Symbols of the NHS

Preston, Diane; Smith, Alison; Buchanan, David; Jordan, Simone

doi:10.1177/1350507696273004

Cited by 7 publications

(3 citation statements)

References 5 publications

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“…Importantly, the story is also told to Ado within a place – a hospital setting which is part of the UK National Health Service (NHS), an institution culturally dominated by historical influences and hierarchical structures (Preston et al, 1996). Due to its symbolic place in the British consciousness (Preston et al, 1996), the NHS experiences very high expectations, together with practical demands, with the 2020 annual survey reporting higher than average levels of sickness absence amongst employees, compared to all other sectors in the UK (NHS Employers, 2022). Loss of control over work is recognised as a significant factor in stress reactions and therefore it seems possible that the place in which the story unfolds is an important factor in the initial reactions of Ado's colleagues.…”

Section: Methodsmentioning

confidence: 99%

“…Preston et al (1996, p. 344) suggest that NHS culture is built on a set of ‘symbolic relationships’ based on professional roles and tasks, central to which is the role of management. Since Ado is expected to focus on care planning and the timely discharge of patients, his unwarranted actions could be interpreted as breaching these ‘symbolic relationships’ and most notably the hierarchy of management.…”

Section: Continuing Bondsmentioning

confidence: 99%

“…What is lost within these defensive actions is the opportunity for individual growth and creativity (Menzies Lyth, 1959) illustrated by Ado whose action in creating and offering the pebble to the patient is immediately deemed ‘unprofessional’ by his colleague, with his manager telling him never to repeat this. Echoing Preston et al's concept of ‘symbolic relationships’ within the NHS (1996) and Menzies Lyth's classic study on hospitals, Weiss -gal (p. 282) also suggests that occupations establish and maintain these dominant norms as a way of defending against the other. In this case it seems possible that Ado's identification as a Shaman and his African heritage had permitted him to step outside of more traditional professional boundaries in order to ‘walk alongside’ (Beyers et al, 2017) his patient, an act which both transgresses and de-stabilises the defensive working practices of the team and creates a dramatic reaction from his manager.…”

Section: Continuing Bondsmentioning

confidence: 99%

See 2 more Smart Citations

‘You Took me Back to the sea:’ Using Narrative to Explore and Inform the Practice of Social Work with Dying People

Turner

2022

Illness, Crisis & Loss

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This article centres on a qualitative interview extract, the ‘Story of the Pebble’, in which a West African Hospital Social Worker Ado, working in a UK context, and identifying as a Shaman, describes successfully trusting his instincts to create a symbol for a dying patient. Despite criticisms from colleagues, Ado's capacity to understand his patients needs are justified both before and after her death. The article discusses significant themes from the interview extract, including the meaning of professionalism, practice wisdom and cultural influences in a UK social work context, as well as through Ado's heritage and identification as a Shaman. The article considers holistic patient care in a medical context and suggests this has some useful lessons for social workers, particularly those involved with dying people. Although the extract, and wider research study from which it is drawn, pre-date the Covid 19 pandemic, this is referenced throughout, linking the interview extract to ways of helping practitioners and educators to consider people holistically at end of life.

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Section: Methodsmentioning

confidence: 99%

Section: Continuing Bondsmentioning

confidence: 99%

Section: Continuing Bondsmentioning

confidence: 99%

See 1 more Smart Citation

‘You Took me Back to the sea:’ Using Narrative to Explore and Inform the Practice of Social Work with Dying People

Turner

2022

Illness, Crisis & Loss

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The boundaries of cellular pathology: how pathologists see their clinical role

Jenkins¹,

Philips²,

Grisaffiî³

et al. 2002

The Journal of Pathology

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There has been much recent public attention on the effects of the practices of cellular pathology on patients and their relatives. It is important to establish clearly pathologists' views about their professional relationships to clinicians and patients. A national postal questionnaire survey was performed to investigate how cellular pathologists perceive their role in clinical practice and whether there are important differences between different groups of pathologists. Responses were received from 773 pathologists, of whom 167 were trainees. On the basis of responses to 25 attitude statements, it appears that the profession shares a core belief that pathologists are clinicians rather than scientists and sees diagnosis as its main clinical responsibility. However, the role that each pathologist feels clear about differs significantly between pathologists, with a stronger consensus over function, responsibility, and professional image than on the clinical practice of pathology, job satisfaction, and the impact of technological change. Academic activities are a minority interest, although academic pathologists express better job satisfaction and more radical views of professional practice. Young trainees are more likely to work in teaching hospitals, to be female, to have trained outside the UK, and to have had experience in other specialties. They have, however, a more restricted view of the clinical role of pathology than accredited pathologists. Most cellular pathologists see themselves as clinicians with a special role in diagnosis, but how this is interpreted and the extent to which pathologists involve themselves in clinical decision-making is inconsistent. This professional dilemma should be addressed by research to obtain more systematic knowledge of the clinical impact of cellular pathology and especially the ill-defined links between diagnosis and clinical decision-making.

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Managing development in an era of radical change: evolving a relational perspective

Doyle

2000

Journal of Management Development

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Despite an apparent increase in investment and commitment over the last ten years, more recent studies now give grounds for reservations about overall ability of management development to meet the challenges of radical change and fulfil its strategic potential. Argues that the constraints imposed by a complex array of contextual influences emanating from an increasingly turbulent organisational system pose risks to investment and commitment in development. Unless these influences can be managed effectively, management development may start to lag behind or fall out of synchronisation with the needs and demands of managers and their employing organisations. Examines the case for a shift towards a more situated and contextual view of management development where the complex dynamics induced by radical change are considered and managed alongside or even ahead of development strategies and approaches. Posits a framework for a more relational approach and explores some of the issues this raises.

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Symbols of the NHS

Cited by 7 publications

References 5 publications

‘You Took me Back to the sea:’ Using Narrative to Explore and Inform the Practice of Social Work with Dying People

‘You Took me Back to the sea:’ Using Narrative to Explore and Inform the Practice of Social Work with Dying People

The boundaries of cellular pathology: how pathologists see their clinical role

Managing development in an era of radical change: evolving a relational perspective

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