Caring holistically within new managerialism.

Abstract

This article explains the attempts of nurses to practice humanistic, holistic care in line with their professionalizing strategy. Ideally, the intention of nurses is to broaden their concerns beyond the physiological needs of patients, thereby circumventing biomedical control over their work. However, the author argues that resource constraints, and the coalescing of biomedical and managerial definitions of patients, suggest that holistic notions of care are subjected to a new form of calculus and normalizing technology. Critically, nurses are more preoccupied with the day-to-day struggle to free up resources for healthcare, in particular bed spaces, and to pre-empt the problem of bed blocking. Such work suggests that the "emptying of beds" is not just a symbol of accomplishment for nursing work. From the governmentality theory of Foucault, the administration of "beds" has become part of the managerial power/knowledge discourse and an instrument for making nurses toe the financial bottom-line.