The impact of managed care on nurses’ workplace learning and teaching This paper examines the impact of managed care on the informal learning process for nurses in a major US‐based health organisation. Through the analysis of focus group data we report the nurses’ view of the effect recent changes have had on the nurse/patient/care relationship. Managed care, our research indicates, has transformed the learning milieus for nurses with two effects. First, nurses have seen their need for informal learning increase while (...) the time and context for that learning has diminished. Second, the process of teaching patients and families has also been adversely affected even as managed care creates the need for more patient education. We report the analysis of the data collected at group interviews involving nurses working in both hospital and community settings of a leading US‐based HMO. All interviews took place during September of 1997 at various sites in California. This study is part of a larger Social Science Research Council of Canada funded investigation into managed care in the US and Canada. (shrink)

This paper looks at the entangled histories of animal-human relationship and modem surgery. It starts with the various different roles animals have in surgery - patients, experimental models and organ providers - and analyses where these seemingly contradictory positions of animals come from historically. The analyses is based on the assumption that both the heterogeneous relationships of humans to animals and modern surgery are the results of fundamentally local, contingent and situated developments and not reducible to large-scale social explanations, such (...) as modernization. This change of perspective opens up a new ways of understanding both phenomena as deeply interwoven with the redrawing of the nature-culture divide. (shrink)