Subordinated masculinities : A critical inquiry into reproduction of gender norms in handovers and rounds in a forensic psychiatric care

Aims and objectives To examine how gendered discursive norms and notions of masculinity are (re)produced in professional conversations about men cared for as patients in forensic psychiatric care, with a particular focus on the centrality of language and gender. Background During verbal handovers and ward rounds, care staff converse to share information about patients and make decisions about their mental status. Spoken language is thus a pivotal tool in verbal handovers and ward rounds, one able to reproduce discourses and gender norms. Design Qualitative. Data collected from audio recordings of verbal handovers and ward rounds in a forensic psychiatric clinic were subjected to discourse analysis. The COREQ checklist was used. Results While discussing patients, staff subordinated them by reproducing a discourse typical of heteronormative, family-oriented care. The overarching discourse, which we labelledsubordinated masculinities, was supported by three other discourses:being unable to take responsibility,being drug-addictedandperforming masculinity. Such discourse was identified as a disciplining practice that subordinate's patients as a means to maintain order, rules and gender norms. Conclusion The study reveals a caring practice that position male patients as children or disabled individuals and, in that way, as subordinated other men within a context were staff reproduces a heteronormative family structured care. The process also reveals a practice were downplaying aggressive and deviant behaviour could disempower and reduce patients ' responsibility for personal actions and their possibilities to participate in their care. That finding especially seems to contradict previous findings that patients want to be able to act responsibly and, to that end, want care staff to help them. Relevance to clinical practice Nurses need to deepen their understanding of how language (re)produces discursive norms of gender and masculinity in forensic care and that process's consequences for such care.Peer reviewe

Disciplined into good conduct : Gender constructions of users in a municipal psychiatric context in Sweden

Aims and objectives To examine how gendered discursive norms and notions of masculinity and femininity were (re)produced in professional conversations about users of long‐term municipality psychiatric care. Focus is on the staff’s use of language in relation to gender constructions. Background Psychiatric care in Sweden has undergone tremendous changes in recent decades from custodian care in large hospitals to a care mainly located in a municipal context. People who need psychiatric care services often live in supporting houses. In municipal psychiatric care, staff conduct weekly professional meetings to discuss daily matters and the users’ needs. Official reports of the Swedish government have shown that staff in municipal care services treat disabled women and men differently. Studies exploring gender in relation to users of long‐term psychiatric care in municipalities have problematised the care and how staff, through language, construct users’ gender. Therefore, language used by staff is a central tool for ascribing different gender identities of users. Design The content of speech derived from audio recordings were analysed using Foucauldian discursive analysis. The COREQ checklist was used in this article. Results The results indicate that by relying on gender discourses, staff create a conditional care related to how the users should demonstrate good conduct. In line with that, an overall discourse was created: Disciplined into good conduct. It was underpinned by three discourses inherent therein: The unreliable drinker and the confession, Threatened dignity, Doing different femininities. Conclusion The community psychiatric context generates a discourse of conduct in which staff, via spoken language (re)produces gendered patterns and power imbalances as a means to manage daily work routines. Such practices of care, in which constant, nearly panoptic, control despite the intention to promote autonomy, urgently require problematising current definitions of good conduct and normality.Peer reviewe