PDF (PhD Thesis) - UWE Research Repository - University of the ...

This suggests to me, that hygiene needs and emotional support are
undervalued, having less social and cultural capital in the ward. My
assumption is that both are central to effective nursing care. It is only
recently that ‗basic nursing skills‘ has been renamed ‗essential nursing
skills‘. This language could imply less symbolic capital than technical
nursing skills forming part of extended nursing roles. Bourdieu suggested it
is through linguistics that identity is formed. While in 1960 Menzies-Lyth
proposed nurses used depersonalisation and fragmentary work processes
to act as a function against the anxiety generated by the job. She
suggested working with the suffering of patients and carrying out mundane
and repetitive work created anxiety for nurses. Consequently, by not
providing hygiene needs or emotional support nurses may be able to
protect themselves from the patient‘s suffering. I suggest in a close nurse-
patient relationship as I found in nursing Mary 32 , it is possible to
experience strong raw emotions through a parallel process involving
transference and counter transference. If there is less engagement, and a
close relationship does not develop with the patient then the nurse is
unlikely to experience transference, possibly reducing the emotional
impact, especially discomfort. However, reflection is sometimes generated
by discomfort so perhaps nurses were not engaging with reflecting
because they wanted to avoid or were not ‗feeling‘ while giving care.
In West et al‘s (ibid) study, 65% of respondents said they had too much
work to do while 33% felt they were understaffed resulting in less time for
direct patient care. This led me to again question the lack of time in
practice as a systemic staffing issue. Perhaps it is unrealistic to expect
nurses to engage emotionally and practically with their patients especially
if they are understaffed?
32 See previous chapter
117