1.5.3 The doctor-nurse relationship In reality, however, the nurse spends much more time with patients and often knows a lot that the doctor does not. Somehow the nurse needs to be able to communicate essential knowledge to the doctor, in the patient’s presence, without appearing to undermine the doctor’s ‘omniscient’ status. According to Leonard Stein’s research in America, they achieve this through playing ‘the doctor–nurse game’. T 1.4.3 Structures that both enable and constrain Life within a society is made possible by structures. They operate at many levels, from the details of daily life (e.g. the routines of getting up in the morning, or the ritual greetings we use when we meet people) to the broader organisation of society (e.g. the channels through which mass media ‘news’ is generated, or the rules under which benefit payments are made). Even the language through which I am communicating now is a structured system of written symbols. But structures not only 1 Playing roles together Care relationships are seldom just a matter of ‘doing what come naturally’. For one thing, you may be caring for, or being cared for, by someone you would not otherwise get on with. A care relationship has to adapt to circumstances: it may be brief, as in an acute hospital ward, or it may be very long lasting; it may be flexible according to need or it may involve a high degree of regularity. It is a distinctive relationship with unique elements. Some of the things you and the other perso 1.3.6 Relocation: acceptance Of equal importance in terms of adjustment is an acceptance of the new situation and identification with the new life (Lieberman and Tobin, 1983). Reed and Roskell Payton (1995) have shown how ‘adjusting to life in a care home is a complex process, requiring a range of social skills’. They have observed a range of strategies from those people who ‘"push" themselves on strangers’ to those who ‘construct familiarity’ using what little they know about people and places to find common 1.3.3 Change on a daily basis: shared care for the elderly In the case of Mr Bright care is shared between his wife and formal carers and changes in the place of care are primarily to give Mrs Bright a break and Mr Bright a change of scene. Click below to hear an audio clip describing a day in the life of Mr and Mrs Bright. 1.2.4 Places and spaces as resources Attachment to places can be a resource within care relationships, especially where people have a shared history of attachment to places. An older couple may have experienced the ups and downs of moving between places together for much of their lives. Or a daughter may be caring for her mother in the home where she was born and brought up. A shared understanding of the home environment and the support which may be available locally can be invaluable in developing a care relationship. Such know 3.3.1 Care: a cautious definition For study purposes, we do need a definition of care, just as we needed a definition of informal carer. So we propose that in the context of health and social care we define care as: something that is needed when people cannot function in daily life without the practical help of others. But, as I have shown, care is a loaded word. It is both a word used by ordinary people to mean love, tende 1.5.2 Duration and frequency We do not know if Katrina's caring responsibilities took up more than 20 hours per week. In a sense, though, whether they did or not is immaterial. What is important is that her schooling was adversely affected. We can speculate that, even if caring accounted for less than 20 hours per week, the emotional impact of being a young carer overflowed into a far larger proportion of her life. Introduction Care is needed at all stages of life. This unit makes care in the family its focus because the overwhelming majority of care, including health care, is supplied in families, much of it in private, much of it unnoticed and unremarked upon. The meaning of the term (informal carer) and the word (care) itself are explored. This material is from our archive and is an adapted extract from Understanding Health and Social Care (K100) which is no longer taught by The Open University. If y 4 Audio clip 3: Enid Francis Enid Francis lived in a modern residential area on the outskirts of Derby. She shared a house with her husband, Wally, and two grown-up sons, Mark and John. Her husband had had to give up work eighteen months before his retirement, because of a heart complaint. Their two sons, aged 35 and 32, were both autistic. Enid's day was organised around meeting their needs for care and support. On weekdays, they attended a day centre, which she would have to get them ready for. When they came home in t 1 Arrangements for care and support In this audio unit, Helen Robinson interviews five different, but not untypical, people who have set up arrangements for care and support, which suit themselves and others. All the arrangements involve cash payments, or have done so at some point in time. However, they all also include transactions which, though they aren't made in cash, involve other forms of exchange – goods, emotions, knowledge, and/or help. Before you listen to each of the clips, take time to read through the note 6.6 A few final thoughts This final section has concentrated on the heart, the lungs and the blood – the body's cardio-respiratory system. We saw briefly how the body takes oxygen in through the lungs, and discussed the importance of this for athletes in various sports. To understand the role of oxygen in the body and its importance to athletes, we had to draw on information that we had discussed in earlier sections about the way oxygen is carried in the blood and the way that the heart pumps blood to different par 4.3 Measuring your heart rate The most common way of measuring heart rate is by feeling the pulse at one of the arteries. The pulse is quite literally that – a pulse of blood running through the artery each time the heart does one pumping motion. 1 What to expect In this unit you will look at how sport can be understood from a scientific perspective. This is a large topic with many possible approaches. We will try to focus on specific details while maintaining a broad overview of the subject using examples from many different sports such as running, athletics, cycling and swimming to illustrate the different ways in which sport and science interact. You will see that even a brief introduction to the science of the human body is enough to answer Learning outcomes After completing this unit you should be able to: Knowledge and understanding evaluate end-of-life care approaches in the UK and challenges to care delivery. Cognitive skills evaluate the usefulness of theoretical models of death, dying and bereavement; recognise the relevance of critical social perspectives associated with death, dying and bereavement. Practical and/or professional skills Acknowledgements The content acknowledged below is Proprietary (see terms and conditions) and is used under licence. Grateful acknowledgement is made to the following sources for permission to reproduce material in this unit: The material acknowledged below contains Proprietary content which is used under licence (not subject to Creative Commons licence). See Terms and conditions. 2.3 Making choices and developing a personal care plan The social work task of supporting a person's admission to care involves many skills. Social workers must be able to assess the person's needs and coping mechanisms, and the quality of provision to meet needs. They must be familiar with the National Care Standards for their nation. To liaise effectively with service users, families, home providers and other professionals involved in assessment, good communication and negotiating skills are essential. If there is a need for residential c References 1.4 Service users' views: What services? When people are consulted about the services they have received they express strong views not only about access to services but also about what those services are. For example, the shift from a home help service to a personal care service has raised many concerns. The consultations for the book this course was based on and other research (see, for instance, Sinclair et al., 2000) both indicate that (unknown to managers) workers sometimes go beyond their allotted tasks in order to meet service Learning outcomes After studying this course, you should be able to: understand the critical importance of service users' views in all aspects of health and social care management.
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Bowes, A. M. and Dar, N. S. (2000) ‘Researching social care for minority ethnic older people: implications of some Scottish resea
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