Othering in the nursing context: A concept analysis

Abstract

Aim‘Othering’ is described as a social process whereby a dominant group or person uses negative attributes to define and subordinate others. Literature suggests othering creates exclusive relationships and puts patients at risk for suboptimal care. A concept analysis delineating the properties of othering was conducted to develop knowledge to support inclusionary practices in nursing.DesignRodgers’ Evolutionary Method for concept analysis guided this study.MethodsThe following databases were searched spanning the years 1999–2015: CINAHL, PUBMED, PsychINFO and Google. Search terms included “othering”, “nurse”, “other”, “exclusion” and “patient”.ResultsTwenty‐eight papers were analyzed whereby definitions, related concepts and othering attributes were identified. Findings support that othering in nursing is a sequential process with a trajectory aimed at marginalization and exclusion, which in turn has a negative impact on patient care and professional relationships. Implications are discussed in terms of deriving practical solutions to disrupt othering. We conclude with a conceptual foundation designed to support inclusionary strategies in nursing.

Generational ‘othering’: The myth of the Millennial learner

“…Originally formulated by de Beauvoir to describe the process of "differentiating women according to a dominant male standard", 50 othering is now more broadly applied to describe how "interpersonal differentiation generates a distinct form of social exclusion and subordination". 50 The dominant agent group creates a representation of the other target group characterised by the latter's differences from the agent group's normative standard, to reflect different positions in social space and to reinforce political and power differentials between representative members of the agent and target groups. 16,[51][52][53] In our analysis, as generational stereotypes are formulated, they entrench perceived differences in age cohorts.…”

Written reports of adverse events in acute care—A discourse analysis

“…Arnason further argues that, although this methodological exclusion of the subject might be medically effective, this approach will not lead to a good professional–patient relationship (2000). Another way to view this marginalization of the patient is by the concept known as othering, a sequential process of social exclusion and subordination that has been shown to have a negative influence on care and the professional–patient relationship (Roberts & Schiavenato, ). The authors propose that such dominant–subordinate relationships put the patients at substantial risk of adverse events because these diminish the patients' capacity to tell the nurses about their condition.…”

“…The authors propose that such dominant–subordinate relationships put the patients at substantial risk of adverse events because these diminish the patients' capacity to tell the nurses about their condition. The authors therefore suggest that nurses play an important role in strengthening these relationships by instead including the diversity of differences among individuals to improve care (Roberts & Schiavenato, ).…”

Adverse Drug Reactions, Power, Harm Reduction, Regulation and the ADRe Profiles

“…The near medical monopoly over prescribing means that other members of the care team are rarely as attentive to the side effects of mental health medicines as would be desirable. There is a risk that patients in care homes are disadvantaged by their ‘sick role’ status and unintentional ‘othering’ [ 18 ], and risk being labelled by their diagnoses and prescriptions, without adequate oversight of ongoing pharmacotherapeutic regimens. Ways need to be found to increase the effectiveness of medicines’ monitoring by front-line care staff.…”