Staff who work on the wards of a Personality Disorder Unit located within a
Special Hospital are directly responsible for caring for patients contained in
conditions of high security. This research looks at how staff manage
personality disordered patients in this environment. This group of patients
represent complex practical (in terms of where and how they should be managed) and conceptual (in terms of the nature and treatability of their
condition) problems at the heart of which is their perceived dangerousness. The remit of the Special Hospital demands that ward staff deliver the care and
treatment of its patients while simultaneously maintaining conditions of the
highest security. Ward staff are faced daily with having to reconcile these
apparently conflicting objectives.
In this thesis I have argued that ward staff resolve this complex situation by concerning themselves primarily not with delivering care and/ or control but
with the maintenance of 'order' on these wards. Specifically ward staff use their first-hand gathered knowledge and experience to choose the most appropriate course of action to avert or reduce potential incident situations. They do this by appearing able to confer legitimacy on their responses to patients which provides conditions conducive to the maintenance of a relatively stable order on the wards. This they do through the negotiation of 'right' staff-patient relations.