Transformative ‘cultural shifts' in nursing: participatory action research and the ’project of possibility‘Robinson, Andrew
doi: 10.1111/j.1440-1800.1995.tb00069.xpmid: 7664151
Transformative ‘cultural shifts’ in nursing: participatory action research and the lsquo;project of possibility’ For some time scholars have called for changes in nursing in order to address the subjugated position of nurses within health care. This paper argues that through an engagement with participatory action research, nurses open up a possibility to bring about transformative shifts in nursing culture. The motivation for nurses to engage with this research process arises out of an acknowledgement that they can no longer live with the sense of pain and crisis endemic in much of their nursing practice, and a desire to take action to bring about transformative change within their local ward cultures. However, their participation in critical reflective and collaborative processes that underpin action research exposes an array of minor scattered nursing practices which frustrate possibilities for transformative change. Drawing on empirical accounts from research conducted by the author, the paper argues that once made explicit, these minor practices and the regimes of truth that nurture and sustain them, can be reconstructed and the possibility of transformative cultural shifts in nursing will then emerge.
Telling a story, writing a narrative: terminology in health careWiltshire, John
doi: 10.1111/j.1440-1800.1995.tb00070.xpmid: 7664152
Telling a story, writing a narrative: terminology in health care This paper examines the current use of the terms ‘story’, ‘narrative’ and ‘voice’ within health care. It argues that the focus on narrative forms is related to nursing's professional development of an alternative epistemology to science, and to nursing theorists' mistrust of ‘Enlightenment’ modes. However, in order for this project to be productively developed it is necessary to distinguish story from narrative: the former is an informal activity, the latter is meditative and theoretical. Both have dierapeutic dimensions.
Professionalism as ideology: a socio‐historical analysis of the discourse of professionalism in nursingTurkoski, Beatrice B.
doi: 10.1111/j.1440-1800.1995.tb00071.xpmid: 7664153
Professionalism as ideology: a socio‐historical analysis of the discourse of professionalism in nursing For most of this century, extensive and heated discourse has surrounded defining, conceptualizing, and implementing nursing professionalism. These discussions, for the most part, have approached professionalism as a set of universal, unchanging, objectively‐measured criteria. This study explores professionalism as an ideology; an image drat a social group gives of itself to itself, as a community with a history and identity. Analyses of eight decades of the American Journal of Nursing identify ways that the language of professionalism gives meaning to changing and competing social structures through rationalization and legitimation. The study further identifies how change has often been illusionary, illuminating how the language of professionalism has served to legitimate, and conceal reality. Identifying and understanding how political, social, and economic domination and asymmetry are rationalized and legitimated through language and ideology will allow nursing to demystify constraints and coercion in the delivery of health care. School of Nursing Graduate Faculty, Kent State University, Kent OH 44242, USA
Courting competency: nursing and the politics of performance in practiceWalker, Kim
doi: 10.1111/j.1440-1800.1995.tb00072.xpmid: 7664154
Courting competency: nursing and the politics of performance in practice Nurses have long anguished over how best to assess performance in clinical practice. The ‘competency’ movement appears to have provided a solution to this problem. In this paper I undertake a ‘radical hermeneutic’ interrogation of the cultural text of clinical practice doubled with a poststructuralist interpretation of the literal text of the Australian competency project. Through this work I attempt to expose some of the deeply embedded assumptions that underwrite the competency movement and amplify the problems posed by an uncritical appropriation of competency based training and assessment in nursing education.
Foucault and modern medicinePeerson, Anita
doi: 10.1111/j.1440-1800.1995.tb00073.xpmid: 7664146
Foucault and modern medicine Modernity as a concept or ideal, resulting from the age of Enlightenment and the French Revolution gave hope of a better future and new possibilities. To be modern means an ‘enlightened’ individual and society, welcoming change and development. In this paper, I will discuss Foucault's analysis (1973) of problematics in medicine in eighteenth century France. Three themes prominent in the text are: ‘the birth of the clinic’, ‘the clinical gaze’ and the power‐knowledge relationship. Three problematics identified in modern medicine by Foucault and which are particularly relevant to twentieth century medicine are: (i) the extension of the clinical gaze from the individual body to the wider population; (ii) the increasing medical intervention and use of technology in fundamental life processes; and (iii) the relationship between society and medicine. I will argue that Foucault's analysis is fraught with ambiguities. It is useful, however, for establishing an explanation for medicine today and for presenting a particular interpretation of modernity.