This article is drawn from participant observation in two nursing homes where the author worked as a nursing assistant. Based on conversations with residents, nursing assistants, and administrators, the ways in which everyday life in nursing homes is dominated by the ideology of capitalist medicine are illustrated. This is addressed in terms of the subordination of nursing assistants within a medical hierarchy, overemphasis on medical tasks in this work, and the pervasive assumption that residents of nursing homes are mentally ill. These are seen as mutually reinforcing components of nursing home culture, although experienced very differently by residents, nursing assistants, and administrators. While from the administrative standpoint they provide a rational model of organization, for residents and nursing assistants they create a climate that is counterproductive to health care.
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