Decision-making, uncertainty and risk: Exploring the complexity of work processes in NHS delivery suites

Lankshear, Gloria; Ettorre, Elizabeth; Mason, David

doi:10.1080/13698570500390499

Cited by 37 publications

(28 citation statements)

References 16 publications

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“…Our therapeutic landscapes perspective has highlighted that the spatial and material context for these behaviours, as well as the social relations involved, are put in question by this vision of a more flexible and intuitive approach to risk governance. The challenge, then, for the next generation of psychiatric hospital design is likely to focus on how to create spaces of care which offer reasonable levels of technical safety, but also flexibility to accommodate changes in practice, including a possible future trend toward practice guidelines that allow for 'therapeutic risk-taking', negotiated in a way that empathises with patients' experiences and feelings (UKCC, 1998;Bowles, et al 2002 p.258;Lankshear, Ettorre, & Mason, 2005). Critical comments by our participants suggest they are potentially active forces for change in these directions.…”

Section: Engineering Security Vs Therapeutic Carementioning

confidence: 99%

Compassionate containment? Balancing technical safety and therapy in the design of psychiatric wards

Curtis

Gesler

Wood

et al. 2013

Social Science & Medicine

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'Compassionate containment? Balancing technical safety and therapy in the design of psychiatric wards.', Social science medicine., 97 . pp. 201-209. Further information on publisher's website:http://dx.doi.org/10. 1016/j.socscimed.2013.06.015 Publisher's copyright statement: NOTICE: this is the author's version of a work that was accepted for publication in Social science medicine. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reected in this document. Changes may have been made to this work since it was submitted for publication. A denitive version was subsequently published in Social science medicine, 97, 2013, 10.1016/j.socscimed.2013.06.015 Additional information: Use policyThe full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-prot purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. landscapes. There were also more subtle implications, partly relating to 'Panopticist' theories about how the institution uses technical safety to supervise its own mechanisms, through the observation of staff behaviour as well as patients and visitors. Furthermore, staff seemed to feel that in relying on technical safety measures they were, to a degree, divesting themselves of human responsibility for risks they are required to manage. However, their critical assessment showed their concerns about how this might conflict with a more therapeutic approach and they contemplated ways that they might be able to engage more effectively with patients without the imposition of technical safety measures. These findings advance our thinking about the construction of therapeutic landscapes in theory and in practice.4

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Section: Engineering Security Vs Therapeutic Carementioning

confidence: 99%

Compassionate containment? Balancing technical safety and therapy in the design of psychiatric wards

Curtis

Gesler

Wood

et al. 2013

Social Science & Medicine

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“…By the end of the 70's a medical model of pregnancy and childbirth was firmly entrenched. In the 1990s formalised risk management systems were introduced into the NHS and the assessment, management and prevention of risks became the pivotal focus of the maternity services (Lankshear et al 2005). Underpinning the biomedical approach is the view that pregnancy and childbirth are inherently risky, and therefore in need of medical supervision and technological interventions (Symon 2006).…”

Section: Introductionmentioning

confidence: 99%

Pregnancy, risk perception and use of complementary and alternative medicine

Mitchell

McClean

2013

Health, Risk & Society

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“…As a consequence of this control of practice, it is argued that some senior midwives are demotivated and continue to sustain this medical domination by the way that they approach care with unwritten sanctions and rules which can be difficult to challenge (Hunter, 2005;Lankshear et al, 2005). This impacts on midwives and in turn students who may feel pressured to conform and therefore feel unable to provide the care they feel to be most appropriate (Lavender and Chapple, 2004).…”

Section: Discussionmentioning

confidence: 99%

Meeting the health and social needs of pregnant asylum seekers: Midwifery students' perspectives. Part 2: Dominant discourses and approaches to care

Haith-Cooper

Bradshaw

2013

Nurse Education Today

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Citation: Haith-Cooper, M. and Bradshaw, G. (2013) Meeting the health and social needs of pregnant asylum seekers; midwifery students' perspectives. Part 2; Dominant discourses and approaches to care. Nurse Education Today, 33 (8) 772-777.Copyright statement: © 2013 Elsevier. Reproduced in accordance with the publisher's selfarchiving policy.Meeting the health and social needs of pregnant asylum seekers: Midwifery students' perspectives. Part 2: Dominant discourses and approaches to carePregnant women seeking asylum in the United Kingdom appear particularly vulnerable, having complex health and social care needs and could benefit from a woman centred approach to midwifery care. This article is the second of three parts and reports on the findings from one objective of a wider doctorate study. It focuses on exploring midwifery students' perceptions of how to approach the care of pregnant women seeking asylum. Although the design of the study is explored in article one, in this context, the data was subject to critical discourse analysis to meet this objective. Key words and phrases were highlighted which appeared to reveal power and ideology implicit in the language used when discussing midwifery care of the pregnant woman seeking asylum. Dominant discourses were identified which appeared to influence the way in which care was approached and the possible sources of these discourses critically analysed. The findings suggest an underpinning ideology around following policies and guidelines to meet the physical needs of the woman at the expense of her other holistic needs. Despite learning to adopt a woman centred approach in theory, once in practice some students appear to be socialised into (re)producing these dominant medical and managerial discourses with "midwifery discourse" being marginalised. In addition, some students appeared to have difficulty understanding how to adopt a woman centred approach and the importance of considering the woman's context and its impact on care. These findings have implications for midwifery educators and this article identifies that the recent Nursing and Midwifery Council requirement for students to undertake a caseloading activity could provide the opportunity for them to adopt a consistent woman centred approach in practice, rejecting dominant medical and managerial discourses. However, these discourses appear to influence midwives caring for women more widely and will be difficult to challenge.

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Decision-making, uncertainty and risk: Exploring the complexity of work processes in NHS delivery suites

Cited by 37 publications

References 16 publications

Compassionate containment? Balancing technical safety and therapy in the design of psychiatric wards

Compassionate containment? Balancing technical safety and therapy in the design of psychiatric wards

Pregnancy, risk perception and use of complementary and alternative medicine

Meeting the health and social needs of pregnant asylum seekers: Midwifery students' perspectives. Part 2: Dominant discourses and approaches to care

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