Just saying i

INDIVIDUAL

|

    INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

Imaginary	numbers
Social	care?

'Other exhausted words' ... ?

"A writer I admire expresses in a few words his disdain for plausible but empty political language, beginning with one good example. "The word, Fascism," he writes, "has now no meaning insofar as it signifies 'something not desirable.'" He adds other exhausted words, including democracy, freedom and patriotic - convenient terms for establishing righteousness, easily melting into self-righteousness.

The writer is George Orwell, in his celebrated 1946 essay "Politics and the English Language." Orwell contended that language had become corrupt and debased in his time, but the survival of his examples into the present contradicts him, suggesting that not only the problem but the very examples may be timeless."

Plain, direct language remains rare, desirable - and risky in ways that authority, even more than the rest of us, tries to avoid." ...

... "Dilution of meaning is familiar in a way that can make us feel comfortable, or even worse, comfortably righteous."

Individual
   |

      INTERPERSONAL    :     SCIENCES               

HUMANISTIC  --------------------------------------  MECHANISTIC      

 SOCIOLOGY  :   POLITICAL 

|

Group

concept critical thinking parity	framework evidence-based transformation
holistic care integrated care person-centred	outcomes prevention sustainable health care

n.b. With some words more exhausted than others; while some have not, as yet, been fully exercised.

Pinsky, R. When language fails us and the moment. The New York Times International Edition. January 30, 2024, p.12.

Previously: 

The view from Wigan Pier* ...

(many) Care Transitions and The Little '-' That Could

Some people looking at Hodges' model may believe that the model perpetuates the dichotomies of old:

Human --- Machine
Individual --- Group
Sick --- Healthy
Supply --- Demand
Home --- Hospital
Self care --- Nursing care

In the 1990s as a community mental health nurse I was involved with a group of general nurses looking at ways of improving:

• discharge planning
• continuity of care

These issues remain and with the dichotomies of care above we can see how Hodges' model can assist our thinking and planning about transition. Not just one transition, but several.

This past week I was fortunate to attend one of a series of workshops -
Delivering High Quality Health Care for All: Bringing the social and technical together for a joined-up approach to deliver supporting systems and technologies
10th/11th December 2009, Leeds, UK

Organised by the UK Faculty of Health Informatics and the BCS Socio-Technical Group

The event was very good, stimulating and challenging. In the closing debate the appeal of 'socio-technical' and how to market a much needed joined-up approach in health IT came down at one point to the difference between:

'socio-technical' and 'sociotechnical'

In trying to find an alternative title, the hyphen was lost, and whilst it is not a crucial issue - for me that hyphen represents the axes of Hodges' model. Hodges' model acts as a high level aide-mémoire and that little hyphen can perform the same trick. The hyphen reminds us of the differences. The dichotomies that need to be navigated and negotiated in our dialogues about care AND caring. These are most evident in transfers and transitions (after all - "getting out of bed is a risk").

There are mini and macro transitions. Care pathways are not yellow-bricked unbroken splines from cottage to cottage hospital. They should be tortured if they do reflect person-centered experiences and needs.

Some transitions are process laden and repetitive, such as drug administration and must be protected - free from interruption. Although grounded in a social exchange of (correct) identities: a registered nurse, the right patient, right drug, right dose, right duration and right time these can be framed within the SCIENCE domain. That is where (for me) the conventional 'drug round' can be found. Counselling is another transition (if effective it also moves people on). 'Counselling' can be found in the INTRAPERSONAL domain - close to the border with SOCIOLOGY.

Other transitions and transfers are more involved:

• person's home to attend day care (for the first time!)
• person's home to residential home
• hospital ward to home
• home encounter with the crisis team
• telecare consultation
• ...

Care is constantly passed hence the need to write and record. Passed from -

person-to-person
team-to-team
team-to-carer
time-to-time
discipline-to-discipline
self-care

This is the outcome that is sought. Ultimately passing responsibility back to the individual and when applicable their family. Having formal integrated care pathways is one thing, but they are never truly continuous, clear and true. And as they say crossing bridges you may have to break step and surely different disciplines march to different tunes? Today though the most audible tune must be socio-technical. ...

Additional link: The Little Engine That Could
Image source:
Drug round tabard http://internet-workwear.co.uk/acatalog/Drug_Round_Tabard.html

Socio-tech paper and Skype: hodges_model

I've been working on the socio-technical (s-t) structures in nursing informatics paper....

The guidelines insist on definitions, so in addition to socio-tech and socio-tech structures I've added s-t-political. It is possible to consider s-t in isolation, but I don't think this is a valid exercise. The politics of matters s-t are all over. Hodges' model can really bring these to the fore.

It's always a struggle to balance the content, how much background to cover. In the paper I've thrown in a horse and litter, plus the moon for good measure. Instead of sociotechnical I've opted for socio-technical; the hyphen's important which I'll need to explain.

There is a question that's cropped up about this word - 'technology'. Is 'technology' special as an -ology?

I'm trying to get in the habit of plugging the Skype phone in, there must be a way to preserve the microphone setting!

Skype: hodges_model

h2cmng AT yahoo.co.uk

Update - REFERENCE:

Jones, P. (2009) Socio-Technical Structures, the Scope of Informatics and Hodges’ model, IN, Staudinger, R., Ostermann, H., Bettina Staudinger, B. (Eds.), Handbook of Research in Nursing Informatics and Socio-Technical Structures, Idea Group Publishing, Inc. Chap. 11, pp. 160-174.