Nursing as total institution

Area of Science:

• Healthcare Studies
• Sociology
• Critical Theory

Background:

• Late-stage capitalism transforms healthcare into a total institution, demanding conformity and perfection from nurses and patients.
• This system resembles Deleuze's concept of enclosure, creating carceral systems and leading to a 'post-enclosure' society of control.
• The political economy of capitalism functions as an insidious, invisible total institution, unlike physical technologies previously identified.

Purpose of the Study:

• To analyze how the healthcare industrial complex enforces nurse conformity.
• To explore how this conformity operationalizes nurses in service to the institution.
• To assert the necessity for nursing to cultivate a radical imagination for a more just and equitable future.

Main Methods:

• Conceptual analysis drawing on Deleuze's theories of enclosure and control.
• Examination of the political economy of late-stage capitalism within healthcare.
• Interrogation of institutional structures and their impact on nursing practice.

Main Results:

• Healthcare institutions under capitalism function as total institutions, demanding obedience and perfection.
• Nurses are operationalized to serve the institution, often at the expense of their well-being and patient care.
• The current system fosters a covert and insidious form of control through its economic structures.

Conclusions:

• Nursing must embrace a radical imagination to envision and create alternative, more equitable healthcare futures.
• This involves confronting paradoxes such as providing care within capitalist systems and divesting from extractive structures.
• The paper serves as a starting point for interrogating institutional power dynamics and nursing's role within them.