Date: Sun, 15 Nov 1998 13:15:00 -0700
Message-Id: <199811152015.NAA12364@noodle.hi-line.net>
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To: MedSoc@csf.colorado.edu
From: Libbie Chute <Libbie.Chute@hi-line.net>
Subject: Nurses and patients
What a stimulating dialogue this is!  I am a new PhD whose dissertation was
the process individuals go through as they learn to live with a chronic
illness.  It is a qualitative study.  The respondents dealt with doctors
through appointments.  They had few social interactions with nurses, though
many of them were nurses.  Now I am temporarily working as a social worker
in a nursing home with a census of about 130.  Nurses are very powerful in
this forum.  A doctor can prescribe a medication, say for pain, and advise
that it can be taken every 4 hours at the patient's request.  This is
interpreted by some nurses as at their discretion.  Whether or not the
patient actually gets the medication depends upon the nurse's interpretation
of whether the resident is really in pain or just wants to take something,
or if the patient caused the pain by doing something s/he knows s/he
shouldn't.  If a patient innovates and calls the doctor on an outside line
after being refused by a nurse, s/he is labeled manipulative.  Sometimes is
a social worker sides with the patient and tells the nurse to call the
doctor, the nurse will refuse.    I'm not saying this happens very often,
but it does give one a sense of the power nurses' have in this situation.
On the other hand, nurses often catch symptoms before patients even realize
they are having them.

I found that Qualitative Health Research had a number of articles on
nurse/patient interaction.  Seems to me there are more of these articles
coming from Canadian researchers (Calgary perhaps?)

Hope this is helpful.
Libbie Chute, PhD

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Elizabeth (Libbie) E. Chute, PhD   Home Phone:  406-265-2686
1141 14th Avenue              E-mail:   Chute@hi-line.net
Havre, MT  59501-4683         Affiliation:  Department of Sociology
                           SUNY Stony Brook
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