understanding of career ambitions amongst

low-paid, low-status workers, while adding weight to a literature suggesting that career

aspirations can be driven by values and norms, not only by a means-end rationality.

1 INTRODUCTION

The capacity of low-status, low-paid workers to secure meaningful career progression

has long been viewed by researchers as problematic (Appelbaum et al., 2003; Gautie

and Schmitt, 2010; Thomas, 1989). Arthur et al’s(1989: 9) widely adopted definition

of a ‘career’as ‘the evolving sequence of a person’s work experiences over time’is

broad enough to allow the authors to claim that ‘everyone who works has a career’.

However, amongst those employed in low-paid, low-status roles, these work

experiences have often been characterised as shallow and restricted (Charles and

Grusky, 2004; Thompson, 2010), perhaps accounting for the limited attention paid

to such workers in a careers literature mainly devoted to managerial and professional

employees (Pringle and Mallon, 2003).

Presented as constrained by material and structural forces, the careers of traditional

blue-collar factory and white-collar office workers have typically been characterised

by truncated career pathways and a lack of the personal resources needed to pursue

them (Atkinson, 2010; Hebson, 2009; Thomas, 1989). Indeed, these forces have not

only been viewed as generating modest career aspirations amongst such workers,

but a relative absence of ambition has, in turn, been regarded by some researchers

as a ‘remarkably rational’response by the employees themselves to the barriers they

face in progressing their working lives (Chinoy, 1952: 454; Pascall et al., 2000).

❒Ian Kessler, Stephen Bach and Vandana Nath, King’s College, London, UK. Correspondence should

be addressed to Ian Kessler, Professor of Public Policy and Management, King’s College, London, UK.

E-mail: ian.kessler@kcl.ac.uk

Industrial Relations Journal 50:2, 150–167

ISSN 0019-8692

© 2019 Brian Towers (BRITOW) and John Wiley & Sons Ltd

Such an impoverished view of careers runs the risks of overlooking the employment

of low-paid workers in a wide range of industrial and organisational settings, likely to

provide very different career opportunities. More questionably, to present modest

aspirations as a rational response to the barriers faced is to flirt with a deterministic

view of career ambitions amongst low-paid employees. It remains open to empirical

inquiry whether such employees in some or all contexts have the cognitive capacity

to move beyond the challenges they face and perceive their careers in more imagina-

tive terms.

We explore this cognitive capacity amongst healthcare support workers (HSWs) in

NHS England. In September 2018, there were over 150,000 HSWs comprising around

15 per cent of the NHS England workforce (https://digital.nhs.uk/data-and-infor-

mation/publications/statistical/nhs-workforce-statistics/nhs-workforce-statistics-de-

cember-2017), and the development of career aspirations amongst these workers

represents an intriguing case. As a low-paid, low-status group, HSWs face many of

the structural and material challenges likely to ‘dampen-down’career aspirations.

However, working closely with nurses and in a sector with notionally well-developed

career pathways, it is pertinent to consider whether their aspirations have become

detached from rational consideration to assume a more ambitious form.

We present case study material to suggest that HSWs can indeed achieve cognitive

distance from structural and material challenges to envisage imaginative career

futures, particularly the ambition to become a registered nurse. A resilient nurse aspi-

ration is, however, presented as a departure from rationality not least because the

HSWs themselves recognise that this goal is unlikely to be realised. It is a finding

mainly explained by the nature of HSWs workplace interactions, which normalise

and encourage the ambition to become a nurse and lend this goal some intrinsic value.

The article comprises the following main parts: exploring the construction of career

aspirations amongst low-paid workers; contextualising the HSWs’career aspirations;

setting out our research questions, approach and methods; presenting the findings;

and finally drawing out their implications.

2 THE CONSTRUCTION OF CAREER ASPIRATIONS AMONGST

LOW-PAID WORKERS

The career options available to low-paid workers have typically been presented as

structurally constrained by the patterns of work organisation and job design in mod-

ern employment settings. In manufacturing, Thomas (1989) has highlighted Fordist

forms of work organisation as driving-out hierarchically differentiated work roles,

in turn leading to flat grading structures that stifle‘blue-collar’career development

opportunities. Similarly, the design of much office and service work has been viewed

as creating routine ‘white-collar’roles (Fraser, 2001) that foreshorten career pathways

and lead Truss (1993) and Belt (2002) respectively to characterise secretarial and call

centre work as a ‘female ghetto’. Indeed, in their study of low-paid roles in the service

sector, Berg and Frost (2005: 663) note that, ‘These are dead-end jobs with little or no

chance of upward mobility.’

However, whether in the context of these constrains workers in low level, standard

manufacturing and service jobs retain the cognitive capacity to construct career plans

and ambitions remains more open to consideration. Much of the literature casts

doubt on the development of this capacity. In a review of survey findings, Li et al.

(2002: 621) note that employees from ‘working class’backgrounds are far less likely

151Career aspirations amongst healthcare support workers

© 2019 Brian Towers (BRITOW) and John Wiley & Sons Ltd