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Summary:
Vividly documenting the real world of the contemporary hospital, its nurses, and their moral and ethical crises, Dan Chambliss offers a sobering revelation of the forces shaping moral decisions in our hospitals.
Based on more than ten years' field research, Beyond Caring is filled with eyewitness accounts and personal stories demonstrating how nurses turn the awesome into the routine. It shows how patients, many weak and helpless, too often become objects of the bureaucratic machinery of the health care system and how ethics decisions, once the dilemmas of troubled individuals, become the setting for political turf battles between occupational interest groups. The result is a compelling combination of realism and a powerful theoretical argument about moral life in large organizations.
Customer Reviews:
Average Customer Rating:
Sometimes the best insight comes from without
Customer Rating:
Sociologist Daniel Chambliss spent over two years (divided into in three blocks, over 11 years) observing and interviewing North American nurses about their work. In "Beyond Caring" he distills almost fifteen years' experience as a sociologist into a lucid exploration of what it is like to be a nurse. Though this book is centred around the meaning of 'care' within a nursing context, the nature of this work means that it also allows insight into other aspects of nursing ideology and practice, including why nurses leave the occupation. Particularly interesting to me, as a nurse with almost 15 years experience in clinical work, is the ongoing discussion about how routine and habituation alter perception (predominantly in chapters 1 and 2); how death is de-emphasised (discussed throughout but especially in chapter 6); and an explanation about why nursing priorities are often so diferent from the priorities of patients and relatives. He spends some time looking at how the ethical aspects of cases get lost, which I found very valuable when undertaking a Masters in Health Ethics, and I have recommended it to several colleagues for their own studies. In addition Chambliss looks at the impact on nurses of implementing decisions but having little or no voice in the decision-making process. It is difficult for me to read this book without having a nursing perspective, but I think it would be rewarding reading not just for nurses but also for other health professionals, and for anyone interested in how hospitals run.
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