The routinization of hospice: Charisma and bureaucratization

Care = organisation + physical labour + emotional labour

“…Yet while research on hospices in the United States and Britain shows there is a wide variation in services, the organisational pressures they face suggest that they are best understood within the ideal-type of workplace health care, rather than on the model of 'family' care to which they aspired (Kastenbaum 1982;Abel 1986;Johnson etal 1990;Seale 1989Seale , 1991James and Field 1992). Contrasting findings from an ethnographic study of nursing in one hospice (James 1984(James ,1986 with domestic care highlights the tensions of attempting to transfer a family model of care into the workplace.…”

Spirituality and discourse: A postmodern approach to hospice research

“…Early hospice leaders were characterised by their 'spirituality'; their singleness of focus; their power to engender enthusiasm in followers; and their ability to stimulate change through their single-minded spiritual devotion to what they were doing (James & Field 1992, p 1366. For example, the British leader of the modern hospice movement (DuBois 1980), Dame Cicely Saunders, whose pioneering work established St Christopher's Hospice in London in 1967, acknowledges the importance of her Christian spirituality as the inspiration and guidance behind her work (Du Boulay 1984).…”

“…In her book, Sharing the Darkness: The Spirituality of Caring, Cassidy (1991) communicates the essence of this spiritual framework for her work with the dying. Such leaders were characteristic of hospice development, as reports indicate that Christianity, in particular, gave the impetus for hospice formation (James & Field 1992, p 1366 This leader's ability to implement that dream through a consciously conceived, single-minded plan of actively enlisting the support, skills and energy of many resourceful individuals was legendary to those who were members of, or associated with, the organisation. The core dynamic of this process was expressed in such comments as:…”

“…This support, in turn, depends on the follower's belief and interest in the leader and their mission (James & Field 1992, p 1366. The transcripts of this research strongly privilege the notion of this particular charismatic leader's early and ongoing support from his followers.…”

‘We mustn’t judge people ... but’: staff dilemmas in dealing with racial harassment amongst hospice service users

“…The modern hospice movement has been characterised by a narrow focus and a highly committed, and socially homogenous group of founder members (James and Field 1992) ± largely, white, middle class and Christian professionals. The philosophy of hospice care, marked by individuallytailored, holistic care has been represented as challenging and transforming traditional' medical models of terminal care (Field 1989).…”