On the bullshitisation of mental health nursing: A reluctant work rant

This discussion paper offers a critical provocation to my mental health nursing colleagues. Drawing upon David Graeber's account of bullshit work, work that is increasingly meaningless for workers, I pose the question: Is mental health nursing a bullshit job? Ever-increasing time spent on record keeping as opposed to direct care appears to represent a Graeberian bullshitisation of mental health nurses' work. In addition, core aspects of the role are not immune from bullshit. Professional rhetoric would have us believe that mental health nursing is a therapeutically beneficent occupation organised around ideals of care and compassion and providing fulfilling work for practitioners. Yet, there are some key characteristics of the experience of mental health nursing work that afford alternative judgements on its value and meaningfulness. Not least of these is the fact that many mental health nurses feel quite existentially unsettled in the practise of their work and many service users do not recognise the professional ideal, especially when compelled into increasingly coercive and restrictive services. In this context, Graeber's thesis is explored for its applicability to mental health nursing with a conclusion that many aspects of mental health nursing work are commensurate with bullshit but that mental health care can possibly be redeemed from bullshitisation by authentically democratising reforms. Engaging with posthumanist ideas, this exploration involves a flexing of aspects of Graeber's theory.     

海南某三甲综合医院入院患者人口社会学分布及时间变化趋势分析

目的探讨某三级甲等综合医院2014年-2019年入院患者人口学分布及时间动态变化情况,为弹性调配医疗资源提供参考。方法对某院2014年1月1日-2019年12月31日入院人次169 842采用χ²检验比较省内外不同年龄组入院人次差异,用动态指标分析入院人次变化趋势,季节指数法分析入院人次季度变化情况。结果省内外患者入院人次在不同年龄组之间的分布差异有统计学意义。入院人次省内20岁～40岁住院人次最多,占34.23%;省外≥60岁住院人次最多,占54.55%。入院人次呈上升趋势,2019年较2014年增长30.88%。移动平均趋势剔除后的季节指数,第1季度为102.72%、第4季度为105.93%,为高峰期;第2季度为95.54%,第3季度为95.81%,为低谷期。结论某院省内患者入院人次以20岁～40岁人员居多,省外以60岁以上人员最多,均呈逐年增长的趋势,并随着月份和季度的变化具有明显的季节性和周期性。医院管理部门应依据入院人次的变化特点,合理制定工作计划、优化医疗资源配备,从而提升病区医疗服务质量。     

Considerations on immunization anxiety-related reactions in clusters

A cluster of adverse events following immunization (AEFI) represents a stress test for an immunization program. The community can suspect on vaccine-related reaction leading to mistrust on the immunization program. An immunization anxiety-related reaction is one of the hypotheses to be tested and can be reasonably accepted when the vaccine-related and immunization error-related reactions are ruled out and no coincidental events can explain the cases. Immunization program approaches widely accepted to understand and respond to adverse events are root-cause analysis and systems analysis. Psychiatric cognitive frame will support the root-cause analysis assigning a causal relationship to individual temporary disorders of the affected vaccinees. Communication will focus on vaccine safety and absence of errors in the immunization program. Systems analysis addresses the whole context considering the fear spread as a systemic threat. Socio-psychological frame offers a broader opportunity to understand and respond to a specific community. Management is based on communication to change community belief in misperceptions of vaccine risks and support the idea of immunization as a causal factor, different from the vaccine. Communities can consider use of psychiatric labels, Mass Psychogenic Illness or Mass Hysteria, as an act of inconsiderateness. Labels like immunization anxiety-related reactions in clusters or collective immunization anxiety-related reactions are recommended to bridge the causal perception of the community with the result of the scientific investigation of the cases.     

Finding a way between nihilism and romanticism: Some reflections on the practice and politics of the sociology of risk

This editorial argues that aspects of a number of contemporary debates within the sociology of risk, including those concerned with the nature of expert knowledge, the capacity of theory to address practical real-world issues, and the appropriate political stance of the scholar, were pre-figured in helpful and insightful ways in the work of the British medical sociologist Philip M. Strong (1945–1995). The recent publication of a selection of Strong's essays, which had earlier appeared in a disparate range of books and journals, makes a valuable resource available not only to specialist health researchers, but also to the wider risk research community.     

Exploring identity in the ‘figured worlds’ of cancer care‐giving and marriage in Australia

Following changes in the structure and funding of the Australian medical system, patients have become ‘consumers’ or ‘clients’. Family and friends have become ‘carers’ or ‘caregivers’, signifying their increased responsibilities as patients move from hospitals to communities. While policy makers embrace the term ‘carer’, some argue that the title is not widely recognised and has disempowering connotations. This paper examines spouses’ reflections on the term ‘carer’ based on qualitative interviews with 32 Australians caring for a spouse with cancer from a study conducted between 2006 and 2009. Recruitment involved survey and snowball sampling. Following a grounded theory approach, data collection and analysis were performed simultaneously. Using Holland and colleagues’ sociocultural ‘identity as practice’ theory and a thematic approach to analysis, findings depict identification with the ‘spouse’ and ‘carer’ label as relationally situated and dependent on meaningful interaction. Although others argue that the term ‘carer’ is a ‘failure’, these findings depict identification with the label as contextual, positional and enacted, not fixed. Furthermore, and of most significance to practitioners and policy makers, the title has value, providing carers with an opportunity to position themselves as entitled to inclusion and support, and providing health professionals with a potential indicator of a spouse's increased burden.     

Emergency department: A sociological perspective

As a complex space that can be interpreted on individual, societal and systemic levels, there is a need for analysis of emergency medicine that transcends the biomedical paradigm to explore its sociological influences. The ED is a social structure of different roles, responsibilities and relationships that can be analysed through observation of the different institutionalised activities which highlight the hierarchies and culturally influenced interactions taking place between actors. Institutionalised activities that provide insight into the social structure of the ED include deference to doctors by patients in the context of environmental chaos, segregated handover of information and discharge‐oriented patient care that de‐emphasises the impact of social background.     

Leadership of interprofessional health and social care teams: a socio-historical analysis

reeves s., macmillan k. & van soeren m. (2010) Journal of Nursing Management 18, 258–264
Leadership of interprofessional health and social care teams: a socio-historical analysis Aim The aim of this paper is to explore some of the key socio-historical issues related to the leadership of interprofessional teams. Background Over the past quarter of a century, there have been repeated calls for collaboration to help improve the delivery of care. Interprofessional teamwork is regarded as a key approach to delivering high-quality, safe care. Evaluation We draw upon historical documents to understand how modern health and social care professions emerged from 16th-century crafts guilds. We employ sociological theories to help analyse the nature of these professional developments for team leadership. Key issues As the forerunners of professions, crafts guilds were established on the basis of protection and promotion of their members. Such traits have been emphasized during the evolution of professions, which have resulted in strains for teamwork and leadership. Conclusions Understanding a problem through a socio-historical analysis can assist management to understand the barriers to collaboration and team leadership. Implications for nursing management Nursing management is in a unique role to observe and broker team conflict. It is rare to examine these phenomena through a humanities/social sciences lens. This paper provides a rare perspective to foster understanding – an essential precursor to effective change management.     

Emergence of Nordic nursing research: no position is an Island

This paper reports on a detailed analysis of findings from a larger study of 'Nordic nursing theorists and clinical nurses' reflections on and experience with production and use of research, theory and findings'. The development of nursing science in the Nordic countries goes back to the late 1970s. With use of a sociological approach the aim was to explore whether nursing science has constituted itself as an autonomous nursing research field in Bourdieu's terms. In-depth interviews were undertaken with a purposive sample of 10 professors drawn from seven universities in the Nordic countries. The interview agenda explored the participants' research activities and knowledge production. Our conclusion is that one cannot speak of nursing research in the Nordic countries as a fully developed and autonomous field. Yet we see the outlines of an emerging nursing research field with a common doxa. At least three distinct positions operate in Nordic nursing research: a clinical and applied oriented position, a profession and knowledge oriented position and a theoretical and concept oriented position. Epistemologically speaking the positions are of a 'spontaneous', 'cyclical' and 'break' character. In a relational perspective each position has created its specific form via its relations with other positions in the field.     

Sociology and nursing: Role performance in a psychiatric setting

The role of sociology in nursing continues to cast new light on many aspects of health and illness. Over the last 20 years, nursing practice has seen sociological theory become a valuable clinical tool, both in the diagnosis and prognosis of a wide range of illnesses and long‐term conditions. Nevertheless, of these, the sociological examination of mental health problems and its impact upon nursing practitioners has received little coverage, simply because, as a discipline, mental health nursing has historically been wedded to a biomedical model, one which continues to embrace psychiatry/psychology as the driving force in the diagnosis and treatment of psychopathology. Adopting a sociological approach, this paper brings to light previously unexplored insights into the way nurses interact with patients experiencing mental health problems. Drawing on social interactionist methodology, this paper considers depression and other mental health problems in relation to current psychiatric nursing practice. Specifically, the paper focuses on aspects of role performance and interpersonal care in a psychiatric setting, and the impact the individual role may have on the wider aspects of institutional and official practices. The paper concludes by making a number of recommendations/observations for nursing practice.