Legitimate nurse’s aides[Des aides-soignants légitimes]

Work in psychiatric hospitals, much like in general hospitals, brings together actors from widely diverse professional and socioeconomic backgrounds, who nevertheless work as a team in caring for the patients. However, the influence of hierarchical and economic factors in management decisions has led to a cascading task drop further consolidated by both the formal and informal organization of labor. Indeed, the less prestigious and technical tasks are relegated from psychiatrists to nurses, who then pass on their own less rewarding tasks to nursing assistants. The latter, thus, are left in charge of the larger share of "dirty work", which forces them into a socially and professionally illegitimate position; a position that is particularly visible in their exclusion and self-exclusion from team-wide briefings. Basing our reflection on long-term field work in three mental health units, we will present the unconventional mechanics present in the third unit wherein nursing assistants have significant sway over workplace decisions despite their hierarchical position. From a mixed perspective of both the sociology of psychiatry and the sociology of professions, we will attempt to elucidate the root causes of this framework through an exploration of the history of the unit, as well as the psychiatric ideology to which it subscribes.