Nursing in a therapeutic community: the Fulbourn experience, 1955–1985

Abstract

To explore the role of the mental health nurse in wards run on therapeutic community principles in one English provincial hospital. Under a pioneering Medical Superintendent, the restrictive regime for patients with mental health problems in Fulbourn Hospital was replaced by a new commitment to 'social therapy'. Ward doors were unlocked, patients were encouraged to undertake work-based activities and finally the wards were reorganised on 'therapeutic community' principles. This study used oral history methods to supplement evidence from published sources. A total of 27 oral history interviews were conducted between 2003-2008 and these data were analysed in the context of documentary material from local archives. The establishment of wards at Fulbourn run on therapeutic community lines posed considerable challenges to the customary working practices of their mental health nurses. The two themes highlighted in this paper were the symbolic meaning of the abandonment of nursing uniforms in favour of casual clothing and the hospital authorities' preparedness to accept the risks associated with implementing the philosophy of the therapeutic community. Oral history has a unique role to play in recording the detailed aspects of nursing practice which are often difficult to reconstruct from documentary sources alone. Nurses played a key role in the transformation of the therapeutic milieu of Fulbourn Hospital and their experiences have relevance to current debates in mental health care.