S.TRUEMAN PhD THESIS 2016

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A study’s level of inquiry determines the nature of the obligatory passage point. In this study, the researcher chose a meso level of analysis. Accordingly, the study examined the social world of remote general nurses delivering mental healthcare at a group level. If the scope of the study prescribed a more specific or detailed topic, such as examining practices of communication by remote nurses in a primary healthcare centre, then more refined and detailed data would be collected to justify the assertion of the existence of an obligatory passage point (and likely more than one). For example, an obligatory passage point for a remote nurse to contact a nurse practitioner might be a mobile phone; to video conference with a psychiatrist could require two obligatory passage points, video conferencing equipment or computer software (e.g., Skype). Data collection at such a level of specificity was not undertaken in this study. Nimmo’s study (2014) concerning the materialities of clinical handover in intensive care units illustrates this point. He found that clinical handovers were the obligatory passage points for the drawing together of ‘multiple things of healthcare … patient, machines, buildings and rooms, information, activities, texts, ideas, a disease, a diagnosis, an illness, staff, responsibility, a plan, a family … the person, the exchange of information between the treating teams’ (p. 6), therefore ‘[h]andover, can be posited as an obligatory passage point through which the linkages of a jumble of networks connect’ (p. 98). The multiple things in Nimmo’s study are more specific (micro-scale) than the interaction of groups in this study’s social world (meso-scale). Micro-scale analysis can also, pursuant to the same field of inquiry, lead to more than one obligatory passage point. Hence Nimmo found three; formal, informal clinical handovers and ward rounds. This study’s finding, concerning obligatory passage points, is