PROCESS OF DEFINITION AND ACTION: THE CASE OF DANGEROUSNESS.
Contributors: University of California, San Francisco.
Published: 1989
Number of pages: 278
Subjects: Health Sciences, Nursing.; Health Sciences, Mental Health.
Description: Using grounded theory methodology and dimensional analysis a substantive theory was constructed, explaining the process by which psychiatric nurses define and deal with dangerousness and get along as colleagues. The study consisted of 18 subjects, including 15 nursing staff members and three nursing leaders from two locked in-patient psychiatric units. A total of 23 semi-structured interviews and 80 hours of participant observation were conducted.

In this study, dangerousness is conceptualized as a perception of the evaluator and not a characteristic of the evaluatee. As such, it represents a symbolic construction which has no essence apart from that construction. The process of defining (constructing) and dealing with dangerousness represents a sequence of events operating with two general conditions as context. These two general sets of conditions are the nurses' personal and professional histories and the general everyday events of the psychiatric unit in which the nurse works. Together, these create a "mind-set" or sensitivity to danger from patient action and establish for the nurse a perspective toward work, patient actions and how to read them.

Once a property or aspect of a patient's action is read as a sign of danger, in the context of professionals at work, it is rendered problematic and calls for the nurse to conduct a rapid "natural analysis". This natural analysis is an accumulation of all the considerations that would be brought to bear in defining anything as dangerous and includes: knowledge, professional perspectives, risk, tolerance, resources, and temporality. This analysis leads not only to an evaluation of the level of danger posed (potentiating), but also to the development of a mode of intervention to take in response to the patient event (role-take).

Since each specific patient event has some properties that are never identical with any other prior event, the process of defining and dealing with dangerousness requires negotiation among the nurses. These negotiations may precede or follow the intervention and may be formal, as in the case of a sit-down meeting, or informal as in the case of a subtle hand gesture. Interventions are designed to abate the danger posed and also operate unintentionally to "test" the nurses' analyses.

The process of definition and action has consequences for the patients, staff, and the unit, which become part of the nurses' experiences, influencing her next analysis. Through this process, nurses learn how their colleagues see, define, and act in particular situations. It is in this way that consensus is reached among professionals and it is this process which empirically defines dangerousness.
Notes: Source: Dissertation Abstracts International, Volume: 50-05, Section: B, page: 1851.

Thesis (D.N.S.)--UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, 1989.

School code: 0034.