ABSTRACT
The negotiation and renegotiation of social reputation is complex. It is clothed within the dialogue and the actions, in other words the dialectical relations between all participants on the ward. Patients were aware of the need to negotiate with staff. Always there was an awareness of the considerable power of the staff to define appropriate behaviour. Negotiating in this context is the process of arriving at a working definition of a given situation. N. Fineman develops the concept of negotiation in the context of the counselling of alcoholic clients as follows: Staff members understood their interactions with clients as negotiated contractual agreements. The view that most roles and activities are negotiable rather than static carries within it an implicit critique of functionalist accounts both of organisations and of roles. Negotiating is common to most forms of social interaction between persons involved in the delivery and the receipt of health care.
