Nursing models in a special hospital: a critical analysis of efficacity

Models of care from the general field of nursing applied in special hospitals appears to be unworkable in this type of environment in terms of their inability to affect patient care. It is argued that these external models, adopted due to a crisis of confidence in special hospitals, fail because their fundamental constructs clash with that of the institution's particular sociology. A historical analysis of the development of special hospitals and nursing models reveals a dichotomy of emergent values, highly complex in nature, which conflict from the notion of Parsonian role-adoption. From this position, it is suggested that the strength of value systems are such that this leads to a non-negotiable stalemate of forensic elements of client and institution, and the 'treatment' ethic as prescribed by the medicalization of criminology. This article critically analyses the six most commonly-used nursing models in special hospitals and pinpoints the areas of breakdown within this type of environment from a sociological perspective. Finally, it argues for a new direction away from 'generalist' ideals of nursing towards a theoretical construction of 'specialism' in forensic care.