Sociology for Nurses: Questions for Discussion

1. What is Sociology?
2. Why Should Nurses Study Sociology?
3. What is Health?
4. Nursing as an Occupation?
5. Researching Health
6. Gender
7. The Family, Health and Caring
8. Age and Ageing
9. Long Term Illness and Conditions
10. Disability
11. Social Class and Health
12. Race and Ethnicity
13. Policy in Health
14. Managing in Health Care
15. Social Care
16. Global Health

1. What is Sociology?

1. Should sociologists develop neutral understandings of the social world or should they try to influence change?
2. next time you are on placement, ask yourself ‘What is going on here?’ Describe what you are doing, or seeing, and try to explain it.
3. is it useful to think of the world in terms of ‘structure and ‘action’?

2. Why Should Nurses Study Sociology?

1. in Jefferys 1979 study, good patients were defined in terms of their medical characteristics and whether they fulfilled at least one of the following criteria:
(a) They allaowed the doctor to practise the skills necessary for passing exams

(b) They allowed the doctor to practise their speciality

(c) They tested the doctor’s competence and maturity

Reflect on this and consider the extent to which nurses and other healthcare workers categorize patients in this way.
2. Do you agree with Daykin and Clarke (2000), amongst others, who argue that there is a discrepancy between nursing practise and professional rhetoric?
3. Try to identify other sociological studies and explore the contribution they make to you nursing practice in particular, and to nursing as a profession, more generally.

3. What is Health?

1. In what ways does specialization within nursing reinforce a medical model of health and illness?
2. think about Illich’s theory of iatrogenesis and consider it in relation to (a) breast enhancement, and (b) sadness.
3. how far do you think parson’s concept of the sick role can be used to explain ill health amongst the following groups: older people who care for ageing spouses; overweight children; and people with myalgic encephalomyelitis (ME)?
4. Is obesity an individual or societal problem?
5. Do you agree that a holistic approach makes nursing more emotionally and intellectually rewarding?

4. Nursing as an Occupation

1. Historically, nursing was considered as ‘women’s work’ because of the association between women and caring work. Does this have any relevance for nursing today? Do men and women have different expectations from a career in nursing?
2. ‘In all branches of nursing status is gained by moving away from direct care, creating the “polo mint problem”‘ (Davies 1995). What can nurses do to raise the value of caring roles within society?
3. Debates continue over whether the move of nurse education into higher education better prepares nurses for present and future roles than the old apprenticeship training. What are the benefits to nursing of a combination of academic education and learning in practice?

5. Researching Health

1. Using your practice experience, what are the key issues that matter most to health service users?
2. How does the way that research is conducted influence research findings?
3. How does qualitative research inform nursing practice?
4. What specific aspects of CHD does clinical research fail to explain?

6. Gender

1. How would you define gender? Is gender the only signifier of difference? If not what other aspects of people’s identities are significant? How do different aspects of an individual’s identity interact?
2. Why and how is gender significant when we consider issues of health and illness? How do historical definitions of gender impact on contemporary experiences?
3. Why and how is gender significant when we consider the care of people who are sick? To what extent have you been aware of this significance during your placements? Do you think that your gender has been relevant in your experiences as a patient?
4. Why is it important to consider the relationship between gender and other aspects of difference and diversity when considering health and illness and the care of sick people?
5. How far could you argue that ‘gender’ has influenced your decision to become a nurse? Has gender influenced your choice of branch of nursing?

7. The Family, Health and Caring

1. Why is it important for nurses to recognise the diversity of family life?
2. To what extent does the family perform a useful function in society?
3. ‘The family maintains the health of individuals and the population.’ Discuss.
4. Discuss the following statement: ‘The family can harm your health.’

8. Age and Ageing

1. Why do you think we need separate hospitals for children who are sick?
2. Mental health services for children and adolescents have been called a neglected area of health care. Why do you think this is?
3. The press often reports that Britain has the highest rates of teenage pregnancy and binge drinking. Do you think it is fair to label teenagers as irresponsible?
4. In 1965 the term ‘midlife crisis’ was coined to describe a period of self-doubt in middle years. Why might people experience such doubts in middle age?
5. The retirement age is set to rise over the next few decades, and some people suggest that it may need to be as high as 70 years. Why do you think this change is necessary? What are the implications for health services?

9. Long Term Illness and Conditions

1. Thinking about a patient/client with an long term condition that you have met on placement, how was their own expert knowledge of their illness used in their treatment plan?
2. ‘Pain is what the patient says it is, not what the nurse thinks it is’ has become a mantra in medical care. To what extent is the patient’s story of their physical or emotional pain given credibility in clinical practice?
3. The mental health charity MIND states that 71 per cent of people with mental health problems experience hate crimes, harassment and abuse in their communities. Why do you think that this occurs? Can you think of other long term conditions that attract hostility?
4. Around 250,000 survivors following a stroke suffer from difficulty in communicating. The Stroke Association has a campaign on the issue called ‘Lost Without Words’. Why do you think that a campaign such as this is necessary? What other campaigns do you know about that seek to improve the lives of people with long term illness.

10. Disability

1. Nursing has often been said to predominantly offer a medical approach to disabled people. How can nurses provide person-centred care and still draw upon the social model of disability in their practice?
2. As a nurse, how might you find out about the experiences of people with complex disabilities, who cannot speak and find it hard to communicate with strangers?
3. The life expectancy of people with learning disability is increasing, and many are now reaching old age. What challenges may this present to the people themselves, their carers, and to health and social services?
4.The 2001 census showed that there are 175,000 young carers in the UK, 13,000 of whom care for more than 50 hours a week. What do you think the impact of caring may be on the health and wellbeing of young people?

11. Social Class and Health

1. Nursing is categorised as a lower professional occupation in the National Statistics Socio-economic Classification, whereas doctors are higher professional. Why do you think that each occupation is classified like this?
2. ‘Class is an outdated concept’. What is the value of a classification based on class in the 21st century? What use can be made of it in healthcare?
3. What do you consider the main obstacles to social mobility?
4. What are the likely health issues for the following people:
i. A single mother working part time in a fast food outlet and living in a local authority flat
ii. An unemployed couple with two children living in a housing association house
iii. A solicitor living with his wife who is a full time mother of three children
iv. A female accountant living alone
5. In his forward to ‘Tackling Health Inequalities 10 years on’ Marmot stated that inequalities in health arise because of social inequalities in society, not simply because of inequalities in healthcare. What are the inequalities in society that influence how healthy we are?

12. Race and Ethnicity

1. Pair up with a colleague from a different ethnic group from you and discuss what similarities and differences you have in ideas about health and illness.
2. Think about a patient you have nursed from a different ethnic group to yourself. What differences were there in their ideas of health and illness?
3. In your answers to 1 and 2 can the differences you identified also be explained by factors other than ethnicity?
4. What do the terms ‘race’ and ‘ethnicity’ mean to you? Discuss your definitions with others in your group. Why do you think that these terms are controversial?
5. In 2005 the Department of Health published a document ‘A practical guide to ethnic monitoring in the NHS and social care’. How do you think that such a guide can help NHS Trusts provide appropriate care to the population?

13. Policy in Health

1. In 2009 the Department of Health issued guidance to the NHS recommending an approach to the economic downturn which emphasised Quality, Innovation, Productivity and Prevention (QUIPP for short). To what extent has this mantra survived in professional and managerial discussion about the NHS?
2. The major economic downturn caused by the world banking collapse of 2008/9 will have had two types of impact on health policy. What has the impact been on NHS expenditure and financial stability? How have health policy makers responded in terms of cutbacks, reorganizations, recruitment, changing levels of service?
3. A major issue for all areas of health care is the need to collaborate with other services in order to achieve a seamless service for patients Reflect on your placement experience of one of these significant areas for cooperation and collaboration between services. Are there ways in which seamless pathways of care could be improved? What are the most recent policy statements from the Department of Health, the Care Quality Commission, other government departments or a special enquiry that apply?

14. Managing in Health Care

1. Think of an example of the following sociological concepts in action. Try and relate them to your particular branch of nursing: Bureaucracy; Division of Labour; Negotiated Order; Informal Organization; Power.
2. Find out what the different Agenda for Change Bandings are. Which ones do you think you are already achieving?
3. Think about your last clinical placement. Was there a policy for hand-washing to reduce hospital acquired infection? Explain why it was or was not adhered to using the concepts of bureaucracy and negotiated order.
4. Why is it important for nurses to understand about the management and organisation of health care?

15. Social Care

1. What approaches might make it easier to integrate health and social care services?
2. When you’re considering moving into a care home, you may be worried about what will happen to your pets, your furniture and other personal belongings. It’s important to ask about a care home’s policy on pets and household effects before you move in’. How far do you think that care homes should go to ensure that residents can feel completely at home? What effect may consideration for the wishes of one resident have on others?
3. Think of a patient you have cared for recently. What support, advice and guidance would he or she have needed to take the lead in the organization and funding of their care?

16. Global Health

1. Why is global health improving, but not for everyone?
2. Why are global issues of concern to nurses and other health care workers?
3. Why is globalisation defined as a ‘mixed blessing’?
4. Explore the ‘pro-globalisation’ and ‘anti-globalisation’ movements by exploring the following websites: World Growth, Consumers International, Friends of the Earth International, and the International Policy Network. Which side of the debate convinces you most and why?
5. Reflect on your experiences of working with nurses and health professionals from other countries. What have you gained from this experience?