person in receipt ofhealth care. Some take client to describe a partnership between a
practitioner and a client rather than a paternalism by a professional on a patient.
Generally speaking nurses working with adults who have some physical illness tend to
use the term ‘patient’, nurses working in the area of mental health tend to talk about
‘clients’, nurses working with people with learning difficulties often consider their
client group as ‘service users’, and children’s nurses tend to refer to their client group as
children.
The phrase ‘patient and/or client’ or ‘patient/client’ is sometimes used in the literature
but this tends to add an awkwardness and, in some cases, an unnecessary complexity to
ideas under discussion. The debate on whether or not persons in receipt ofhealth care
are best described as patients, clients, service users or by some other designation arises,
at least in part, because of the breadth ofhealth and nursing care provision. While the
term ‘patient’ would be generally accepted as appropriate to use for a person admitted to
a general hospital ward for surgery, the term ‘client’ might better describe the person
admitted as an emergency to a mental health facility. For the sake of simplicity and
clarity the term ‘patient’ will be the dominant choice of term. Nevertheless, where, on
occasion the term ‘client’, ‘service user’ or ‘child’ is used it will be synonymous, and
used interchangeably, with the term ‘patient’ throughout this thesis and will denote any
individual who is in receipt of the care provided by nurses.
A NOTE ON DEFINITIONAL DIFFICULTIES FOR NURSING
Nursing is a demanding activity. There are over 600,000 registered practicing nurses in
the UK providing nursing care 24-hours a day, seven days a week, 52 weeks a year. It
might be thought that with so many occupied in the activity there would exist a fairly
clear idea about the nature of nursing. The debate about terminology crystallises some
of the tensions within nursing. There is a tendency to consider nurses as a homogenous
group but this is to mistake the scope of nursing practice. Nursing is a broad church.
The four traditional branches of nursing are: adult nursing; children's nursing; learning
disabilities nursing; and mental health nursing. However, this categorisation does not
sufficiently identify the full range or focus of activity undertaken by nurses, for there is
a bewildering array of roles within and between each branch (for example, community
nurses, hospital nurses, practice nurses, consultant nurses, research nurses, clinical nurse
specialists, occupational health nurses and so on). This breadth of activity represents
both a spectrum of nursing services and a range of institutions in which nursing practice
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