Rehabilitation for the Unwanted: Patients and Their Caretakers by Elizabeth Eddy

Author:Elizabeth Eddy [Eddy, Elizabeth]
Language: eng
Format: epub
Tags: Public Policy, Social Services & Welfare, Social Science, Political Science, Sociology, General
ISBN: 9781351494021
Google: TG9QDwAAQBAJ
Goodreads: 36811374
Publisher: Routledge
Published: 2017-09-29T00:00:00+00:00

THE PARTY LINE

Another major adaptation of the rehab population is what Goffman calls conversion to the official view. As we pointed out earlier, however, the official view is not a very consistent one. Most of the staff members center around one of two orientations—the custodial or the therapeutic. The custodial view is upheld mainly by nursing personnel and to some extent by the resident physicians. The therapeutic view is espoused mainly by the higher-ranking physicians (who see little or nothing of the patients), the therapeutic specialists, and the social workers. (Of course, the actual situation is not quite as “pure” as we make it sound here. One does hear therapeutically-oriented statements and see therapeutically-oriented acts on the part of nurses, and a few of the social work and therapy specialists often seem to act more with a custodial orientation in mind than a therapeutic one). To these two staff orientations there are corresponding patterns of patient reaction.

Custodial. The colonizers have married themselves to the institution and gain their satisfactions out of it, but largely in spite of the actions of the staff rather than because of them. The converts to the custodial view, on the other hand, ally themselves to the custodial forces, often cooperating with them, and try to get other patients to go along with this view.

Our two most clear-cut custodial converts are not part of our sample of sixty because they were on rehab long before we came—in fact, their long stay on rehab is probably due in part to their espousal of the nursing viewpoint. (They are part of the old timers group described in Chapter 3.) Sara Kent and Marian Marsh are both severely disabled middle-aged women. In spite of their need for a great deal of service, they tended to be quite patient and did not make the insistent demands for service that was found among many of the young adults. They treated the younger Negro women who worked as aides (both these patients are Negro) somewhat as daughters—they would listen to their troubles, give advice, exchange small talk on matters of common interest. In turn, they received better-thanaverage attention from the nursing staff, who not only met their physical wants more readily, but also socialized with them, performed special favors for them, and listened to their opinions about their own care and treatment.

These two patients made efforts to induct other patients into the ways of rehab, not so much in promoting enthusiasm for and cooperation in the therapy program, but in trying to get patients to cooperate in the ward routines and avoid making unnecessary demands. Their theme seemed to be: “Play along with the nurses and doctors, do what they say and don't try to push them around, and you will be better taken care of than if you try to act smart or make trouble. Besides, the staff knows best how to run things and we shouldn't try to tell them.” This theme seemed to serve them well, but they were much less successful in getting other patients to go along with it.

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