The context of care: issues of power and control between patients and community mental health nurses

Issues of power and control are inevitably linked to the nurse–patient relationship within mental health settings. This paper discusses power relations between nurses and patients within the context of the home visit as an important component of the provision of care to patients living with enduring mental illness. An interpretive ethnographic account was adopted to explore how nurses and patients negotiated issues of power and control with respect to the specific responsibilities associated with community mental health nursing practice. The home visit involved a shifting of power in favour of the patient; patients behaved as ‘hosts’ and nurses as ‘guests’. However, within this framework, nurses still exerted power in relation to certain aspects of patients' daily living which are deemed to be within the domain of nursing, and so legitimise the nurse's interventions. This study explicates the daily exigencies of community mental health practice and provides insights into difficult aspects of nurses' work, which have received little attention in the nursing literature to date.