S.TRUEMAN PhD THESIS 2016

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hospital. She reported, from an actor-network perspective, that nurses are the obligatory passage point(s) for the various hospital systems to continue functioning in an orderly manner: ‘Barely anything happens that does not pass through the hands of a nurse … they are the network builders, system enablers and principal mediators through which the diverse elements that comprise trajectories of care [become] ordered’ (p. 136). This statement directly parallels the present study’s first finding in relation to the delivery of remote mental healthcare. Allen’s (2015) study further reports that practices undertaken by nurses are relatively ‘invisible’, despite being vital to the quality and efficiency of the hospital. Allen then describes, using actor-network theory terminology, how nurses’ organising practices cause translational mobilisation. By this term, Allen means movement of an entity (e.g., hospital, hospital department, unit, ward) in space and time, ‘ensuring temporal articulation, and aligning the socio-material configurations that support action’ (2015, p. 136). Nurses initiate and facilitate action, resolve anomalies and contradictions, plan, respond and formulate strategies to overcome obstacles to progression: Much of the work that nurses do is in reaction to unexpected contingencies, whether these are clinical or organisational in origin. Mobilisation is also intended to convey something of the energy entailed by organising work and its involved and continuous character. (Allen, 2015, p. 136) Many of Allen’s findings are consistent with those of this study. From an obligatory passage point and ‘moments of translation’ in nursing perspective, there exist strong similarities between the hospital based nurses, and remote generalist nurse’s actions and behaviours.