Political dreams, practical boundaries: the case of the Nursing Minimum Data Set, 1983-1990

The initial development of the Nursing Minimum Data Set (NMDS) was analyzed based on archival material from Harriet Werley and Norma Lang, two nurses involved with the project, and American Nurses Association materials. The process of identifying information to be included in the NMDS was contentious. Individual nurses argued on behalf of particular data because of a strong belief in how nursing practice (through information collection) should be structured. Little attention was paid to existing practice conditions that would ultimately determine whether the NMDS would be used.

Observing your patient

The importance of the nurse being with her patient and observing them has been emphasized many times, especially by Florence Nightingale:

Problematizing special observation in psychiatry: Foucault, archaeology, genealogy, discourse and power/knowledge

Special observation by mental health professionals is the recommended approach for those people deemed as at risk or risky. Recent research and academic writing have challenged the benefits of observing people/patients who are defined as 'at risk', and a more human engagement process is being recommended. Despite this assault, practice has not changed substantively, suggesting a need for a thorough exploration and questioning of the practices and process. The paper outlines three Foucaultian approaches to historical analysis. It applies aspects of Foucault's archaeology/genealogy, discourse and power/knowledge to explore the practices of special observation as a means of controlling risk, especially suicide risk. We identify the regulatory function of the 'gaze', professional codes and government policy in relation to restricting professional practices. We argue that observation can be related to moral therapy, wherein the person relinquishes madness for responsibility through a disciplinary process and, in governing risk, a 'professional industry' is created. The regulation of statements about people with mental health issues are exposed and related to what can be said and done by professionals. Finally, we look at productive power in relation to observation, and how it is intimately related to resistance. We conclude with 'soft' recommendations for practice discursively produced through the writing of the paper.

Embracing bioethics in neonatal intensive care, part I: evolving toward neonatal evidence-based ethics

Ethical treatment dilemmas are not new to the NICU. With technologic advances over the past 20 years, NICU care has developed rapidly, and survival rates have improved for some of the tiniest and most critically ill infants. In guiding clinical practice, however, standards in evidenced-based medicine have often superseded standards in evidence-based ethics. Part I of this article presents a historical review of neonatal care and an overview of cases that have set precedents in neonatal ethical debate. It also includes recommendations for enhancing the skills of neonatal nurses as patient advocates in NICU ethical issues, an area that is, at times, controversial and baffling to clinicians.

Male pelvic floor: history and update

Our understanding of the male pelvic floor has evolved over more than 2,000 years. Gradually medical science has sought to dispel ancient myths and untruths. The male pelvic floor has many diverse functions. Importantly, it helps to support the abdominal contents, maintains urinary and fecal continence, and plays a major role in gaining and maintaining penile erection. Weakness of the male pelvic floor muscles may cause urinary and fecal incontinence and erectile dysfunction. Function may be restored in each of these areas by a comprehensive pelvic floor muscle training program. Spasm of the pelvic floor muscles may produce pain and require relaxation techniques. Additional research is needed to add further evidence to our knowledge base.

Peplau in cyberspace: an analysis of Peplau's Interpersonal Relations Theory and computer-mediated communication

This paper explores the applicability of Peplau's Interpersonal Relations Theory to the context of computer-mediated communication. Although Peplau never intended her theory be applied to this mode of communication, research from the fields of communication and social psychology suggest that such application may be possible. After Peplau's theory is briefly summarized, research and theory dealing with computer-mediated communication are explored, and questions for future research endeavors are offered.