An ethnography of humor, ritual and defiance in a cancer care setting

Abstract

Purpose Health care organizational research should pay greater attention to the specific settings where health is practiced. An ethnographic account of humor, ritual and defiance is presented from 29 months spent in a private, concierge-type radiation oncology center. A thick description of the setting and interaction among center staff and patients is offered in an attempt to establish why qualitative research of health care settings is so important. Findings are compared to Ellingson’s work on health care setting. Humor, ritual and defiance have therapeutic value and deserve greater attention in cancer treatment centers and health care organizations more broadly. The paper aims to discuss these issues. Design/methodology/approach An ethnographic account of humor, ritual and defiance is presented from 29 months spent in a private, concierge-type radiation oncology center through thick description. Findings This study reinforces the literature on the value of institutionalizing humor and ritual to improve patients’ experience in cancer care given the dominance of large public institutions, most easily accessed by academic researchers. Suncoast Coast Radiation Center’s “institutionalized humor” is an important finding that should be examine further. Scholarship can also illuminate the use of ritual in settings where health care is practiced. Research limitations/implications This study is limited to a particular research setting which is a private, concierge care radiation oncology treatment center in the Southeastern USA. Practical implications Cancer care centers should consider carefully institutionalizing humor and ritual into their daily practices. Further, patient defiance should be reinterpreted not as a patient deficiency but as a therapeutic coping mechanism by patients. Social implications While nearly half of cancer care in the USA is offered in private, for-profit institutions, the vast majority of the understanding of cancer care comes only from non-profit and government-run institutions. Shining a light of these neglected cancer care settings will add to the understanding and the ability to improve the care offered to patients. Originality/value This is the first health ethnography in a concierge care, cancer care treatment setting. It tests the proposition that humor, ritual and defiance play an important role in a private concierge cancer care organization.

Making work visible in a breast cancer support business

“…The first author's long-term involvement and familiarity with the scene prompted her desire to undertake a research project to learn more about the store as an organizational space and site of care (see e.g. Pettegrew, 2017). Her personal history was not only an aid to gaining entry to the setting, but provided her with an evolving vantage point, from client to volunteer to researcher, and a perspective on the business and its workers that was both empathetic but grounded in everyday practice..…”

“Resisting the Ban”

“…Mental health nursing scholarship rarely examines acts of "everyday resistance". With some exceptions, relevant to "psychiatric nursing", that are worth noting (see Skorpen et al, 2008;Wood et al, 2013;Buus et al, 2018) as well as general nursing (Pettegrew, 2017) there is generally a lack of scholarship on the activities of "everyday resistance" that occur on the wards. I argue that the study of acts of "every resistance" is most likely important because they serve a host of latent social functions (see Merton, 1957).…”

Διαμορφώνοντας Μια Εναλλακτική Οργανωσιακή Κουλτούρα Στο Δημόσιο Σύστημα Υγείας

“…Κι αυτό αναγνωρίζουν πως δεν είναι πάντα εφικτό.Κι αν έτσι όπως περιγράφεται η καθημερινότητα της Αργούς, ληφθεί υπόψη το εύρημα της διάχυτης θεραπευτικής λειτουργίας της, μπορεί κανείς να συλλογιστεί τις προεκτάσεις των αναποτελεσματικών χειρισμών στην ατμόσφαιρα της ευρύτερης ζωής της.Όπως στις βιβλιογραφικές αναφορές που συνδέουν το οργανωσιακό κλίμα με τις επιδράσεις του στη θεραπευτική διαδικασία(Aziati & Adejuno, 2014. Bridges et al, 2013. Pettegrew, 2017.…”