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An ethnographic study of nursing culture as an exploration for determining the existence of a system of ritual.

The idea that much of nursing is 'ritualized' activity which is harmful to patient care assumes that 'ritual' itself is unacceptable behaviour or practice. At a time when market forces are clearly influencing the delivery of care and, in turn, changes in nursing practice, it has become important both to clarify what 'ritual' is and to determine its existence and 'form' within nursing. This study explored nursing culture for 'ritual' in a ward setting and used ethnography as both method and description. Rituals were found to exist in the working day of the nurses studied, but was not an indication that 'ritualized behaviour' is harmful to individualized patient care. There is a clear need, however, to determine specifically the difference between 'unsafe outdated practices' and ritual in a cultural 'sense'. This would ensure that what had to be relinquished would in no way jeopardize the future existence of nursing and nurses as socially cohesive groups with their own culture.