Nursing: The Functional Significance of an Institutional Pattern

Abstract

THIS paper is concerned with three sets of problems suggested by the patientnurse relationship. (1) Why and how do the variables, which pattern the role expectations of the nurse (and patient), function in relation to activities directed toward restoration of the patient's health? This, of course, does not mean that the problems in the patient-nurse situation always are or must be solved, or that a particular structure or set of them is the only possible solution. Further, it is understood that the pattern of variables constituting the framework of the role is an abstraction from the mutually interdependent expectations of its occupants and the public. These expectations are activated from a latency condition while the personal relationships are in process. A factor such as faith in science and its medical discoveries, for example, is subsidiary to the role elements inherent in the patient situation and serves to enhance, not create, confidence in the physician. Thus, the Hippocratic oath is as basic to modern medicine as to that of ancient Greece. (2) What are some of the dysfunctional consequences of the pattern variables and how do they come about? (3) Is it possible to understand the process of differential role internalization in the medical professions in the same terms as the internalization of the patient's role? 1 For the sociologist perhaps the two most significant consequences of an illness serious enough to require hospitalization are the disruption of the patient's normal round of activities and what this implies. With due regard for the qualifications necessitated by deliberate exaggeration, it is suggested that the heretofore accepted frame of reference, legitimate expectations, patterns of perceiving, feeling, thinking and acting, processes of interaction with others, dis-