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Nursing as total institution.

Jess Dillard-Wright1, Danisha Jenkins2

  • 1University of Massachusetts Amherst, Amherst, Massachusetts, USA.

Nursing Philosophy : an International Journal for Healthcare Professionals
|July 5, 2023
PubMed
Summary
This summary is machine-generated.

Healthcare systems under capitalism create total institutions that demand conformity from nurses and patients. Nursing must develop a radical imagination to create more equitable futures for care.

Keywords:
Goffmanabolitionanarchismnursingpolitical economytotal institution

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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.