Business Anthropologist in Sydney Hospital
Yesterday I had a chance of observing organisational space in a Sydney hospital as I joined a UTS Centre for Health Communication group. Rick Iedema and his staff do wonderful ethnographic research in hospitals filming professional collaboration around patient care. Yesterday’s topic was the designed spatial settings in hospital. In our group was apart from the UTS researchers also hospital staff and the architect of the visited spaces. Completely dressed up as hospital employees we were able to visit the different surgery and recovery rooms. One of the staff members washed her hands when entering a new room. When I asked her about that she told me that all the doctors were obliged to wash their hands when going from one patient to another in order to prevent the spread of diseases. For many years academic articles have been written, she told me, to show the neg correlation between handwashing and disease spreading. However, still only 15% of the male doctors did wash their hands. Therefore, she saw herself as a role model to show others that handwashing should be done every time. Articles, information, stickers, and role model however had not helped to increase the handwashing rituals of male doctors. ‘It is behavioural,’ she said. I told her that ethnographic study would probable show that hand washing was perceived as to be in the female domain by male doctors. That handwashing, in contrast to scrubbing of surgeons, is not in the professional domain of doctors. Interventions to increase the handwashing should therefore be based upon changing the meaning of handwashing in the professional culture. This is where interests of contemporary businesses and organisations such as this Sydney hospital have interests in anthropologists and their methods. The detailed accounts of what really happen at the work floor of a, for example, hospital makes professionals aware of their own action. Helping with their reflection on action in order to increase their reflection in action (Schön).
There are many rituals in hospitals that are questioned by researchers but that are exercised by practitioners. The Amsterdam Academic Centre had a campain last year to recruit nurses who where asked to get rid of unnessasary rituals by showing a picture of a Ladakhi oracle acting a cleaning ritual with a patient. In my anthropological fieldwork in the early 1990s I encountered many rituals among the Ladakhi shamans in the upper Indus valley in Northern India. This Tibetan Buddhist community has male (llhamo’s) and female (llapa’s) village oracles and eight monastery oracles. The oracle is perceived as the possessor of power and the linking between the human and the spiritual world. By virtue of calling and training the oracle is able to restore the disturbed relation between patients and the supernatural forces that have brought disorder (Miller 1997). The power is not exclusively attached to the person of the oracle. It is the relation between the oracle and his patients that generates the power (Taussig 1987). The shaman and his audience construct a joint interrogation of their ideological environment. Shamans employ their power in public rituals for the benefit of the community or individuals. And there is why the rituals in the Sydney hospital are so difficult to get rid of as the are part of a larger construction of healing.