The politics of essentiality: Praise for dirty work in healthcare organizations during the COVID-19 pandemic

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The study focuses on the COVID-19 pandemic's impact on the recognition, through discourses of essentiality, of low-status workers and more specifically of care aides as an occupational group that performs society's "dirty work". The pandemic appears as a privileged moment to challenge the normative hegemony of how work is valued within society. However, public recognition through political discourse is a necessary but insufficient element in producing social change. Based on the theory of performativity, the study empirically probes conditions and mechanisms that enable a transition from discourse of essentiality to substantive recognition of the work performed by care aides in healthcare organizations. We rely on three main sources of data: scientific-scholarly works, documents from government, various associations and unions, and popular media reports published between February 2020 and July 1, 2022. While discourse of essentiality at the highest level of politics is associated with rapid policy response to value the work of care aides, it is embedded in a system structure and culture that restrains the establishment of substantive policy that recognizes the nature, complexity and societal importance of care aide work. The study shows the importance of the institutionalization of competing logics in contemporary health and social care systems and how it limits the effectivity of discourse in promulgating new values and norms and engineering social change.