Ethical vulnerabilities in nursing history: Conflicting loyalties and the patient as ‘other’

Lagerwey, Mary D.

doi:10.1177/0969733010368746

Cited by 11 publications

(13 citation statements)

References 31 publications

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“…It is possible that because the participants’ view the ‘immoral’ manner in which care is funded in this way, they perceive the business aspects of their own roles as morally reprehensible. Ashforth and Kreiner () and Lagerway () suggest that the presence of moral discomfort is indicated by behaviours such as denial of responsibility, refocusing on more morally acceptable facets of the role and reframing the role to instil it with positive value. Many participants in this study used these strategies, which further reinforces that they are ill at ease with the monetary and selling aspects of their role.…”

Section: Discussionmentioning

confidence: 99%

‘I feel like a salesperson’: the effect of multiple‐source care funding on the experiences and views of nursing home nurses in England

2014

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Citation: Thompson, Juliana, Cook, Glenda and Duschinsky, Robbie (2015) 'I feel like a salesperson': the effect of multiple-source care funding on the experiences and views of nursing home nurses in England. Nursing Inquiry, 22 (2). pp. [168][169][170][171][172][173][174][175][176][177] Northumbria University has developed Northumbria Research Link (NRL) to enable users to access the University's research output. Copyright © and moral rights for items on NRL are retained by the individual author(s) and/or other copyright owners. Single copies of full items can be reproduced, displayed or performed, and given to third parties in any format or medium for personal research or study, educational, or not-for-profit purposes without prior permission or charge, provided the authors, title and full bibliographic details are given, as well as a hyperlink and/or URL to the original metadata page. The content must not be changed in any way. Full items must not be sold commercially in any format or medium without formal permission of the copyright holder. The full policy is available online: http://nrl.northumbria.ac.uk/policies.html This document may differ from the final, published version of the research and has been made available online in accordance with publisher policies. To read and/or cite from the published version of the research, please visit the publisher's website (a subscription may be required.) 'I feel like a salesperson': the effect of multiple-source care funding on the experiences and views of nursing home nurses in EnglandThompson, Juliana Cook, Glenda Duschinsky, Robbie AbstractThe difficulties faced in the recruitment and retention of nursing staff in nursing homes for older people is an international challenge. It is therefore essential that the causes of nurses' reluctance to work in these settings are determined. This paper considers the influence that multiple-source care funding issues have on nursing home nurses' experiences and views regarding the practice and appeal of the role. The methodology for this study was hermeneutic phenomenology. Thirteen nurses from seven nursing homes in the North East of England were interviewed in a sequence of up to five interviews, and data was analysed using a literary analysis method. Findings indicate that participants are uncomfortable with the business aspects that funding issues bring to their role. The primary difficulties faced are: tensions between care issues and funding issues; challenges associated with 'selling beds'; and coping with self-funding residents' changing expectations of care. The findings of the study suggest that multiple-source care funding systems that operate in nursing homes for older people pose challenges to nursing home nurses. Some of these challenges may impact on their recruitment and retention.

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Section: Discussionmentioning

confidence: 99%

‘I feel like a salesperson’: the effect of multiple‐source care funding on the experiences and views of nursing home nurses in England

2014

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“…Overall, it is the different 'other' who evokes abjection. Invariably the other is attributed a negative value (Jacob et al, 2009) and 'othering practices'such as marginalization and distancing -are common in nursing and health care (Hellzen et al, 2004;Johnson et al, 2004;Lagerway, 2010). Abject is concerned with repression and the experience of being an outsider, being excluded or ignored (Lindahl, 2011).…”

Section: Abjection and Nursingmentioning

confidence: 99%

“…Overall, a woman's responses are often limited by available options, and while some women flee, others keep the peace by capitulating to their partner's demands (Heise et al, 1999). One midwife in our study recalled her feelings of being horrified at a woman's decision to stay with her partner: Nursing is not exempt from the influence of cultural ideologies (Lagerway, 2010) or immune from broader social assumptions (McCabe, 2010). Nursing practice does not occur in a vacuum and nurses are exposed to the same cultural mores as the clients with whom they have contact.…”

Section: Abjection and Domestic Abusementioning

confidence: 99%

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Domestic abuse as a transgressive practice: understanding nurses' responses through the lens of abjection

Bradbury‐Jones

Taylor

2013

Nursing Philosophy

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Domestic abuse is a worldwide public health issue with long-term health and social consequences. Nurses play a key role in recognizing and responding to domestic abuse. Yet there is considerable evidence that their responses are often inappropriate and unhelpful, such as trivializing or ignoring the abuse. Empirical studies have identified several reasons why nurses' responses are sometimes wanting. These include organizational constraints, e.g. lack of time and privacy; and interpersonal factors such as fear of offending women and lack of confidence. We propose, however, that these factors present only a partial explanation. Drawing on the work of Julia Kristeva, we suggest that alternative understandings may be derived through applying the concept of abjection. Abjection is a psychological defence against any threat (the abject) to the clean and proper self that results in rejection of the abject. Using examples from our own domestic abuse research, we contend that exposure of nurses to the horror of domestic abuse evokes a state of abjection. Domestic abuse (the abject) transgresses established social boundaries of clean and proper. Thus when exposed to patients' and clients' experiences of it, some nurses subconsciously reject domestic abuse as a possibility (abjection). They do this to protect themselves from the horror of the act, but in so doing, render themselves unable to formulate appropriate responses. Rather than understanding the practice of some nurses as wilfully neglectful or ignorant, we argue that through a state of abjection, they are powerless to act. This does not refute existing evidence about nurses' responses to domestic abuse. Rather, as a relatively unknown concept in nursing, abjection provides an additional explanatory layer that accounts for why some nurses respond the way they do. Crucially, it elucidates the need for nurses to be supported emotionally when faced with the transgressive practice of abuse.

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“…Historically entrenched postcolonial perceptions cause healthcare professionals to blame illness on individual behaviour rather than on the impact of social injustices that affect health (Lagerwey 2010). Furthermore, there is a tendency to attribute an individual’s situation and behaviour to a perceived cultural norm rather than as a function of social processes.…”

Section: Implications For Nursing Practice Education Research and Lmentioning

confidence: 99%

New light through old windows: nurses, colonists and indigenous survival

2012

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The aim of this study was to explore the influences, processes and environments that shaped the practice of European nurses for indigenous New Zealand (NZ) Māori communities who were being overwhelmed by introduced infectious diseases. Historical data were accessed from multiple archival sources and analysed through the lens of colonial theory. Through their work early last century, NZ nurses actively gained professional status and territory through their work with Māori. By living and working alongside Māori, they learned to practise in new ways that influenced Māori health. By developing a new role in new professional territory, nurses extended their practice to include health promotion as well as disease prevention. Māori survival from epidemics improved, and the population grew over that period. For Māori, however, Eurocentric care alleviated their immediate health problems, but the detrimental impact of the mechanisms of colonisation overall has continued to the present day.

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Ethical vulnerabilities in nursing history: Conflicting loyalties and the patient as ‘other’

Cited by 11 publications

References 31 publications

‘I feel like a salesperson’: the effect of multiple‐source care funding on the experiences and views of nursing home nurses in England

‘I feel like a salesperson’: the effect of multiple‐source care funding on the experiences and views of nursing home nurses in England

Domestic abuse as a transgressive practice: understanding nurses' responses through the lens of abjection

New light through old windows: nurses, colonists and indigenous survival

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