The Rules in Institutional Care: An Ethnographic Style Study IntroductionAngela Kydd*, Deidre Wild and Ann Fleming
Department of Nursing, University of the West of Scotland, UK
- *Corresponding Author:
- Angela Kydd
Department of Nursing
1.26 Caird Building Hamilton
University of the West of Scotland, UK
Tel: 01698 283100 x 8342
E-mail: [email protected]
Received date: March 17, 2016; Accepted date: July 26, 2016; Published date: July 29, 2016
Citation: Kydd A, Wild D, Fleming A (2016) The Rules in Institutional Care: An Ethnographic Style Study Introduction. J Gerontol Geriatr Res 5: 326. doi:10.4172/2167-7182.1000326
Copyright: © 2016 Kydd A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: The purpose of this paper is to report on one area of findings that came from a larger doctoral study looking at what life was like for older people in receipt of long-term care in a hospital environment that was due for closure.
Method: Over the period of a year, the study's researcher regularly frequented a longterm care ward as a 'visitor'. Over time, she witnessed many day to day events experienced by frail older patients and recorded these as their stories in field notes as well as in her own related reflective notes. All data were transcribed and thematically analyzed.
Results: The researcher saw evidence of institutionalized rituals on the ward and underpinning these were one or other of four forms of thematically identified 'rules': procedural rules, hospital rules, unspoken rules and spontaneous rules. The imposition of these rules had a negative effect upon patients who were powerless in opposing them. In contrast for staff under stress, the 'rules' seemed to justify poor practice and served to excessively empower them over their patients. It was also clear that when staff displayed stress, emotional care for patients was poorer and the rules were exercised more frequently.
Conclusions: As the ward manager neither challenged poor practice nor prompted change towards person centered care, in the absence of management leadership, staff were left to their own devices as to their ways of working. Given staff shortages and the pressures that this placed upon workload resulted in an inappropriate economy of scale in terms of care-giving. This caused the older people to hold a inner sense of injustice and distress, that they felt unable articulate or to counter.