Love is not a marketable commodity: new public management in the British National Health Service

Strategies of emotion management: not just on, but off the job

Intensive care nurses, like professionals in other intense occupations characterized by high degrees of uncertainty, manage the emotions that result from their work both on and off the job. We focus on the job strategies - calling-in, sharing their experiences with others and engaging in a range of activities oriented to emotional recovery - that 37 intensive care nurses use to manage their emotions off the job. These strategies show how the social organization and division of labor in intensive care units influences nurses' emotional management outside of them and how organizational troubles for hospitals becomes personal ones for staff. They further support theoretical approaches that view emotions as dynamic elements belonging to individuals rather than aspects of people that can be fully appropriated by organizations.

Modernizing the British National Health Service (NHS) -- some ideological and policy considerations: a commentary and application

The modernization of the British National Health Service, discussed by Peter Bradshaw in his paper, is having profound effects on nursing and patient care. The aim of this paper is to engage with the debate he has initiated in order to demonstrate its importance to nursing. The focus will be on key elements of the policy process not addressed by Peter Bradshaw as his emphasis was mainly on ideological concerns, but which nonetheless warrant consideration. These include the increasingly important role of evidence in policy making, and the role of nurses in the policy process. To this end four main themes are explored. First, specific comment is made on some of the points raised by Peter Bradshaw, in the context of the available evidence; secondly the role of evidence in the formulation and evaluation of policy is discussed; thirdly the policy process and nursing is examined; finally some tentative suggestions are made concerning the actions nurses and nurse managers can take to become more active in the health policy arena. The intention is to use Peter Bradshaw's work as a point of departure in examining further, some of the issues he highlights and to contribute to the debate.

The new public management and the new nursing: related by rhetoric? Some reflections on the policy process and nursing

The importance of health policy in terms of its effects on nursing is now recognized as an issue of concern for nurses; however, the essentially dynamic character of policy requires that consideration of its nature and consequences is continuous. This paper addresses the parallel development of the New Public Management (NPM) and the New Nursing as a means of demonstrating the perceived disjunction between events in nursing and the wider policy arena. The nature of policy is discussed and the relationship between the NPM and the New Nursing is explored. An examination of the unintended consequences of policy implementation and the role of rhetoric in the development of the NPM and the New Nursing demonstrates that these contrasting ideologies have emerged from a similar set of circumstances and have developed along a broadly similar timescale. The final effects of this process, however, are not yet clear. It is suggested that although the processes of policy formation and implementation are inherently complex there is an opportunity for nurses to exert some influence over them. Finally it is argued that if nurses become skilled in the art of rhetoric and combine this with a thorough understanding of the policy process they may be able to shape policy directly when and where it is implemented.

An analysis of nursing in context: the effects of current health policy

This paper intends to analyse the effects of recent health policy changes in the United Kingdom upon nursing, examining some of the anomalies raised by the rhetoric of the politics and the actualities of the change process and exploring and analysing nursings' presence within that change process. Specific reference will be paid to the philosophy and ideology of the reforms and comparisons made with some of the original factors underpinning the purpose and functioning of the British National Health Service and professional groups within it. In particular, this paper considers the functioning of nursing as an holistic, intuitive, humanistic, and caring act within the context of the scientific, rational, performance and outcomes-orientated new public management ideology presently sweeping the health service. The resultant tensions this apparent dichotomy is causing nursing will be tentatively explored. Lastly, an agenda for change will be proposed which will identify ways in which nursing can respond and, more importantly, be proactive within the contextual changes highlighted.

The last post? Defending nursing against the postmodernist maze

Is postmodernism in many ways the empiricist-liberal tradition at the inevitable end of its intellectual and political tether? Or is postmodernism the 'laughter of genius' that art and argument in their traditional forms are dead? Can postmodernism be applied to social and economic issues whilst carrying a denial of the manner by which Western thought has shaped these issues? Can postmodernism provide moral pathways to help us with contemporary ethical issues? How can postmodernist thought encompass the activities of nurses, particularly in the area of psychiatric care? Can nurses afford postmodernist suppositions in the face of suffering and pain? If postmodernism exists, does it exist everywhere (as does nursing) or is it a more localized event?