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Salzmann-Erikson M. The intersection between logical empiricism and qualitative nursing research: a post-structuralist analysis. Int J Qual Stud Health Well-being 2024; 19:2315636. [PMID: 38346230 PMCID: PMC10863514 DOI: 10.1080/17482631.2024.2315636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 02/03/2024] [Indexed: 02/15/2024] Open
Abstract
PURPOSE To shed light on and analyse the intersection between logical empiricism and qualitative nursing research, and to emphasize a post-structuralist critique to traditional methodological constraints. METHODS In this study, a critical examination is conducted through a post-structuralist lens, evaluating entrenched methodologies within nursing research. This approach facilitates a nuanced exploration of the intersection between logical empiricism and qualitative nursing research, challenging traditional methodological paradigms. RESULTS The article focusing on the "what abouts" of sample size, analytic framework, data source, data analysis, and rigour and methodological considerations, challenging the predominance of semi-structured interviews and the reliance on spoken voice as primary data sources, and re-evaluating the conventional notion of "rigour". CONCLUSIONS I advocate for a shift from qualitative positivism towards more interpretive and post-qualitative inquiries, this work proposes new trajectories through interpretive, critical, post-qualitative, and artistic turns in nursing research, aiming to transcend positivist limitations and foster a plurality of perspectives and research as praxis. Implications emphasize the need for nursing researchers to expand methodological horizons, incorporating visual and artistic methods to enrich understanding and representation of health experiences, moving beyond positivist norms towards a more inclusive and ethically sound research paradigm.
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Affiliation(s)
- Martin Salzmann-Erikson
- Department of Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
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2
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Strus JA, Holmes D, O'Byrne P, Hammond C. Lefebvre's production of space: Implications for nursing. Nurs Philos 2024; 25:e12420. [PMID: 36750689 DOI: 10.1111/nup.12420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 08/23/2022] [Accepted: 01/18/2023] [Indexed: 02/09/2023]
Abstract
In this paper, we argue that nurses need to be aware of how the production of space in specific contexts - including health care systems and research institutions - perpetuates marginalized populations' state of social otherness. Lefebvre's idea regarding spatial triad is mobilized in this paper, as it pertains to two-spirited, lesbian, gay, bisexual, trans and queer populations (2SLGBTQ*). We believe that nurses can create counter-spaces within health care systems and research institutions that challenge normative discourses. Lefebvre's work provides us the necessary tools to understand how various places or environments produce identities. In understanding Lefebvre's principles, we believe that nurses can play an essential role in creating counter-spaces, thereby instigating counter-institutional practices, for those who experience otherness.
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Affiliation(s)
- Jacqueline A Strus
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Dave Holmes
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Patrick O'Byrne
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Chad Hammond
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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3
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Miller GE, Holmes D. Self-Deception in Clinical Nursing Practice: A Concept Analysis. Clin Nurs Res 2024; 33:114-122. [PMID: 37872731 PMCID: PMC10731826 DOI: 10.1177/10547738231206610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
In this paper, we explore the phenomenon of "self-deception" within the context of nursing, focusing on how nurses employ this coping mechanism when faced with dissonance, distress, and conflicting situations in clinical settings. Our primary objective is to examine the phenomenon of self-deception using Rodgers' evolutionary method of concept analysis. Focusing on nurses' experiences in challenging situations, our analysis highlights how self-deception is often employed as a coping strategy. According to our conceptual analysis, self-deception in nursing clinical practice highlights tensions between different paradigms and expectations in healthcare settings. These tensions stem from the power dynamics and subservience that nurses often face, which can hinder their ability to advocate for themselves, their patients, and the nursing profession.
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4
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Zainuddin SA, Abdullah B, Nasir NAM, Abdullah T, Nawi NC, Patwary AK, Hashim NAAN. Sustainable risk management practice in the organization: a Malaysian case study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:24708-24717. [PMID: 36344894 PMCID: PMC9640835 DOI: 10.1007/s11356-022-23897-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 10/25/2022] [Indexed: 05/04/2023]
Abstract
Businesses are becoming more conscious of operational risk management practices due to the COVID-19 pandemic. However, some firms practice risk management without fully comprehending how it might help them and their needs. As a result, companies that practice risk management without realizing it are being controlled by the discipline itself. The goal of this study is to look into the epistemic process of risk management practice in the workplace. This phenomenological study interviewed 39 risk management officers, executives, and employees. Data are thematically analyzed. This study discovered five epistemic processes of risk mapping using Foucault's governmentality paradigm. This phenomenological study, interestingly, revealed the black box of risk management practices, as well as the behavior of risk management officers, executives, and risk owners who preferred to monitor the compliance aspects of risk management practices rather than comprehend the capabilities of risk management that could be used within their strategic planning process. Unaware of this black box, organizational actors were blanketed by the organization's culture of fear, which created the impression that the authority was always watching every word said and every action taken. Practically, this study contributes an improved understanding of the real function of risk management that helps them justify the practice and reduce unnecessary fear. The paper concludes with limitations and research recommendations.
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Affiliation(s)
- Siti Afiqah Zainuddin
- Global Entrepreneurship, Research and Innovation Centre, Universiti Malaysia Kelantan, Kota Bharu, Kelantan Malaysia
- Faculty of Entrepreneurship and Business, Universiti Malaysia Kelantan, Kota Bharu, Kelantan Malaysia
| | | | - Noorul Azwin Md Nasir
- Faculty of Entrepreneurship and Business, Universiti Malaysia Kelantan, Kota Bharu, Kelantan Malaysia
| | - Tahirah Abdullah
- Faculty of Entrepreneurship and Business, Universiti Malaysia Kelantan, Kota Bharu, Kelantan Malaysia
| | - Noorshella Che Nawi
- Global Entrepreneurship, Research and Innovation Centre, Universiti Malaysia Kelantan, Kota Bharu, Kelantan Malaysia
- Faculty of Entrepreneurship and Business, Universiti Malaysia Kelantan, Kota Bharu, Kelantan Malaysia
| | - Ataul Karim Patwary
- Faculty of Hospitality, Tourism and Wellness, Universiti Malaysia Kelantan, Kota Bharu, Kelantan Malaysia
| | - Nik Alif Amri Nik Hashim
- Faculty of Hospitality, Tourism and Wellness, Universiti Malaysia Kelantan, Kota Bharu, Kelantan Malaysia
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5
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López‐Deflory C, Perron A, Miró‐Bonet M. An integrative literature review and critical reflection on nurses' agency. Nurs Inq 2023; 30:e12515. [PMID: 35971209 PMCID: PMC10078309 DOI: 10.1111/nin.12515] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 01/25/2023]
Abstract
The idea of agency has long been used in the nursing literature in the study of nurses' roles regarding the patients they take care of, but it has not often been used to study its relationship with nurses themselves and their status in the healthcare system. The purpose of this article is to analyze how the idea of agency is used in nursing research to better understand how we might advance our thinking around nurses' agency to shape nursing and healthcare with an emancipatory intent. Based on the results of a literature review focused on the study of conceptions, treatments, and applications of the concept of agency in nursing, we present a critical discussion to reflect on the need to consistently define the idea of nurses' agency, to guide research concerned with this topic in theoretical frameworks with emancipatory and social change tenets, and to make a call to develop the idea of agency as a central one to rework nurses' relationship with themselves. The idea of agency provides a valuable analytical framework for the study of a wide range of issues around nurses' status in healthcare organizations and in the healthcare system while offering a means for nurses' emancipation.
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Affiliation(s)
- Camelia López‐Deflory
- Department of Nursing and PhysiotherapyUniversity of the Balearic IslandsPalmaBalearic IslandsSpain
- Care, Chronicity and Health Evidences Research GroupHealth Research Institute of the Balearic Islands (IdISBa)PalmaBalearic IslandsSpain
| | - Amélie Perron
- School of Nursing, Faculty of Health SciencesUniversity of OttawaOttawaOntarioCanada
| | - Margalida Miró‐Bonet
- Department of Nursing and PhysiotherapyUniversity of the Balearic IslandsPalmaBalearic IslandsSpain
- Care, Chronicity and Health Evidences Research GroupHealth Research Institute of the Balearic Islands (IdISBa)PalmaBalearic IslandsSpain
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6
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Purvis JK. Applying a Foucauldian lens to the Canadian code of ethics for registered nurses as a discursive mechanism for nurses professional identity. Nurs Inq 2022; 30:e12536. [PMID: 36260285 DOI: 10.1111/nin.12536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/13/2022] [Accepted: 09/22/2022] [Indexed: 11/28/2022]
Abstract
This study examines the Canadian Code of Ethics for Registered Nurses as a discursive mechanism for shaping nurses' professional identity using a Foucauldian lens. Nurses are considered essential in healthcare, yet the nursing profession has struggled to be recognized for its discipline-specific knowledge and expertise and, as such, has remained the subject of and subject to the dominant discourses within healthcare and society generally. Developing a professional identity in nursing begins after the necessary education and training are achieved and embodies the profession's history, values, code of ethics, and expectations of the profession that distinguish it from other professions. Since nurses' professional identity is shaped through discourse, it raises the question of whether there are spaces to reconceptualize nurses' subject position within health care. Since professional identity is considered the embodiment of knowledge and practice, the code of ethics bears examination both for its effect on nurses' professional identity and as a potential site from which to challenge hegemonic assumptions. This article discusses the concept of professional identity in nursing and its development through the discursive formations in the code of ethics. The sources of power/knowledge are examined as both mechanisms of control and as spaces for change.
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Affiliation(s)
- Janet K Purvis
- Rankin School of Nursing, St Francis Xavier University, Antigonish, Canada
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7
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López‐Deflory C, Perron A, Miró‐Bonet M. Social acceleration, alienation, and resonance: Hartmut Rosa's writings applied to nursing. Nurs Inq 2022; 30:e12528. [PMID: 36115014 DOI: 10.1111/nin.12528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 11/27/2022]
Abstract
This article aims to present the life and work of German thinker Hartmut Rosa as a philosopher of interest for nursing. Although his theoretical framework remains fairly unknown in the nursing domain, its main key concepts open up a philosophical and sociological approach that can contribute to the understanding of a wide range of study phenomena related to nurses, nursing, and healthcare. The concepts of social acceleration, alienation, and resonance are useful to explore healthcare organizations' performance by bringing the time dimension of modernity to the center; to grasp nurses' experiences of caring for patients; and to understand nurses as agents endowed with the capacity to deploy their political agency to create alternative forms of relationship to themselves, to others, and the world, challenging the institutional order of healthcare organizations when it fails to resonate with their professional ethos. In this article, we propose Hartmut Rosa's theoretical framework as a new and inspiring phenomenological and critical lens that should be further explored to advance knowledge concerning phenomena that are found at the crossroads of the nursing domain and other fields of knowledge.
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Affiliation(s)
- Camelia López‐Deflory
- Department of Nursing and Physiotherapy University of the Balearic Islands Palma Balearic Islands Spain
- Care, Chronicity and Health Evidences Research Group Health Research Institute of the Balearic Islands (IdISBa) Palma Balearic Islands Spain
| | - Amélie Perron
- School of Nursing, Faculty of Health Sciences University of Ottawa Ottawa Ontario Canada
| | - Margalida Miró‐Bonet
- Department of Nursing and Physiotherapy University of the Balearic Islands Palma Balearic Islands Spain
- Care, Chronicity and Health Evidences Research Group Health Research Institute of the Balearic Islands (IdISBa) Palma Balearic Islands Spain
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8
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Scandinavian Online Cancer Information as Expressions of Governmentality: A Comparative Qualitative Study. ANS Adv Nurs Sci 2022:00012272-990000000-00013. [PMID: 35820413 DOI: 10.1097/ans.0000000000000436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We compared online distributed information provided to patients with cancer in Scandinavian countries through the lens of governmentality. A secondary comparative qualitative analysis was conducted. Discourses in online patient information showed differences in governmentality techniques across the countries: Norway used a paternalist approach, Denmark an educative approach, and Sweden an individualistic approach and expected the patients to make the "right" decisions. Online information for patients with cancer in Denmark and Norway showed high professional and health care system involvement, whereas in Sweden, there was high patient involvement. There was almost no use of the person-centered approach among the online discourses.
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9
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Laurin AC, Martin P. Towards democratic institutions: Tronto's care ethics inspiring nursing actions in intensive care. Nurs Ethics 2022; 29:1578-1588. [PMID: 35726836 DOI: 10.1177/09697330221089093] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Care as a concept has long been central to the nursing discipline, and care ethics have consequently found their place in nursing ethics discussions. This paper briefly revisits how care and care ethics have been theorized and applied in the discipline of nursing, with an emphasis on Tronto's political view of care. Adding to the works of other nurse scholars, we consider that Tronto's care ethics is useful to understand caring practices in a sociopolitical context. We also contend that this vision can be used specifically to politicize nurses, by encouraging them to think critically about the context in which they work and how they can participate to change the status quo, notably by prompting the democratization of care in institutional settings. We illustrate this by demonstrating how moral distress that can occur with aggressive or futile treatments in the intensive care unit can be reduced if nurses are systematically included in the decision-making process. By showing some ways in which nursing political actions can begin to change the status quo as it pertains to futile treatments at the end of life, we can help empower nurses to strive to be included in political spaces and voice their concerns to have their professional needs met.
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Affiliation(s)
| | - Patrick Martin
- 4440Laval University, Quebec Heart and Lung Institute, Quebec, Canada
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10
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Boulton M, Garnett A, Webster F. A Foucauldian discourse analysis of media reporting on the nurse-as-hero during COVID-19. Nurs Inq 2021; 29:e12471. [PMID: 34729856 PMCID: PMC8646255 DOI: 10.1111/nin.12471] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 10/17/2021] [Accepted: 10/18/2021] [Indexed: 01/13/2023]
Abstract
This study uses a Foucauldian discourse analysis to explore media reporting on the role of nurses as being consistently positioned ‘heroes’ during COVID‐19. In so doing, it highlights multiple intersecting discourses at play, with the caring discourse acting as a central one in negatively impacting nurses' ability to advocate for safe working conditions during a public health emergency. Drawing on media reports during the outbreak of COVID‐19 in Ontario, Canada in the spring of 2020 and on historical information from SARS, this study seeks to establish caring as a discourse and examine if the caring discourse impedes nurses' ability to protect themselves from harm. The results of this analysis explicate how public media discourses that position nurses as caring, sacrificial and heroic may have impacted their ability to maintain their personal safety as a result of the expectations put upon the nursing profession.
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Affiliation(s)
- Maggie Boulton
- Arthur and Sonia Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Anna Garnett
- Arthur and Sonia Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Fiona Webster
- Arthur and Sonia Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, Ontario, Canada
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11
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Molina-Mula J. Grounded theory qualitative approach from Foucault's ethical perspective: Deconstruction of patient self-determination in the clinical setting. World J Clin Cases 2021; 9:8312-8326. [PMID: 34754841 PMCID: PMC8554413 DOI: 10.12998/wjcc.v9.i28.8312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/30/2021] [Accepted: 08/27/2021] [Indexed: 02/06/2023] Open
Abstract
This paper aims to explain the construction of the autonomous subject from Foucault's ethical perspective for the qualitative analysis of interprofessional relationships, patient-professional relationships, and moral ethics critique. Foucault tried to break loose from the self, which is merely the result of a biopolitical subjectivation and constituted an interpersonal level. From this, different elements involved in the decision-making capacity of patients in a clinical setting were analysed. Firstly, the context in which decision-making occurs has been explained, distinguishing between traditional practices involved in self-care and the more modern conceptions that make certain possible transformations. Secondly, an attempt is made to explain the formation of the medicalisation of society using the transformations of what Foucault called "techniques of the self". Finally, the ethical framework for a subject's "self-creation", insisting more on the exercises of self-subjectivation, reinforcing the ethics of the self by itself, the "care of the self", has been explained. The role of the patient is understood as an autonomous subject to the extent that the clinical institution and the professionals involved comprehend how the patient's autonomy in the clinical environment is constituted. All these elements could generate grounded theory on the qualitative methodology of this phenomenon. The current ethical model based on universal principles is not useful to provide a capacity for patients decision-making, relegating to the background their opinions and beliefs. Consequently, a new ethical perspective emerges that aims to return the patient to the fundamental axis of attention.
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Affiliation(s)
- Jesús Molina-Mula
- Nursing and Physiotherapy Department, University of Balearics Island, Palma 07122, Illes Balears, Spain
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12
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Mattar E Silva TW, McLean D, Velloso IC. Disciplinary power on daily practices of nurses and physicians in the hospital. Nurs Inq 2021; 29:e12455. [PMID: 34414630 DOI: 10.1111/nin.12455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 08/03/2021] [Accepted: 08/07/2021] [Indexed: 11/30/2022]
Abstract
To understand power relations, it is important to consider that power is an attribute, and whoever has it at a given moment is in the condition of dominant and whoever is under its exercise is dominated. Moreover, we must consider that these positions are interchangeable, changing when relations of force change. Power relations represent the pursuit of supremacy through knowledge, with struggles for better positioning in the social structure. In this study, we analyze the effects of disciplinary power on daily practices of nurses and physicians in the hospital environment, more specifically in intensive care units. From the perspective of disciplines, power is exercised in a discreet, modest, calculated and permanent way, through the establishment of rules and norms. In this context, despite the strong appreciation of a medical-centered model, it is observed that nurses gain visibility through knowledge and the defense of institutional norms and rules, which can generate tensions in daily professional practices.
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Affiliation(s)
- Tauana W Mattar E Silva
- Graduate Program, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Donna McLean
- Department of Nursing Foundations, Faculty of Nursing, MacEwan University, Edmonton, Alberta, Canada
| | - Isabela C Velloso
- Department of Applied Nursing, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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13
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Asymmetric Power Relations in Gynaecological Consultations for Cervical Cancer Prevention: Biomedical and Gender Issues. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157850. [PMID: 34360140 PMCID: PMC8345629 DOI: 10.3390/ijerph18157850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 11/17/2022]
Abstract
A generic qualitative research, using a poststructuralist feminist perspective, was conducted in a Spanish gynaecology unit with the following aims: (a) to analyse how asymmetric power relations in relation to biomedical knowledge and gender shape the medical encounters between gynaecologists and women diagnosed with cervical intraepithelial neoplasia and (b) to explore the cognitive, moral, and emotional responses expressed by patients. A total of 21 women diagnosed with cervical intraepithelial neoplasia were recruited through purposive sampling. Semi-structured interviews were recorded and transcribed, and a thematic analysis was carried out. Two major themes were identified: (a) gendered relations in cervical intraepithelial neoplasia medical encounters are based on hidden, judgmental moral assumptions, making women feel irresponsible and blamed for contracting the human papillomavirus infection; (b) biomedical power is based on the positivist assumption of a single truth (scientific knowledge), creating asymmetric relations rendering women ignorant and infantilised. Women reacted vehemently during the interviews, revealing a nexus of cognitive, moral, and emotional reactions. In medical encounters for management of cervical intraepithelial neoplasia, patients feel they are being morally judged and given limited information, generating emotional distress. Healthcare professionals should question whether their practices are based on stereotypical gender assumptions which lead to power asymmetries during encounters.
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14
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Fjørtoft AK, Oksholm T, Førland O, Delmar C, Alvsvåg H. The position of home-care nursing in primary health care: A critical analysis of contemporary policy documents. Nurs Inq 2021; 29:e12445. [PMID: 34289213 DOI: 10.1111/nin.12445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 11/27/2022]
Abstract
Internationally, primary health care has in recent years gained a more central position in political priorities to ensure sustainable health care for the population. Thus, more people receive health care locally and in their own homes, where home-care nursing plays a large role. In this article, we investigate how home-care nursing is articulated and made visible in contemporary Norwegian policy documents. The study is a Fairclough-inspired critical discourse analysis seeking to uncover the position of nursing in the prevailing political ideologies on current primary health care. In the documents, we identified several complementary and conflicting understandings about home-care nursing. Home-care nursing is presented as a basic part of a municipality's health services, but at the same time, its content and contribution are unclear and almost invisible. We argue that the absence of nursing leads to significant perspectives being left out and tie this to the fact that some patient groups and tasks seem to be disadvantaged. The political placement of home-care nursing in the health-care landscape is thus not just about nursing as a professional practice but also concerns fundamental care values in our society in relation to disadvantaged groups and work tasks.
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Affiliation(s)
- Ann-Kristin Fjørtoft
- Center of Diaconia and Professional Practice, VID Specialized University, Oslo, Norway.,Faculty of Health Sciences, VID Specialized University, Bergen, Norway
| | - Trine Oksholm
- Faculty of Health Sciences, VID Specialized University, Bergen, Norway
| | - Oddvar Førland
- Centre for Care Research Western Norway, Western Norway University of Applied Sciences, Bergen, Norway
| | - Charlotte Delmar
- Faculty of Health Sciences, VID Specialized University, Bergen, Norway.,Department of Nursing Science, Institute of Public Health, Health Faculty, Aarhus University, Aarhus, Denmark
| | - Herdis Alvsvåg
- Faculty of Health Sciences, VID Specialized University, Bergen, Norway
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15
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Racine L, Vandenberg H. A philosophical analysis of anti-intellectualism in nursing: Newman's view of a university education. Nurs Philos 2021; 22:e12361. [PMID: 34157208 DOI: 10.1111/nup.12361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 05/07/2021] [Accepted: 06/04/2021] [Indexed: 11/29/2022]
Abstract
Canadian and international nursing educators are increasingly concerned with the quality of university nursing education. Contemporary nursing education is fraught by a growing anti-intellectualism coupled with the dominance of neoliberalism and corporate university business culture. Amid these challenges, nursing schools must prepare nurses to provide care in an era compounded by social and health inequities. The purpose of this paper was to explore the philosophical and contextual factors influencing anti-intellectualism in nursing education. We use John Henry Newman's view of the purpose of a university education as a heuristic perspective to examine anti-intellectualism in nursing. We contend that the ideological worship of technological advances, a culture of consumerism, quality improvement and risk management, the primacy of doing over thinking, competency-based curricula and business models rooted in neoliberal financial policies reinforce anti-intellectualism in nursing. Anti-intellectualism is a complex issue to address within the corporate university culture. We propose multiple strategies at the disciplinary, university and sociopolitical levels to decrease anti-intellectualism. Counteracting anti-intellectualism requires critical thinking, praxis and emancipation. Nurses should critically examine this anti-intellectual trend as it limits the advancement of the discipline and marginalizes its contributions within the academy. If nurses do not address this challenge, the survival of nursing as an academic discipline may be jeopardized.
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Affiliation(s)
- Louise Racine
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
| | - Helen Vandenberg
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
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16
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Hoff JL, Kuiper M. The governmentality of nursing professionalization in advanced liberal societies. JOURNAL OF PROFESSIONS AND ORGANIZATION 2021. [DOI: 10.1093/jpo/joaa027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
In Western countries, the occupational discipline of nursing is undergoing processes of professionalization. Although professionalization offers an appealing perspective on occupational advancement, it is an ambiguous process, especially in the context of ongoing reforms of advanced liberal states. More specifically, there is a confusing relationship between the professionalization of nursing and the state. This relation is underexamined in theories of nursing professionalization. Instead of seeing the state and professions as two distinct spheres, this article highlights their interconnectedness. It argues that nursing professionalization can be understood as a strategy of advanced liberal governmentality. Through an empirical analysis of the professionalization of Dutch nursing from a Foucauldian perspective, it shows how the appeal to ‘professionalism’ functions as a disciplinary mechanism that produces forms of advanced liberal ‘(bio)power’. This generates academic and practical questions, since nurses—the largest group of healthcare professionals—have distinctive relations with their patients, who regard them as ‘independent’ and ‘caring experts’. Furthermore, it sheds light on the academic debate about the reconfiguration of professionalism by showing how certain ‘professional’ reconfigurations are not only unavoidable but unavoidably (bio)political as well.
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Affiliation(s)
- Jan-Luuk Hoff
- Utrecht University School of Governance, Utrecht University, 3511 ZC Utrecht, the Netherlands
| | - Marlot Kuiper
- Utrecht University School of Governance, Utrecht University, 3511 ZC Utrecht, the Netherlands
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17
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Paradis-Gagné E, Holmes D. Governing families that care for a sick relative: the contributions of Donzelot's theory for nursing. Nurs Philos 2021; 22:e12349. [PMID: 33544430 DOI: 10.1111/nup.12349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 01/07/2021] [Accepted: 01/24/2021] [Indexed: 12/22/2022]
Abstract
According to the literature, the family is now considered to be the most important resource for the care and support of a sick family member. Families are being increasingly invited and trained to play a utilitarian role, not just as family caregivers, but as healthcare agents. Healthcare institutions, based on neoliberal health policies, are encouraging them to perform increasingly complex and professionalized tasks. The burden associated with this expanded healthcare function, however, is significant (fatigue, emotional distress and exhaustion). The aim of this article was to present French sociologist Jacques Donzelot's theoretical perspective on governing through the family. According to Donzelot, such a government is exercised through various power techniques, including the instrumentalization of the family role and the transfer to families of the responsibility for health care. This author describes how healthcare institutions call on the family to perform hospital and biomedical practices within the home. A spin-off of neoliberalism, the practices of governing through families specifically target women, who are considered to be the pillar of the family. Donzelot's perspective is very relevant to nursing, but is still rarely mobilized in the discipline. His critical perspective allows for a re-reading of relations of power and mechanisms of surveillance and control of families, issues that are often overlooked in nursing research.
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Affiliation(s)
| | - Dave Holmes
- School of Nursing, University of Ottawa, Ottawa, ON, Canada
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Ravn IM, Beedholm K, Frederiksen K, Kvangarsnes M, Foss IC, Knutsen IR. In search of the changeable: An analysis of visual representations of nursing in Norwegian and Danish professional nursing journals, 1965–2016. Nurs Inq 2020; 27:e12340. [DOI: 10.1111/nin.12340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 12/10/2019] [Accepted: 12/14/2019] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | - Marit Kvangarsnes
- Norwegian University of Science and Technology, NTNU Ålesund Ålesund Norway
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Evans AM, Holmes D, Quinn C. Madness, sex, and risk: A poststructural analysis. Nurs Inq 2020; 27:e12359. [PMID: 32519411 DOI: 10.1111/nin.12359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 05/05/2020] [Accepted: 05/05/2020] [Indexed: 11/30/2022]
Abstract
The body of the one deemed mad often remains a sexual body with sexual needs. Mental health services respond to these demands of the body in various ways, including constructing rules around physical movement. In this context, we were interested in how mental health clinicians problematized the sexual needs and practices of residents of a long-stay mental health rehabilitation facility and how solutions were constructed in relation to the residents' sexual desires. This paper reports findings from mental health clinicians, as part of a case study where we addressed this question. Mental health clinicians responded to residents' sexuality from a discourse of risk. The notion of the engagement with each resident as a sexual subject was subordinated to the paternalistic notion of protecting the patient from risk. The resident became an object to be monitored and protected rather than a subject with sexual desire and agency. This paternalism also showed itself in relation to a 'no-sex on-site' rule that allowed for a shift of risk from the organization to the resident. Residents, rather than having a relatively safe place to have sexual relations, were required to find a place elsewhere, potentially unsafe, outside the facility.
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Affiliation(s)
- Alicia M Evans
- Australian Catholic University, Fitzroy, Vic., Australia
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Affiliation(s)
- Kylie M. Smith
- Andrew W Mellon Faculty Fellow for Nursing & The Humanities Nell Hodgson Woodruff School of Nursing Emory University Atlanta GA USA
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21
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Abstract
As nurses on this pale blue dot, the impending climate crisis requires us to engage with our world and communities differently if we hope to ensure our planetary survival, human and non. Imagining the next 50 years of nursing theory, we advance a posthuman critique of the discipline. In this article, we lay out a posthumanist critique of nursing. We urge nurses to critically engage with the realities that shape our present and future on a deteriorating planet, decentering the primacy of humans as we engage with the world all around and assemble posthuman tools for our analyses.
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22
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McMillan K, Perron A. Nurses’ engagement with power, voice and politics amidst restructuring efforts. Nurs Inq 2020; 27:e12345. [DOI: 10.1111/nin.12345] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 01/23/2020] [Accepted: 01/23/2020] [Indexed: 11/28/2022]
Affiliation(s)
| | - Amélie Perron
- School of Nursing University of Ottawa Ottawa ON Canada
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Molina-Mula J, Gallo-Estrada J. Impact of Nurse-Patient Relationship on Quality of Care and Patient Autonomy in Decision-Making. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030835. [PMID: 32013108 PMCID: PMC7036952 DOI: 10.3390/ijerph17030835] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 01/25/2020] [Accepted: 01/26/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND The patient is observed to acquire a passive role and the nurse an expert role with a maternalistic attitude. This relationship among others determines the capacity for autonomy in the decision making of patients. OBJECTIVES The aim of this study is to analyse the nurse-patient relationship and explore their implications for clinical practice, the impact on quality of care, and the decision-making capacity of patients. DESIGN A phenomenological qualitative study was conducted. SETTINGS AND PARTICIPANTS Thirteen in-depth interviews with nurses and 61,484 nursing records from internal medicine and specialties departments in a general hospital from 2015-2016. METHODS A discourse analysis and triangulation for these sources were conducted. RESULTS The category elaborated from nursing records was defined according to the following codes: Good Patient, Bad patient, and Social Problem. Analysis of the interviews resulted in a category defined as Patient as a passive object. DISCUSSION A good nurse-patient relationship reduces the days of hospital stay and improves the quality and satisfaction of both. However, in contrast, the good relationship is conditioned by the patient's submissive role. CONCLUSION An equal distribution of power allows decisions about health and disease processes to be acquired by patients, autonomously, with the advice of professionals. The nurse-patient relationship should not pursue the change in values and customs of the patient, but position the professional as a witness of the experience of the health and illness process in the patient and family.
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Asirifi MA. Reflecting on Leadership Development through Community Based Participatory Action Research. Int J Nurs Educ Scholarsh 2019; 16:ijnes-2018-0086. [PMID: 31539359 DOI: 10.1515/ijnes-2018-0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 05/06/2019] [Indexed: 11/15/2022]
Abstract
The need for leadership in nursing is well-documented and Domain Six of the doctoral section of the National Nursing Education Framework of the Canadian Association of Schools of Nursing (CASN) is Leadership. While there are likely many paths to achievement of these leadership components, the intent of this paper is to share my journey through iteration of and reflection on my PhD dissertation research focused on a four-cycle community-based participatory action research study (CBPR) related to clinical teaching in Ghana. The focus of CBPR is to engage the researcher and the participant group (community) in collaborative, and egalitarian processes to assess and problem solve an issue in the community. Similarly, leadership promotes collaborative interpersonal relationships among leaders and followers to address issues and institutes change strategies in policies. This paper presents my experiences in building leadership capacity through this scholarly endeavor (PhD thesis) in relation to the CASN guideline.
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Affiliation(s)
- Mary Asor Asirifi
- Nursing, University of Alberta, 4-174 Edmonton Clinic Health Academy, 11405 - 87 Avenue, Edmonton, AlbertaT6G 2R3, Canada
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Paradis-Gagné É, Holmes D. Donzelot et le gouvernement des familles : une analyse critique des modèles systémiques en sciences infirmières. Rech Soins Infirm 2019:7-15. [DOI: 10.3917/rsi.136.0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Dillard-Wright J. Electronic health record as a panopticon: A disciplinary apparatus in nursing practice. Nurs Philos 2019; 20:e12239. [PMID: 30821896 DOI: 10.1111/nup.12239] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 02/05/2019] [Accepted: 02/05/2019] [Indexed: 12/17/2022]
Abstract
The specific arrangements of power/knowledge that characterize nurse interactions with the electronic health record form a panopticon. As health care moves into the 21st century, sophisticated technologies like the electronic health record shape the terrain of professional possibilities. The longer it is in use, the more it is possible to excavate the inherent disciplinary function of electronic health record. A panopticon is a generalizable, replicable apparatus of power that cultivates discipline when similar behaviours are desired from a group of people. This paper traces the arrangements of power/knowledge that characterize nurse interactions with the electronic health record rooted in a trauma critical care setting. Examining the apparatuses of power/knowledge enforced through panopticism in nursing makes the invisible visible. This in turn enables nurses to address the intended and unintended consequences of the electronic health record. If nurses are to effectively shape the direction of their own futures and the future of health care, nurses will need to unpack the invisible techniques of power such as the electronic health record as a panopticon. In the process of building a visible identity, contextualizing nursing knowledge to better care for patients on the one hand and understand the relationships of power that limit us on the other, nurses are neither apolitical nor powerless. Considering the dialectic of power/knowledge in the healthcare setting helps to illuminate spaces to recharacterize nursing, reveal the contributions and knowledge of nurses, and consolidate the professional power of nurses to affect meaningful change and self-governance in the healthcare setting.
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Block K, Croft A, Schmader T. Worth Less?: Why Men (and Women) Devalue Care-Oriented Careers. Front Psychol 2018; 9:1353. [PMID: 30147665 PMCID: PMC6095964 DOI: 10.3389/fpsyg.2018.01353] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 07/13/2018] [Indexed: 11/20/2022] Open
Abstract
In the present research, we applied a goal-congruity perspective – the proposition that men and women seek out roles that afford their internalized values (Diekman et al., 2017) – to better understand the degree to which careers in healthcare, early education, and domestic roles (HEED; Croft et al., 2015) are devalued in society. Our first goal was to test the hypothesis that men, relative to women, are less interested in pursuing HEED careers in part because they are less likely than women to endorse communal values. A second, more novel goal was to extend goal congruity theory to examine whether gender differences in communal values also predict the belief that HEED careers add worth to society and are deserving of higher salaries. In three studies of undergraduate students (total N = 979), we tested the predictive role of communal values (i.e., a focus on caring for others), as distinct from agentic values (i.e., a focus on status, competition, and wealth; Bakan, 1966). Consistent with goal congruity theory, Studies 1 and 2 revealed that men’s lower interest in adopting HEED careers, such as nursing and elementary education, was partially mediated by men’s (compared to women’s) lower communal values. Extending the theory, all three studies also documented a general tendency to see HEED as having relatively lower worth to society compared to STEM careers. As expected, communal values predicted perceiving higher societal worth in HEED careers, as well as supporting increases in HEED salaries. Thus, gender differences in communal values accounted for men’s (compared to women’s) tendency to perceive HEED careers as having less societal worth and less deserving of salary increases. In turn, gender differences in perceived societal worth of HEED itself predicted men’s relatively lower interest in pursuing HEED careers. In no instance, did agentic values better explain the gender difference in HEED interest or perceived worth. These findings have important implications for how we understand the value that society places on occupations typically occupied by women versus men.
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Affiliation(s)
- Katharina Block
- Department of Psychology, The University of British Columbia, Vancouver, BC, Canada
| | - Alyssa Croft
- Department of Psychology, The University of Arizona, Tucson, AZ, United States
| | - Toni Schmader
- Department of Psychology, The University of British Columbia, Vancouver, BC, Canada
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Delvin ME, Braithwaite S, Camargo Plazas P. Canadian nurse practitioner's quest for identity: A philosophical perspective. Int J Nurs Sci 2018; 5:110-114. [PMID: 31406811 PMCID: PMC6626291 DOI: 10.1016/j.ijnss.2018.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 03/05/2018] [Accepted: 03/05/2018] [Indexed: 11/06/2022] Open
Abstract
The role of nurse practitioners in primary healthcare has been validated over the years and is now being considered as a key solution in various primary healthcare settings to the provision of comprehensive care. The context in which the role has been established positions nurse practitioners' practice within medical and nursing paradigms. As the healthcare system evolves, nurse practitioners must define their identity to advocate for roles that reflect their professional values. A historical overview highlighting the context in which the NP role expanded will guide a philosophical discussion regarding role identity. After exposing tensions between the nursing and medicine disciplines, Abbots' theory of profession will be utilized to understand the foundations leading to initial research on nurse practitioner integration within the healthcare system. Feminist philosopher bell hooks' discourse on marginality will serve as a platform to reflect on the nurse practitioner identity within the current social context. Foucault's notions of governmentality, parrhesia and care of the self will then guide reflections regarding ways for nurse practitioners to locate themselves as a profession.
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Affiliation(s)
- Marie-Elaine Delvin
- School of Nursing, Queen's University, 82 Barrie Street, Kingston, Ontario, K7L 3N6, Canada
| | - Suzanne Braithwaite
- School of Nursing, Queen's University, 82 Barrie Street, Kingston, Ontario, K7L 3N6, Canada
| | - Pilar Camargo Plazas
- School of Nursing, Queen's University, 82 Barrie Street, Kingston, Ontario, K7L 3N6, Canada
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29
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Molina-Mula J, Peter E, Gallo-Estrada J, Perelló-Campaner C. Instrumentalisation of the health system: An examination of the impact on nursing practice and patient autonomy. Nurs Inq 2018; 25. [PMID: 28580614 DOI: 10.1111/nin.12201] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2017] [Indexed: 02/05/2023]
Abstract
Most current management systems of healthcare institutions correspond to a model of market ethics with its demands of competitiveness. This approach has been called managerialism and is couched in terms of much-needed efficiencies and effective management of budgetary constraints. The aim of this study was to analyse the decision-making of nurses through the impact of health institution management models on clinical practice. Based on Foucault's ethical theory, a qualitative study was conducted through a discourse analysis of the nursing records in a hospital unit. The results revealed that the health institution standardises health care practice, which has an impact on professional and patient autonomy as it pertains to decision-making. The results of this research indicate that resistance strategies in the internal structures of health organisations can replace the normalisation and instrumentalisation of professional practice aimed at promoting patient self-determination.
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Affiliation(s)
- Jesús Molina-Mula
- Nursing and Physiotherapy Department, University of Balearic Islands, Palma de Mallorca, Spain
| | - Elizabeth Peter
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Canada
| | - Julia Gallo-Estrada
- Nursing and Physiotherapy Department, University of Balearic Islands, Palma de Mallorca, Spain
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30
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Stahlke Wall S. The impact of regulatory perspectives and practices on professional innovation in nursing. Nurs Inq 2017; 25. [PMID: 28677848 DOI: 10.1111/nin.12212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2017] [Indexed: 11/30/2022]
Abstract
Since at least the 1970s in Canada, there have been calls for health system reforms based on innovative roles and expanded scopes of practice for nurses. Professional regulatory organizations, through legislation, define the standards and parameters of professional nursing practice. Nursing regulators emphasize public protection over the advancement of nursing; regulatory processes and decisions tend to be conservative and risk-averse. This study explored the impact that regulatory processes have on innovation in nursing roles. Nurses in a range of unique practice situations were interviewed, including nurses in non-traditional roles and/or settings, those with cross-jurisdictional career histories, and those working in interdisciplinary practices and educational settings. For these nurses, nursing practice was viewed through a traditional clinical lens, which did not fit for them. They experienced hassle, delay, and inconsistencies in regulatory practices. They felt mistreated and fearful of the regulator and lamented the ways in which ambitious, creative, capable nurses were stymied in attempting new applications for nursing knowledge. Nursing is constraining its own mandate to contribute to health care through stringent licensing processes. Healthcare reform provides an opportunity for nursing regulators to rethink their processes and provide the latitude for nurse-driven change.
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31
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Udod S, Racine L. A Critical Perspective on Relations between Staff Nurses and their Nurse Manager: Advancing Nurse Empowerment Theory. Can J Nurs Res 2017; 46:83-100. [PMID: 29509459 DOI: 10.1177/084456211404600407] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study considers empowerment in nurse-manager relations by examining how conflict is handled on both sides and how the critical social perspective has influenced these relations. The authors use inductive analysis of empirical data to explain how (1) nursing work is organized, structured, and circumscribed by centrally determined policies and practices that downplay nurses' professional judgement about patient care; (2) power is held over nurses in their relationship with their manager; and (3) nurses' response to power is to engage in strategies of resistance. The authors illustrate how power influences relations between staff nurses and managers and provide a critical analysis of the strategies of resistance that result in personal, relational, and critical empowerment among staff nurses. Through resistance, staff nurses engage in alternative discourses to counteract the prevailing neoliberal organizational and managerial discourses of efficiency and cost-effectiveness.
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Affiliation(s)
- Sonia Udod
- College of Nursing, University of Saskatchewan, Saskatoon, Canada
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32
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Abstract
In this article the author explores the possibility of the emergence of nursing laws as a natural consequence of the maturation and evolution of selected areas of nursing knowledge. To support this proposition, the evolution of social and scientific laws and their meanings are discussed. In addition, the roles that empirical validation and logical adequacy play in epistemological development, including the development of discipline-specific laws, are explored. Two areas of nursing knowledge in which laws may be emerging, as well as the foundation of these laws, are identified.
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33
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Smith KM, Brown A, Crookes PA. History as reflective practice: A model for integrating historical studies into nurse education. Collegian 2015; 22:341-7. [PMID: 26552206 DOI: 10.1016/j.colegn.2014.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The role of history in developing professional identity in nursing is well known, and the discipline of nursing history research continues to flourish. Yet this work often struggles to find its way into undergraduate university nurse education courses. We put forward a model for "history as reflective practice" in which we suggest that historical studies can be used as a form of evidence to develop critical thinking and clinical reasoning, as well as situate nursing practice within its social and political context. In this model, we draw on historical scholarship related to the profession, practice and person, focusing on work which demonstrates nursing's contribution to broader systems of health care. Drawing on Lewenson and Lynaugh's 'history by stealth' approach, curriculum mapping and constructive alignment techniques are used to identify the moments in an existing programme where historical scholarship is relevant to an intended learning outcome. We then use an interdisciplinary team to develop learning activities and assessment tasks drawing on both primary and secondary sources that are then embedded within existing subjects. This model encourages students to consider history as a way of knowing and as a form of evidence within their reflective practice. Furthermore, it creates knowledge that continues to foster and acknowledge nurses', and nursing's, contribution to the development of human health.
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34
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Madariaga JC. La historia de la Ley de Responsabilidad Penal de menores de edad en Chile: un ejercicio genealógico y una propuesta de análisis. FRACTAL: REVISTA DE PSICOLOGIA 2015. [DOI: 10.1590/1984-0292/1652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumen El año 2007 comenzó a regir en Chile la ley de responsabilidad penal de menores de edad. Como consecuencia se han desarrollado una serie de programas orientados a intervenir adolescentes, con un fuerte énfasis en el tratamiento y rehabilitación de consumo de sustancias. En el presente trabajo, se busca mirar dicho proceso desde una perspectiva crítica, utilizando un abordaje genealógico. Se da cuenta del surgimiento de un nuevo ámbito de acción para los saberes psi, el joven infractor de ley, como resultado de procesos de configuración y articulación de tres ámbitos de gobierno: el castigo y la privación de libertad, el cuidado de los menores de edad y el control del consumo de drogas. Se concluye con la propuesta de un marco comprensivo crítico para el análisis de las prácticas y los discursos en torno a la intervención de este nuevo sujeto.
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35
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Devereaux A. Pandemic influenza: an evolutionary concept analysis. J Adv Nurs 2015; 71:1787-96. [DOI: 10.1111/jan.12654] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Alana Devereaux
- Faculty of Health Sciences; School of Nursing; University of Ottawa; Ontario Canada
- The Ottawa Hospital; Ontario Canada
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36
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Perron A. Nursing as 'disobedient' practice: care of the nurse's self, parrhesia, and the dismantling of a baseless paradox. Nurs Philos 2014; 14:154-67. [PMID: 23745657 DOI: 10.1111/nup.12015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
In this paper, I discuss nurses' ongoing difficulty in engaging with politics and address the persistent belief that political positioning is antithetical to quality nursing care. I suggest that nurses are not faced with choosing either caring for their patients or engaging with politics. I base my discussion on the assumption that such dichotomy is meaningless and that engaging with issues of relationships firmly grounds nursing in the realm of politics. I argue that the ethical merit of nursing care relies instead on positioning nurses squarely at the centre of care activities, experiences, and functions. Such positioning makes possible what Foucault called 'practices of self-formation', that is, micro-level processes that balance out the ubiquitous economic, cultural, legal, and scientific technologies that steadily constitute subjects in this era of modernity. Nurses, then, become not a group that needs to be controlled and governed, but individuals who must care for their self before they may care for anyone else.
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Affiliation(s)
- Amélie Perron
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ontario, Canada.
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37
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Guta A, Strike C, Flicker S, Murray SJ, Upshur R, Myers T. Governing through community-based research: lessons from the Canadian HIV research sector. Soc Sci Med 2014; 123:250-61. [PMID: 25074512 DOI: 10.1016/j.socscimed.2014.07.028] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Revised: 05/22/2014] [Accepted: 07/12/2014] [Indexed: 11/20/2022]
Abstract
The "general public" and specific "communities" are increasingly being integrated into scientific decision-making. This shift emphasizes "scientific citizenship" and collaboration between interdisciplinary scientists, lay people, and multi-sector stakeholders (universities, healthcare, and government). The objective of this paper is to problematize these developments through a theoretically informed reading of empirical data that describes the consequences of bringing together actors in the Canadian HIV community-based research (CBR) movement. Drawing on Foucauldian "governmentality" the complex inner workings of the impetus to conduct collaborative research are explored. The analysis offered surfaces the ways in which a formalized approach to CBR, as promoted through state funding mechanisms, determines the structure and limits of engagement while simultaneously reinforcing the need for finer grained knowledge about marginalized communities. Here, discourses about risk merge with notions of "scientific citizenship" to implicate both researchers and communities in a process of governance.
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38
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Affiliation(s)
- David A Nicholls
- School of Rehabilitation and Occupation Studies, Auckland University of Technology, Auckland, New Zealand
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39
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Jenkins EK. The politics of knowledge: implications for understanding and addressing mental health and illness. Nurs Inq 2013; 21:3-10. [PMID: 23517498 DOI: 10.1111/nin.12026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2013] [Indexed: 11/29/2022]
Abstract
While knowledge represents a valuable commodity, not all forms of knowledge are afforded equal status. The politics of knowledge, which entails the privileging of particular ways of knowing through linkages between the producers of knowledge and other bearers of authority or influence, represents a powerful force driving knowledge development. Within the health research and practice community, biomedical knowledge (i.e. knowledge pertaining to the biological factors influencing health) has been afforded a privileged position, shaping the health research and practice community's view of health, illness and appropriate intervention. The aim of this study is to spark critical reflection and dialogue surrounding the ways in which the politics of knowledge have constrained progress in addressing mental health and illness, one of today's leading public health issues. I argue that the hegemony of biological knowledge represents an ethical issue as it limits the breadth of knowledge available to support practitioners to 'do good' in terms of addressing mental illness. Given the power and influence inherent within the nursing community, I propose that nurses ought to engage in critical reflection and action in an effort to better situate the health research and practice community to effectively address the mental health of populations.
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Affiliation(s)
- Emily K Jenkins
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
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40
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Nicholls DA, Holmes D. Discipline, desire, and transgression in physiotherapy practice. Physiother Theory Pract 2012; 28:454-65. [DOI: 10.3109/09593985.2012.676940] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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41
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Hurley J. The lifeworld characteristics of mental health nurses engaging in talk-based therapies: a qualitative study from Scotland and England. J Psychiatr Ment Health Nurs 2012; 19:303-9. [PMID: 22074458 DOI: 10.1111/j.1365-2850.2011.01788.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Twenty-four mental health nurses were interviewed to gain a greater understanding of their experiences of working within roles delivering talk-based therapies. The study participants, while echoing the broad direction and purpose of policy that supports mental health nurses expanding talk-based therapy roles, also offered insights into the challenges associated with embedding these roles into mental health settings. One area of findings analysed using Nvivo 8 software related to the characteristics of the environments in which these roles are, or will be enacted. Three key characteristics of these environments were: (1) low power and worth; (2) obstacles to success; and (3) uncertainty. Responses to the challenges found within this study are required from individual nurses, local organizations and strategic levels of nursing to ensure the successful implementation and uptake of talk-based therapy roles into the mental health nursing profession.
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Affiliation(s)
- J Hurley
- Southern Cross University, School of Health and Human Sciences, Coffs Harbour, NSW 2450, Australia.
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Miró M, Gastaldo D, Nelson S, Gallego G. Spanish nursing under Franco: reinvention, modernization and repression (1956-1976). Nurs Inq 2011; 19:270-80. [DOI: 10.1111/j.1440-1800.2011.00565.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Racine L, Perron A. Unmasking the predicament of cultural voyeurism: a postcolonial analysis of international nursing placements. Nurs Inq 2011; 19:190-201. [DOI: 10.1111/j.1440-1800.2011.00555.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Clark FA. Power and Confidence in Professions: Lessons for Occupational Therapy. The Canadian Journal of Occupational Therapy 2010; 77:264-9. [DOI: 10.2182/cjot.2010.01.77.5.2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Background. Powerful professions have the capacity to obtain leadership positions, advocate successfully in the policy arena, and secure the resources necessary to achieve their professional goals. Within the occupational therapy profession, cultivating power and confidence among our practitioners is essential to realize our full capacity for meeting society's occupational needs.Purpose and Key Issues. Drawing from a historical analysis of the medical and nursing professions, this paper discusses the implications of power and disempowerment among health professions for their practitioners, clients, and public image. Theoretical perspectives on power from social psychology, politics, organizational management, and post-structuralism are introduced and their relevance to the profession of occupational therapy is examined.Implications. The paper concludes with recommendations for occupational therapy practitioners to analyze their individual sources of power and evaluate opportunities to develop confidence and secure power for their professional work—in venues both in and outside the workplace.
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Ristovski-Slijepcevic S, Chapman GE, Beagan BL. Being a ‘good mother’: Dietary governmentality in the family food practices of three ethnocultural groups in Canada. Health (London) 2010; 14:467-83. [DOI: 10.1177/1363459309357267] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this qualitative study with three ethnocultural groups in two regions of Canada, we explore how official dietary guidelines provide particular standards concerning ‘healthy eating’ that marginalize other understandings of the relationship between food and health. In families where parents and youth held shared ways of understanding healthy eating, the role of ‘good mother’ was constructed so as to include healthy eating expertise. Mothers expressed a perceived need to be personally responsible for providing skills and knowledge about healthy eating as well as guarding children against negative nutritional influences. Governing of family eating practices to conform to official nutritional advice occurred through information provision, monitoring in shopping and meal preparation, restricting and guiding food purchases, and directly translating expert knowledges into family food practices. In families where parents and youth held differing understandings of healthy eating, primarily families from ethnocultural minority groups, mothers often did not employ the particular western-originating strategies of conveying healthy eating information, or mentoring healthy meal preparation, nor did they regulate or restrict children’s food consumption. Western dietary guidelines entered into the family primarily through the youth, emphasizing the nutritional properties of food, often devaluing ‘traditional’ knowledge about healthy eating. These processes exemplify techniques of governmentality which simultaneously exercise control over people’s behaviour through normalizing some family food practices and marginalizing others.
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Zaforteza Lallemand C, Prieto González S, Canet Ferrer TP, Díaz López Y, Molina Santiago M, Moreno Mulet C, Nieto González A, Sánchez Martín A, Val Pérez JV. [Improving the care of critical patient family members: Agreed on strategies]. ENFERMERIA INTENSIVA 2010; 21:11-9. [PMID: 20170831 DOI: 10.1016/j.enfi.2009.07.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2009] [Accepted: 07/20/2009] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Within the context of participatory action research (PAR), a 4-stage process was established with the general aim of promoting improvements in the care offered to families of patients in the Intensive Care Unit (ICU). The 4 stages consisted of a situational diagnosis, proposals for change, the design and implementation of the proposals, and an evaluation. This paper presents the first 2 stages. OBJECTIVES To define the attention given to families of patients in the Intensive Care Unit. To reach a consensus on areas for action/intervention in the unit. MATERIALS AND METHOD A qualitative methodology. DESIGN PAR. Data-collection technique: 4 focus groups made up of 10 professionals, and consensus with support groups made up of 30 members. Content analysis was performed. The theoretical saturation point was reached. RESULTS Two documents were drawn up: 1) A situational diagnosis, describing the current situation of the attention given to families and 2) 10 proposals for change, 5 of which were given priority. They were: a session to familiarize professionals with evidence concerning families of patients in the ICU and the handing out of informative leaflets, the improvement of (nurse-family and intra-team) informative procedures, more privacy for patients and a reduction in environmental noise, a training plan for professionals, and change in the visiting policy. CONCLUSION By using consensus-based methodologies, strategies for change can be prioritized and designed, adapted to the context in which they will be applied.
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Affiliation(s)
- C Zaforteza Lallemand
- Departament d'Infermeria i Fisioteràpia, Universitat de les Illes Balears, Palma de Mallorca, Islas Baleares, España.
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Gagnon M, Jacob JD, Holmes D. Governing through (in)security: a critical analysis of a fear-based public health campaign. CRITICAL PUBLIC HEALTH 2010. [DOI: 10.1080/09581590903314092] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Gibson BE, Nixon SA, Nicholls DA. Critical reflections on the physiotherapy profession in Canada. Physiother Can 2010; 62:98-100, 101- 3. [PMID: 21359039 PMCID: PMC2871015 DOI: 10.3138/physio.62.2.98] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Zaforteza Lallemand C, García Mozo A, Quintana Carbonero R, Sánchez Calvín C, Abadía Ortiz E, Albert Miró Gayà J. [Opening the intensive care unit to families: what do the professionals think?]. ENFERMERIA INTENSIVA 2010; 21:52-7. [PMID: 20447585 DOI: 10.1016/j.enfi.2009.03.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2009] [Accepted: 03/24/2009] [Indexed: 11/24/2022]
Abstract
AIM A participatory action-research was conducted in an intensive care unit (ICU). A consensus was reached on four proposals for change regarding how to deal with the relatives of the critically ill patients, extending their visiting hours being one of these proposals. This study has aimed to ascertain the contributions of the unit professionals to a new proposal regarding visiting hours. PARTICIPANTS AND METHODS The sample included 93 ICU professionals out of 205. A qualitative methodology study that included a two-item open survey was used: 1. Yes, I agree with the proposal (explain how you would improve it); 2. No, I do not agree with the proposal (explain why and how you would improve it). Content analysis and triangulation of researchers and participants were performed. The theoretical saturation point was reached. RESULTS Five categories emerged: 1) Modify the initial proposal; 2) Agreement with the proposal; 3) Doubts; 4) Barriers to implementation; 5) Flexibilization. CONCLUSIONS ICU professionals are reluctant to open their units, but accept the extension of current visiting hours. The physical structure of the unit is perceived as a major barrier.
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Affiliation(s)
- C Zaforteza Lallemand
- Escola y Departament d'Infermeria i Fisioteràpia, Universitat de les Illes Balears, Illes Balears, España.
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