ABSTRACT
Spencer gives a detailed account of the obstacles which may be encountered in gaining access to bureaucratic elites. The ward was an upgraded Nightingale type with three bays for six patients each, and three side wards on the corridor near to the ward office, treatment room and kitchen. The nursing staffs were perhaps slightly unusual in one respect at least, as they were generally quite highly qualified academically. Deciding when and how to intervene to improve the lives of respondents, especially clients, has long troubled researchers in health settings, but it has been little discussed. The transgression seemed to me to be fairly minor: floors can be cleaned. What is important is that such problems are openly discussed so that research supervisors and colleagues both in the setting and subsequently can offer some kind of reasoned opinion upon researcher conduct.
