This paper examines the problem of how institutions and the phenomena called formal or large-scale organization exist—the problem of the ontology of organizations and institutions. It addresses this problem using an approach that has been developed as part of a sociology exploring the social from women's standpoint, from which standpoint the extra-locality and objectification of these forms of organization are problematized. For the most part, sociology formulates the phenomena of organizations and institutions in lexical forms of organization, institution, information, communication and the like, which suppress the presence of subjects and the local practices that produce the extra-local and objective. This paper argues that texts (or documents) are essential to the objectification of organizations and institutions and to how they exist as such. It suggests that exploring how texts mediate, regulate and authorize people's activities expands the scope of ethnographic method beyond the limits of observation; texts are to be seen as they enter into people's local practices of wrking, drawing, reading, looking and so on. They must be examined as they coordinate people's activities.

This paper explores the socially active character of contemporary forms of expertise through an institutional ethnographic analysis of health services research. The paper draws primarily on interview research to investigate how health services research helps shape text-mediated relations linking government health-care policy with local reform initiatives. In the paper, I focus on the use of a particular research report by managers, physicians, and others at a community hospital in Toronto, Canada as part of their efforts to standardize and reduce the duration of care provided to heart attack patients. I discuss how, through its intertextual presence, health services research helps to co-ordinate medical and managerial practices and rationalities into medico-administrative relations. I offer two examples of this process. The first focuses on the relations co-ordinated through the textual observance of inefficiency. The second addresses how the report helped resolve the problem of physicians’ resistance to reforming cardiac care. My analysis contributes to current perspectives on the relationship between discourse and action.

Workplace resistance is conventionally regarded as the product of worker consciousness and intentionality. More recent studies of resistance have questioned this notion, seeing workplace resistance as emerging out of more spontaneous and non-calculative types of action. This paper examines the discursive production of routine resistance in an organization, showing how notions of employee intentionality and non-intentionality were categories through which resistance itself was produced. We look at an alleged case of sabotage, the enactment of “careful carelessness” and “dumb resistance” as complex discursive productions of both resistance and intentionality. We conclude with a brief discussion of implications for managerial control.

This paper retraces and analyzes the debate around a major infrastructure project in central Stockholm, the construction of a third railroad track over the islet of Riddarholm. Using the analytical framework of the New Rhetoric (Perelman and Olbrechts-Tyteca, 1958), it shows that the debate is not only a matter of diverging views about the necessity or the impact of the project but, as well, a matter of epistemology. Whereas both sides tend to refer to similar values and make use of matching rhetorical devices, they differ quite radically as to which knowledge they regard as valid and as to how they have organized their approach to the debate. Demonstration faces argumentation, the New Rhetoric suggests, as its contribution to our understanding of the genesis of urban projects.

This paper reflects critically on nursing knowledge-based action, its increasingly scientific and text-based manifestations, and the relevance of these practices for power and powerlessness in nursing. Smith's concept of text-mediated relations of ruling (1990. 1999) provides the analytic frame to investigate how nursing case managers articulate public health services and home support for people with disabilities to specific policies, including fiscal policy. An institutional ethnography shows how a nurse's routine text-mediated assessment and exercise of professional judgement establishes a ruling relation with a client (against her intention), as he is “written up” in organizational texts. The analysis of assessment texts spells out how a local perspective is subdued to the ruling discourse. A general argument is made on the basis of this analysis: nurses participate in ruling through the textualization of their knowledge and in the process it dominates their knowing and acting. An ideological construction of nursing knowledge results. The paper suggests what this means for the profession, nurses themselves, and their clients.

This paper is about discipline at work. From a distal perspective, discipline may be understood in terms of an achievement, an effect, an outcome, a social phenomenon already constituted. In contrast, a proximal perspective suggests that discipline is a social process constantly working its way through organizational practices, on its way to be constituted but not quite yet finalized. The paper documents the outcomes and the workings of discipline in LOGICOM, a UK service organization which has embarked recently on a total customer satisfaction (TCS) program. In so doing, it argues that the outcome of disciplinary power is the organizational self. In LOGICOM, employees appear to identify, innovate, comply, be resilient, or rebel against the goal of TCS and the institutionalized means for achieving it. The workings of discipline are then explored via the technologies of domination and technologies of the self that characterize TCS. It is concluded that the workings of such disciplinary mechanisms are not entirely effective and, consequently, the outcomes of discipline are difficult to predict or know from beforehand. Thus, the “disciplined employee” is a fictitious category, something that the organization may strive for, but can never realize.

Canada's publicly insured system of socialized health care is coming under intense scrutiny by governments firmly focused on the politics of national indebtedness and public spending. Contemporary health care reforms aimed at cutting costs and increasing productivity place new emphasis on “official knowledge” constituted through particular textual practices. Since 1994 the Canadian Institute of Health Information (CIHI) has become a powerful regulator of patient care. It has entered business-like accountability and rationing practices based on competitive, market-like comparisons into Canadian hospitals in order to “assist leaders in the health sector make informed decisions” (CIHI 2000). Using Canadian sociologist Dorothy E. Smith's (1987) Institutional Ethnography, with a specific focus explicating a Smithian textual analysis (1990a, 1990b, 1999), this paper explores, in depth, one feature of how a business genre is being inserted into the everyday practices of nurses and doctors who work with the frail elderly in a small community hospital in British Columbia.

This study considers how the work of an amateur orchestra creating a concert performance of a Haydn's concerto is organized by the musical score. The method of inquiry which places the text in the centre of the analysis explores how the surrounding social relations and discourses are carried into an actual work-in-progress; in this process, the score is a link between the macro level of musical discourse embodied in other texts, the related macro level of performance history, and the micro level of individual performance, finally connecting the individual work of actual composers to the exposition of that work. The study furthers existing ethnomethodological and phenomenological examinations of orchestral performance by exposing some of the relations underlying the taken-for-granted ‘common ground’ of the score.

The paper is an attempt to engage with our contemplations of violence and the failure of familiar explanations to capture these contemplations. We begin our explorations of these familiar accounts by examining contemporary debates on media violence but find these problematic. By reducing media violence to mere spectacle or, on the contrary, by seeing such violence as desensitising and destructive, the various positions in the debates deprive violence of meaning and fail to address our fascination with violence. Other explanations that seek to attach meaning or utility to violence, be it economic, symbolic or moral, equally fail to convince. There is always an excess that transcends these explanations, an excess that is ill-captured by the notion of ‘gratuitous violence’ often deployed to condemn violence that does not make sense. Furthermore, the various accounts of violence we review tend to consider violence only in terms of its victims and perpetrators rather than the (fortunately) more common position of the observer. In the remaining of the paper, we try to say something about the sense of violence without investing it with deterministic or moralistic implications. This leads us to re-interpret the notion of desensitisation; for the observer, desensitisation indexes a lack of sensation of violence. This lack of sensation, our inability as observers to sense and make sense of violence, we argue, brings about moral questioning and acuity rather than moral indifference.