Search

Timmins & de Vries are more sympathetic to my editorial than other critics, but they take issue with the details. They doubt whether the bystander phenomenon applies to Mid Staffs nurses; they believe that cognitive dissonance is a better explanation ofwhy nurses fail to behave compassionately; and they think that I am'perhaps a bit rash' to conclude that 'teaching compassion may be fruitless'. In this comment, I discuss all three points. I suggest that the bystander phenomenon is irrelevant; that Timmins & de Vries give an incomplete account of cognitive dissonance; and that it isn't rash to propose that educating nurses 'for compassion' is a red herring. Additionally, I comment on the idea that I wish to mount a 'defence of healthcare staff'. [ABSTRACT FROM AUTHOR]

Summary In this reply to Rolfe & Gardner's critical discussion of my editorial I do two things. First, I describe the theoretical context of the Darley & Batson study. This is the situationist perspective in social psychology, which overlaps with the idea of the cognitive unconscious. Second, I defend my account of the Good Samaritan study against Rolfe & Gardner's criticisms. [ABSTRACT FROM AUTHOR]

Summary Philip-Darbyshire has apparently gained the impression that I used ‘gee-whiz’ social psychology to ‘absolve poor or negligent practice from any hint of personal responsibility and accountability’. In this reply, I first discuss the fundamental attribution error, which Darbyshire trivialises as the ‘fundamental arrogance error’ and a piece of ‘linguistic puffery’. Second I examine Darbyshire's rather naive view of causation. Third, I suggest that, on a more defensible view of causality, situations as causes do not absolve nurses from ‘any hint’ of personal responsibility, but they do set limits to responbility, even if Darbyshire finds this morally incovenient. Finally, I argue that the focus on individual accountability should give way to a public health model of containment and prevention. I conclude with some remarks on ‘outsider disbelief’. [ABSTRACT FROM AUTHOR]

Abstract: The reception of complexity theory in health care is characterised by a tendency to reify the idea of a complex system, which is basically an abstraction. This paper argues for three principal theses: first, to invoke complexity, to refer to complex systems, is to proffer a form of explanation; second, in the context of the social sciences, the form of explanation that complexity represents belongs to a family of explanations which the recent theoretical literature associates with social mechanisms; and, third, complexity explanations refer to a specific type of social mechanism, whose features differentiate it from the other members of the family. The most significant of these features is the jettisoning of the default link between order and design, which is precisely the principle omitted by an influential series of papers in the BMJ. Having defended these claims, the paper presents a brief case study illustrating the analysis. [Copyright &y& Elsevier]

I first identify two different distinctions: between Cartesian cognition and embodied cognition, and between calculative rationality and intuitive know-how. I then suggest that, in the nursing literature, these two distinctions are run together, to create an opposition between ‘Cartesian rationality’ and ‘embodied know-how’. However, it is vital to keep the two distinctions apart, because ‘embodied knowing’ is very frequently rational. In separating the idea of embodied cognition from non-rational intuition, I show how ‘embodiment’ leads to the concepts of distributed cognition and distributed expertise. This has extensive and important implications for how we understand clinical cognition in nursing. [Copyright &y& Elsevier]