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Stina resland* RNT PhD, Kim Lutzn RN PhD, Astrid Norberg RN PhD,
Birgit H. Rasmussen RN PhD and Sylvia Mtt** RN PhD
*Senior Lecturer, Department of Health Sciences, Buskerud University College, Drammen, Buskerud, Norway, Professor, Department of Neurobiology, Care
Sciences and Society, Karolinska Institutet, Professor, Department of Nursing, Ume University, Department of Palliative Care Research, Ersta Skndal
University College, Stockholm, Senior Lecturer, Institute of Health and Care Sciences, Gteborg University, and **Director, Center for Gender Equal Care,
Gteborg, Vstra Gtaland, Sweden
Abstract
Introduction
You are a guest in someones home . . . you must take this
into account.
Correspondence: Dr Stina resland, Senior Lecturer, Buskerud
University College, Department of Health Sciences, Postbox
7053, 3007 Drammen, Norway. Tel: +47 93643831; fax: +47
32869883; e-mail: stina.oresland@hibu.no
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A starting point
Many images spring to mind when reflecting on the
conceivable meaning of the concept guest. We may
think of persons being invited to stay in someones
home, in a hotel or participate in a social relationship. Dictionaries (http://www.merriam-webster.com;
http://www.dictionary.com; Ernby, 2010) reveal that
guest can be a noun, a verb or an adjective related to
a person. A dictionary definition of the meaning of
guest is a person entertained in ones home and a
person to whom hospitality is extended (http://www.
merriam-webster.com). A guest can also be someone
who for reasons of friendship, business, duty, travel,
or the like visits anothers home (http://www.
dictionary.com). A guest can be a familiar person or a
stranger a visiting foreigner (http://dictionary.
babylon.com). These definitions imply that a guest
can be an invited, expected or unexpected visitor to a
persons home.
Furthermore, guest seems to be closely related to
host, defined as; a person who receives or entertains guests at home or elsewhere (http://www.
dictionary.com). The host is responsible for the guest
while the latter is in her/his home (http://www.
merriam-webster.com;
http://www.dictionary.com;
Ernby, 2010). The host is also expected to provide
hospitality, described as; a friendly welcome and
treatment of guests and strangers and the quality
or character of receiving and treating guests and
strangers in a warm, friendly way (http://www.
dictionary.com). Thus hospitality a priori requires the
Jacques Derrida
Jacques Derrida (19302004) was a French philosopher whose critique of Western philosophy had a
major influence on the intellectual world in the late
20th century. In particular, his philosophy on hospitality had an impact on a wide range of disciplines and
areas of study, i.e. philosophy (Naas, 2005), education
(Kameniar, 2007), feminist studies (Hamington,
2010), tourism (Sherlock, 2001; Gibson, 2003), geography (Popke, 2004) and nursing research (Cheek &
Rudge, 1994; Peters, 2002; Rolfe, 2006). One example
is Whiteheads (2011) use of a Derridean discourse
analysis framework for health promotion literature
focusing on nurses and nursing practice.
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arises as conditional hospitality involves the possibility of selecting guests. The tension is also because of
the fact that conditional hospitality insists on agreement on, among other things, ethical principles, duties
and virtues (Friese, 2004). However, as Secomb (2007)
pointed out, conditional hospitality is in the end not
hospitality, for the kindness and generosity must be
reciprocated or the host praised for this minor act of
welcome.
The gift
Derrida pointed out that hospitality is not objective
knowledge, but an act of donation, the giving of something to someone, the aporai of the gift. The gift can
be given either conditionally or unconditionally: conditionally when the gratitude of the guest is expected
and unconditionally if no reciprocity is anticipated
(Wyschogrod, 2003). The only real gift is given anonymously and unconditionally, i.e. nothing is expected in
return and not recognized as a gift by the receiver or
the giver. If the giver starts to consider her/himself as
a giver she/he begins to;
. . . pay himself with a symbolic recognition, to praise
himself, to approve of himself, to gratify himself, to congratulate himself, to give back to himself symbolically the value of
what he thinks he has given or what he is preparing to
give . . .
A gift requires that there is no obligation, reciprocity, exchange or debt, as when the giver begins to
congratulate her/himself and the recipient feels a
sense of gratitude, it annuls the genuine gift situation.
For Derrida, the condition for the possibility of the
gift is at the same time the condition for the impossibility of the gift;
If the other gives me back or owes me or has to give me back
what I give him or her, there will not have been a gift . . .
(Derrida, 1992, p. 12)
Hostipitality
Derrida holds that there is always an element of hostility in hosting and hospitality, constituting what he
termed hostipitality (OGorman, 2007). According
to Caputo & Derrida (2003), an essential aspect of
Derridas philosophy of hospitality is the fact that the
welcome extended to the guest is a function of the
power of the host to maintain mastery of the property.
The idea of having and maintaining mastery underlies
hospitality:
Make yourself at home! This is a self-limiting invitation . . . it means: please feel at home, act as if you were at
home, but remember, this is not true, this is not your home
host, who becomes the hostage . . . and the guest, the invited
2003, p. 111)
(p. 125)
Unconditional hospitality requires that the relationship between the host and the guest is inverted
(Floriani & Schramm, 2010). Floriani & Schramm
(2010) tried to make this inversion clearer by stating
that the relationship between the giver and the recipient of the hospitality must be inverted to achieve
unconditional hospitality, as the host welcomed the
guest into her/his home, which can overturn her/his
sovereignty. When transferred to HBNC, this means
that, in order to be hospitable, the patient/host must
rid her/himself of her/his authority and power over
the property, guarantee security and unconditionally
welcome the nurse/guest into her/his home. In the
threshold inversion, the stranger/guest is the patient
who needs help as she/he is suffering. The nurse
becomes the host, the one who unconditionally welcomes the guest, the patient. Without expecting anything in return, without any hope of being accepted as
host, the nurse must, welcome and be receptive to the
needs of the guest. Thus, as a host the nurse is the one
who has the power and responsibility for providing
care while the former host, the patient, is the
stranger who receives the care. In this way, the nurse
is in a position to unconditionally receive the patient.
Invitation and visitation
In Derridas philosophy, unconditional and conditional hospitality are related to the difference
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(Derrida and
Derrida & Duformantelle (2000) stated that hospitality does not extend to a stranger without a name or
family. For example, if the nurse does not introduce
her/himself by name, the patient/host has no obligation to invite the nurse into her or his home, as
naming someone is to call her/him into being, to
render the invisible visible and to endow a person
with a certain character (Derrida & Duformantelle,
2000).
In an empirical study on HBNC, the patients discursively described themselves as safeguarding their
place, routines, habits and objects in everyday life
(resland et al., 2009), which might indicate that the
patients considered the nurses parasites as opposed
to invited guests.
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receiver is thus non-reciprocal and cannot be considered a same-level relationship. It is the nurses
responsibility to be receptive to the needs of the
patient and care for her/him. However, if the relationship between nurse and patient is conceived as one
between a guest and a host, both the guest and the
host are a priori responsible for the other. As mentioned above, as the owner of her/his home, the
patient/host has a moral imperative to provide hospitality in accordance with the laws of conditional hospitality (Derrida & Duformantelle, 2000). At the
moment of the interpersonal encounter, when a
nurse/guest first meets the patient/host, a need for
protection arises. Even before the encounter there is a
demand and thereby a fixed bond between the nurse/
guest and patient/host (Clancy & Svensson, 2007). In
line with Levinas (1969), Derrida (1981) stated that
our ability to open ourselves to the other without any
conditionality establishes not only our potential to
develop an ethical relationship but also our capacity
to be human. This means that the nurse/guest does
not encounter the patient as a host, but as a fellow
human being, implying that the positions of guest
and host lack significance in an ideal ethical encounter. The host is the unknown Other for whom the
nurse must assume responsibility and the reverse also
applies, i.e. the nurse is the unknown Other for whom
the host must assume responsibility.
Reflections
The aim of this study was to explore how nurses
description of themselves as guests in the patients
home can be understood in the light of Derridas
philosophy of hospitality. The study revealed that (a)
guest must be considered a binary concept; and (b)
hospitality should be seen as an exchange of giving
and receiving between a host and a guest.
Hospitality as an exchange
Derrida & Duformantelle (2000) posed the question
if and how traditional laws of hospitality give rise to
hierarchical positions in the relationship between
Conclusion
This study demonstrates that it is important to reflect
on the meaning of the concepts used by nurses in
HBNC. As previously revealed, there is a tendency to
use concepts without closer reflection on the discourse from which they originate and to which they
are related. One example is the concept guest, traditionally used in discourses related to private matters,
here transferred to a professional discourse in the
context of HBNC.
Despite the fact that the issue of nurses descriptions of themselves as a guest has been explored,
some uncertainties still remain. Do nurses play down
their professional knowledge when describing themselves as a guest in the patients home? What is the
benefit of such a description? Maybe the nurses use
of the concept guest lacks substance and is just used
pragmatically? Should this be the case, there might be
a risk that the concept will serve as a semantic
magnet, i.e. a buzzword used as a routine expression
by nurses in HBNC. There might also be a possibility
that the nurses description of being a guest in the
patients home is narrow and does not match the
patients expectations. The patient may not expect a
guest, but a nurse. Thus, there is a risk that the
patients and nurses expectations of each other
differ. Further theoretical and empirical exploration
of the concept of hospitality related to care would be
fruitful, for example; what is patients understanding
of hospitality and hostility related to nurses
descriptions of themselves as guests in the patients
home?
References
Bauer N.A. (2001) Codependence: is it a home healthcare
concern? Home Healthcare Nurse, 19(7), 432438.
Bell D. (2007) The hospitable city: social relations in commercial space. Progress in Human Geography, 31(1), 722.
Bowers L. (1992) Ethnomethodology II: a study of the community psychiatric nurse in the patients home. International Journal of Nursing Studies, 29(1), 6979.
Caputo J.D. & Derrida J. (2003) Deconstruction in A Nutshell. A Conversation with Jacques Derrida. Edited and
with a Commentary by J.D. Caputo. Fordham University
Press, New York.
Cheek J. & Rudge T. (1994) Nursing as textually mediated
reality. Nursing Inquiry, 1(1), 1522.
Clancy A. & Svensson T. (2007) Faced with responsibility:
Levinasian ethics and the challenges of responsibility in
Norwegian public health nursing. Nursing Philosophy,
8(3), 158166.
Derrida J. (1976) Of Grammatology. John Hopkins University Press, Baltimore, MD.
Derrida J. (1981) Dissemination. University of Chicago
Press, Chicago, IL.
Derrida J. (1992) Given Time: I. The University of Chicago
Press, Chicago, IL and London.
Derrida J. (2000) Hospitality. Angelaki: Journal of the Theoretical Humanities, 5(3), 318.
Derrida J. & Duformantelle A. (2000) Of Hospitality. Stanford University Press, Palo Alto, CA.
Ernby B. (ed.) Norstedts etymologiska ordbok. (2010) Norstedts Akademiska Frlag, Stockholm.
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