Hospitals as total institutions

Jenkins, Danisha; Burton, Candace W.; Holmes, Dave

doi:10.1111/nup.12379

Cited by 12 publications

(13 citation statements)

References 34 publications

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“…Those living unhoused are marginalised people, and their existence demonstrates a politics of death in which their ‘bodies are subjected to prolonged bodily suffering along their life course’ and people must ‘suffer in order to get ‘saved’ by the care assemblage (López, 2020, p. 754). The everyday violence that people who are unhoused must survive is situated in a complex matrix of targeted surveillance, criminalisation, and policing that the healthcare system plays an integral part in Hansen et al (2014) and Jenkins et al (2022). These efforts have resulted in punitive frameworks that influence how institutions manage, discipline, and control this population, even through the process of promoting and providing care (López, 2020).…”

Section: Discussionmentioning

confidence: 99%

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Nursing in deathworlds: Necropolitics of the life, dying and death of an unhoused person in the United States healthcare industrial complex

2023

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This paper begins with the lived accounts of emergency and critical care medical interventions in which an unhoused person is brought to the emergency department in cardiac arrest. The case is a dramatised representation of the extent to which biopolitical forces via reduction to bare life through biopolitical and necropolitical operations are prominent influences in nursing and medical care. This paper draws on the scholarship of Michel Foucault, Giorgio Agamben, and Achille Mbembe to offer a theoretical analysis of the power dynamics that influence the health care and death care of patients who are caught in the auspices of a neoliberal capitalist healthcare apparatus. This paper offers analysis of the overt displays of biopower over those individuals cast aside as generally unworthy of access to healthcare in a postcolonial capitalist system, in addition to the ways in which humans are reduced to ‘bare life’ in their dying days. We analyse this case study through Agamben's description of thanatopolitics, a ‘regime of death’, and the technologies that accompany the dying process, particularly in that of the homo sacer. Additionally, this paper illustrates the ways in which necropolitics and biopower are integral to understanding how the most advanced and expensive medical interventions make visible the political values of the healthcare system and how nurses and healthcare functions in these deathworlds. The purpose of this paper is to develop a greater understanding of biopolitical and necropolitical operations in acute and critical care environments, and to offer guidance to nurses in these spaces as they work to uphold ethical duties in a system that increasingly dehumanises.

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Section: Discussionmentioning

confidence: 99%

“…How do such cases occur in places purported to exist for caring and healing (Jenkins et al, 2022)? Such are the harsh realities of the provision of 'care' amidst capitalism, an economic and political extractive cycle that does not exist without racial slavery and its aftermath (Mbembe & Goldberg, 2018).…”

Section: Discussionmentioning

confidence: 99%

Nursing in deathworlds: Necropolitics of the life, dying and death of an unhoused person in the United States healthcare industrial complex

2023

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“…Making reference to teenage inpatients, Bri ere et al (2012) pointed out that they preferred losing their wallet (identity card and credit card) than their smartphone. The comment recognizes the strong link that exists in many between the smartphone and one's identity, memory and self-image, all therapeutic issues in psychiatric patients (Bri ere et al 2012;Jenkins et al 2021).…”

Section: Discussionmentioning

confidence: 99%

Rules and ward climate in acute psychiatric setting: Comparison of staff and patient perceptions

Corbetta¹,

Corso

Camuccio

2022

Int J Mental Health Nurs

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The ward climate or atmosphere refers to its material, emotional and social conditions. A good ward climate in psychiatric settings can influence the mood, behaviour and self-concept of patients and staff members and improve patient outcomes. Many studies have examined the relationship between ward climate and aggression, but only a few have investigated the effect of a ward's environment, rules and activities. This multicentric observational study aimed to assess the relationship between the rules/activities and the climate of four acute psychiatric units of Northern Italy. The Essen Climate Evaluation Scheme (EssenCES) questionnaire, which was administered to patients and staff, was used to evaluate the different dimensions of ward atmosphere. There was a good response rate (79%) in patients and staff members who completed the questionnaire (114 patients and 109 staff). Safety perception appeared to be quite different in patients and staff. The patients who were authorized to have more visiting hours and more time to use their mobile phone had higher scores on Experienced Safety subscale. A negative correlation between the Therapeutic Hold and Experienced Safety subscales was found in the staff members, and this was due to their negative perception. The ward climate seemed to be affected by the unit's rules, especially with respect to visits and the smartphones use. Nurses need to be aware of the importance of ward climate and how their own perception may differ from and that of patients: this gap could lead to decisions detached from the patients' needs.

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“…Nurses therefore navigate between structures, having and not having power and control in the places in which they work. A number of studies have explored how nurses, given their relationality to health care systems, are central to the flow of institutional power (Herk et al, 2011; Holmes & Gagnon, 2018; Jenkins et al, 2022; McDonald & McIntyre, 2019). For instance, nurses act as a conduit of institutional policies and best practices, navigating and reinforcing these in varied languages to appease their audience, adapting to that of their patients, and at other times, their organization superiors such as a supervisor or physician.…”

Section: Opportunities Within Nursing To Transform Health Care Spacesmentioning

confidence: 99%

Lefebvre's production of space: Implications for nursing

et al. 2023

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In this paper, we argue that nurses need to be aware of how the production of space in specific contexts – including health care systems and research institutions – perpetuates marginalized populations' state of social otherness. Lefebvre's idea regarding spatial triad is mobilized in this paper, as it pertains to two‐spirited, lesbian, gay, bisexual, trans and queer populations (2SLGBTQ*). We believe that nurses can create counter‐spaces within health care systems and research institutions that challenge normative discourses. Lefebvre's work provides us the necessary tools to understand how various places or environments produce identities. In understanding Lefebvre's principles, we believe that nurses can play an essential role in creating counter‐spaces, thereby instigating counter‐institutional practices, for those who experience otherness.

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Hospitals as total institutions

Cited by 12 publications

References 34 publications

Nursing in deathworlds: Necropolitics of the life, dying and death of an unhoused person in the United States healthcare industrial complex

Nursing in deathworlds: Necropolitics of the life, dying and death of an unhoused person in the United States healthcare industrial complex

Rules and ward climate in acute psychiatric setting: Comparison of staff and patient perceptions

Lefebvre's production of space: Implications for nursing

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