Session 6: Wounded Healers

2nd Global Conference

Monday 14th September – Thursday 17th September 2009
Mansfield College, Oxford

Beyond the Pale – Nurses’ Construction of Colleagues with Mental Illness
Terry Joyce
Discipline of General Practice, University of Newcastle, NSW. Australia

This paper will present a qualitative study that used individual interviews to examine the workplace experiences of 29 Australian nurses who have a mental illness employed in health care services.

Background:

Many nurses stigmatise colleagues with a mental illness. The explanation for such action is not simple stigmatisation of mental illness. Instead, there is an element of nursing culture that is stigmatising of those with mental illness.

Method:

Discourse analysis and critical ethnography were the research methods used to unearth the discourses that nurses use to construct ‘normal’ [nursing] cultural beliefs and opinions towards mental illness. Foucault’s work on ‘self-regulation’ was the theoretical approach used to reveal the processes that individual nurses employ in resisting stigma and discrimination at the workplace.

Findings:

As nurses with mental illness they crossed over the metaphoric boundary that separates nurses from patients. Hence, they did not conform to the nursing profession’s ‘rules of normality’. Consequently, many participants were marginalised because of their ‘difference’.

The dominance of medicine’s discourse on mental illness was evident; mental illness is an enduring lack of control that required medical management. Hence, within this discursive framework a nurse with mental illness becomes unpredictable and unreliable, thus, constitutes a risk to the safety to other nurses and patients and themselves. This construction of mental illness adversely affected the decision whether to disclose their abnormality, the techniques that they employed to maintain the image of a professional nurse and the way in which they managed their illness.

Conclusion:

In this study, it is clear that many nurses do not resist and contest discrimination or work to destigmatise mental illness. Instead, often they are perpetrators of stigma. This suggests an urgent need for a cultural change in the construction of mental illness.

Download Draft Conference Paper (pdf)

Thematic discussion.