Summary
Being interested in investigating areas in which social work occurs in nursing, I found my starting point of the project. The focus is placed on drug abusers who use drugs to the extent that it leads to physical, psychological, and/or social damages for the drug abuser or his/her surroundings. When they are sent to a somatic ward, drug abusers experience a lack of focus on their social issues, and they feel stigmatized. There is a clear connection between social issues and health. Not being offered any help might cause the drug abuser to adhere to bad health and a continued life as a socially vulnerable person. The nurses experience that drug abusers are particularly difficult to work with, and they lack knowledge of this group. However, only little light has been shed on what kind of knowledge the nurses lack. Knowledge is defined as the cognitive part of attitudes. The hypothesis was that nurses lack knowledge in relation to the drug abusers’ social issues from a substantiated normative ideal of how the nurse should see and act on social issues. In most cases, acting means to act in an interdisciplinary manner in relation to other specialists within the social assistance system. In the examination of knowledge, involving power was necessary.
The questions of the thesis are: What social issues does the nurse describe from her encounter with the hospitalized drug abuser in a medical ward? What basis of knowledge lies behind these descriptions, and what possibilities of acting does the nurse find? What factors affect the knowledge, and how is power revealed in this?
The project works on the theory of the philosophical hermeneutics as ontology and is critically hermeneutic in its epistemology. As a method, the qualitative interview was used in a semi-structured form, and the interviews were conducted at a medical ward.
The theoretical frame is Flyvbjerg (2009) and his interpretation of Aristotle’s (1995) theory of the knowledge terms epistemé, techné and phronesis. Flyvbjerg’s interpretation is seen as indefinite when it comes to the interaction between the three terms, and therefore the examination of the interaction between the terms and the collected observations proved interesting.
In critical hermeneutics, an objective reality is acknowledged, thus making power a relevant area of examination. At the same time, it would be too simple only to focus on the nurse’s individual knowledge as she will be affected by the context in which she works. Hence, Hasenfeld (2003) and his theory on professionalism and power herein was used.
Based on the analysis, the conclusion is that nurses - from Allardt’s (1975) definition of social issues - describe few social issues and only rarely describe that they act. The explanation for this is their lack of an epistemic knowledge, that is, knowledge of what constitutes and causes social issues. Furthermore, nurses lack techné-knowledge in the form of tools and guidelines in the ward and knowledge of how to address collaborators outside the hospital. Their phronesis-knowledge is influenced by little experience with doing what is good and depends on the individual’s use of power. Thereby, the hypothesis of the project is confirmed. Most interesting is the discovery that all three terms of knowledge play together in that the nurse does not see any social issues and does not act. Other literature has helped to elaborate on this interaction. In addition, the finds show how other factors affect knowledge. Influencing the epistemé-knowledge, the focus of nursing is placed on the human sciences in preference to the social sciences, just as a common conscious culture involving non-action is shown to affect the phronesis-knowledge.
The power which the organization and the medical domain possess also affects the three knowledge terms, making the development of a basis of knowledge difficult. This leads to criticism of a system influenced by an increasing number of specializations at the hospitals and reduction of the social worker’s function.
Recommendations state that social sciences are awarded higher focus in the epistemic part of nursing, and that the health effort from political quarters to a higher extent prioritizes hospitalized drug abusers, for example in the form of special teams for this group of people. Moreover, the finds set the scene for further examination of the interdisciplinary co-operation between the sectors.