Now showing 1 - 4 of 4
  • Publication
    Modes of rationality in nursing documentation: biology, biography and the 'voice of nursing'
    This article is based on a discourse analysis of the complete nursing records of 45 patients, and concerns the modes of rationality that mediated text-based accounts relating to patient care that nurses recorded. The analysis draws on the work of the critical theorist, Jurgen Habermas, who conceptualised rationality in the context of modernity according to two types: purposive rationality based on an instrumental logic, and value rationality based on ethical considerations and moral reasoning. Our analysis revealed that purposive rationality dominated the content of nursing documentation, as evidenced by a particularly bio-centric and modernist construction of the workings of the body within the texts. There was little reference in the documentation to central themes of contemporary nursing discourses, such as notions of partnership, autonomy, and self-determination, which are associated with value rationality. Drawing on Habermas, we argue that this nursing documentation depicted the colonisation of the sociocultural lifeworld by the bio-technocratic system. Where nurses recorded disagreements that patients had with medical regimes, the central struggle inherent in the project of modernity became transparent--the tension between the rational and instrumental control of people through scientific regulation and the autonomy of the subject. The article concludes by problematising communicative action within the context of nursing practice
      1158Scopus© Citations 37
  • Publication
    Nurse teachers' constructions of reflection and reflective practice
    (Taylor & Francis (Routledge), 2010-08-18) ; ;
    This article concerns the meanings that a sample of nurse teachers ascribed to the concepts of reflection and reflective practice as aspects of an undergraduate nursing curriculum. It represents one of the major findings in a qualitative study that set out to explore nurse teachers’ perceptions and experiences of using reflection with diploma nursing students in the Republic of Ireland. Eleven nurse teachers were interviewed intensively, and data were analysed using a strategy resembling grounded theory. Two major themes were identified: reflection and reflective practice as a way of reviewing clinical experiences, and reflection and reflective practice as a way of valuing, developing and professionalising nursing practice knowledge. There was evidence that reflective practice was compartmentalised on nursing curricula, and some participants reported having limited knowledge of reflection. A number of participants alluded to the potential for reflective practice to uncover the hidden wealth of knowledge in everyday nursing practice. There appeared, however, to be a risk that this perceived wealth may be a conceptualisation of the teachers, rather than the students. Reflective learning through the affective domain was perceived as central to caring.
      994Scopus© Citations 22
  • Publication
    Alcohol consumption among 11-16 year olds:"Getting around" structural barriers?
    This paper presents qualitative data from Irish children and adolescents on their experiences in relation to alcohol consumption. A sample of 78 participants (average age 11.5 years) was selected. A proportion of this initial sample were interviewed at intervals over a period of 3 years. The participants’ consumption patterns were analyzed and four categories were generated: covert unsanctioned, overt unsanctioned, overt sanctioned, and peer unsanctioned. As the children got older, peer drinking became a stronger feature of the data; however, it mediated other patterns of behavior. Although the children displayed agency in circumventing adult rules relating to alcohol consumption, the participants were subjected to structural constraints by virtue of their status as children. Moreover, the agentic powers of the participants were procured through their social network rather than arising from an essentialist agency possessed by each individual child. The impact of childhood as a structural dimension weakened to some extent as the participants got older and had more freedom to circumvent adult-defined barriers to alcohol consumption.
      434Scopus© Citations 7
  • Publication
    Social regulation, medicalisation and the nurse's role: insights from an analysis of nursing documentation
    Background: Medicine is recognised as a dominant source of governmentality and social regulation, and although nursing has been implicated in the same process, analytical work in this area has been sparse. Objectives: The article aims to present an analysis of nursing records in order to understand the structural and social processes that mediate the texts. Methods: 45 sets of nursing records drawn from four clinical sites in Ireland were subjected to a discourse analysis. Results: This article focuses on two main themes that were derived from data: (i) the manner in which nurses controlled, regulated and invigilated patients' activities of daily living and (ii) the way in which activities of daily living were mediated by a biomedical worldview in the clinical settings. Through the organising framework of Activities of Daily Living (ADLs), normative social practices relating to hygiene, eating and drinking, sleeping and so forth were surveyed and monitored within clinical settings. We construct qualitative categories around a range of ways that nurses assessed and judged patients' capacities at ADLs. Furthermore, it is argued that the framework of ADLs epitomises the medicalisation of normative social practices, whereupon the most mundane of normal functions become redefined as an actual or potential clinical pathology, legitimating nursing interventions. According to the nursing documentation, biochemical interventions in the form of various medications were the most dominant means through which nurses attempted to restore or improve the functional capacity of an ADL. Conclusion: We conclude by proposing that nurses' invigilation of patients' ADLs is not necessarily a repressive feature of nursing practice, but rather has the potential to be used to advocate on patients' behalf in certain circumstances.
      2616Scopus© Citations 27