S.TRUEMAN PhD THESIS 2016

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Bloomfield (1995) examined the engagement by business organisations of management consultants in the development of information technology. He reports that management consultants in the area of information technology act as intermediaries by interposing themselves between information technology suppliers and the clients, ‘in effect seeking to speak for technology’ (p. 28). They position themselves as an obligatory passage point. This is similar to the position of the remote nurse who is the intermediary between the mental health patient and all the actors in the healthcare system arena. When the patient presents at a primary healthcare centre and requires assistance from a psychiatrist, the nurse does not hand a telephone to the patient and tell them to telephone the psychiatrist. The nurse makes the call, for and on behalf of the mental health patient. In so doing, they are acting as a ‘go-between’ or intermediary. The same position of intermediary, obligatory passage point is assumed when an actor in the health actors’ arena, contacts a nurse and requests they do something involving a mental health patient. According to Bloomfield’s study (1995), in order to be viewed and respected as an intermediary between clients and technology (or suppliers of technology), and to maintain this position, management consultants ‘mobilise various arguments, reports and techniques (e.g., project management or systems analysis methodologies), or specific ideas or ways of thinking and speaking about the world of organisations (e.g., excellence or total quality management), business and information technology, which help construct and reproduce the relationship between the indispensable and the dependent’ (p. 29). Remote nurses likewise have to ensure that they maintain the position of intermediary (as an obligatory passage point). They do this by utilising nursing knowledge(s), technologies and skills to assess that the patient is mentally ill and requires