The social context of occupational stress in a caring profession

This paper examines the relationship between the structure and ideology of the psychiatric system and the actions, worldview and subjective experiences of psychiatric nurses working within both the hospital and the community settings. In contrast to previous occupational stress research, which has tended to concentrate on the perspective of staff without interpreting either the interrelationships between the experiences of caregiver and recipients or the ways in which the social context of care influences all participants' interpretations of their situation, this paper will argue that the occupational stresses facing psychiatric professionals cannot be fully understood without a clear understanding of the ambivalent role of welfare institutions within our society. This necessitates moving beyond the decontextualized, micro-level analyses advocated within the traditional occupational stress literature and drawing on alternative theoretical traditions which facilitate richer interpretations of the complex interplay between the structure and ideology of Western psychiatric systems and the motives, understandings, actions and emotions of different players within the system. With these considerations in mind, this article seeks to forge new links between the theoretical analysis of psychiatry's role within our society and the empirical investigation of occupational stress in psychiatric nursing by elucidating the interpersonal processes which enable the structural contradictions of psychiatry to find concrete expression within the fragmented understanding and inconsistent actions of the various players within the system. As the empirical research will reveal, staff attempts to ameliorate the chronic personal insecurities engendered by these contradictions often have the paradoxical effect of augmenting the problems of the psychiatric system and intensifying the very feelings they are struggling to avoid.