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Re-conceptualising holism in the contemporary nursing mandate: From individual to organisational relationships

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  • Allen, Davina

Abstract

Over the last forty years, nursing's claim to professional expertise has been expressed in terms of its care-giving function. Informed by a distinctive ‘holistic’ approach, models of nursing identify therapeutic relationships as the cornerstone of practice. While ‘knowing the patient’ has been central to clinicians' occupational identity, research reveals that nurses not only experience significant material constraints in realising these ideals, their contribution to healthcare extends far beyond direct work with patients. Amidst growing concern about healthcare quality, a body of critical commentary has emerged proposing that the contemporary nursing mandate, with its exclusive focus on care-giving, is no longer serving the interests of the profession or the public. Drawing on an ethnographic study of UK hospital nurses' ‘organising work’ and insights from practice-based approaches and actor network theory, this paper lays the foundations for a re-conceptualisation of holism within the nursing mandate centred on organisational rather than therapeutic relationships. Nurses can be understood as obligatory passage points in health systems and through myriad processes of ‘translational mobilisation’ sustain the networks through which care is organised.

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  • Allen, Davina, 2014. "Re-conceptualising holism in the contemporary nursing mandate: From individual to organisational relationships," Social Science & Medicine, Elsevier, vol. 119(C), pages 131-138.
    • Handle: RePEc:eee:socmed:v:119:y:2014:i:c:p:131-138
    DOI: 10.1016/j.socscimed.2014.08.036
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    References listed on IDEAS

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    1. Armstrong, David, 1983. "The fabrication of nurse-patient relationships," Social Science & Medicine, Elsevier, vol. 17(8), pages 457-460, January.
    2. Elizabeth Goodrick & Trish Reay, 2010. "Florence Nightingale Endures: Legitimizing a New Professional Role Identity," Journal of Management Studies, Wiley Blackwell, vol. 47(1), pages 55-84, January.
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    Cited by:

    1. Liberati, Elisa Giulia, 2017. "Separating, replacing, intersecting: The influence of context on the construction of the medical-nursing boundary," Social Science & Medicine, Elsevier, vol. 172(C), pages 135-143.
    2. Jennifer Tocher & Barbara Neades & Graeme D. Smith & Daniel Kelly, 2019. "The role of specialist nurses for organ donation: A solution for maximising organ donation rates?," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(9-10), pages 2020-2027, May.
    3. Fatima Yatim & Marie Ferrua & Paula Cristofalo & Anne Girault & Marilene Lacaze & Mario Di Palma & Etienne Minvielle, 2017. "Analysis of nurse navigators’ activities for hospital discharge coordination: a mixed method study for the case of cancer patients," Post-Print hal-03769102, HAL.
    4. Mette Geil Kollerup & Tine Curtis & Birgitte Schantz Laursen, 2018. "Improving posthospital medication management in a Danish municipality: A process evaluation," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(19-20), pages 3603-3612, October.
    5. Fatima Yatim & Paula Cristofalo & Marie Ferrua & Anne Girault & Marilène Lacase & Mario Dipalma & E. Minvielle, 2017. "Analysis of nurse navigators’ activities for hospital discharge coordination: a mixed method study for the case of cancer patients," Post-Print hal-03769421, HAL.
    6. Liberati, Elisa Giulia & Gorli, Mara & Scaratti, Giuseppe, 2016. "Invisible walls within multidisciplinary teams: Disciplinary boundaries and their effects on integrated care," Social Science & Medicine, Elsevier, vol. 150(C), pages 31-39.

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