The other side of caring: abuse in a South African maternity ward

The abuse of women by nurses in maternity units of hospitals world‐wide has been documented in research conducted by universities, non‐governmental organisations and government agencies. In the current paper, patients and nurses of a maternity unit of one particular South African hospital are interviewed about their experiences of childbirth and their experiences of being nurses in a maternity unit. Interviews were analysed using social constructionist grounded theory and Foucauldian discourse analysis. It was found that in both sets of interviews, patient abuse (as experienced or witnessed) was a prominent theme. Accounts of satisfactory nursing were rare. Previous findings about abuse and ritualised abuse of patients by nurses were thus corroborated. In analysing how such problematic interactions constitute an integral part of medical care in a particular maternity ward, and, as such have become ritualised, sanctioned, normalised and ultimately institutionalised, it was found that nurses (who are typically disempowered in the hierarchy of the medical system) and patients (often considered to be docile passive bodies in the context of a medical ward) oscillate between being passive and active, powerless and powerful in the construction of the nurse–patient relationship. It is suggested that both nurses and patients feel frustrated, disappointed, resentful and even enraged in a context where they cannot be in control and cannot care or be cared for. The study seems to suggest that the empowerment of nurses and patients is necessary in order for the abuse to stop. It is further recommended that future research explore cases where nurses and patients are satisfied with the caring that they have given or received; such studies will illuminate the conditions which make good nursing possible in a different way.