The construction of feminist pedagogy in nursing education: a preliminary critique

This project was completed in response to articles that have appeared in nursing journals calling for feminist pedagogy. The object of inquiry is the current discourse of feminist pedagogy. In critiquing the discourse, Foucault's notion of "regime of truth" was used as a tool for analysis. It is the author's contention that feminist pedagogy, as currently constructed in nursing education, has likened Freire's notion of liberatory education with feminist scholarship. Feminist scholarship has taken a subordinate role to stories of classroom processes. Many so-called feminist strategies are, in reality, progressive educational strategies adorned with seductive language. Adopting a questioning stance, rather than merely proclaiming that "all is bliss" in the feminist classroom, would benefit all who are involved in the construction of feminist pedagogy. If nursing education is to seriously engage with feminist scholarship, as the author believes it must do, then it must not play a secondary role in feminist pedagogy.     

Extended, expanded, multi-skilled or advanced practice?--rural nurses in Australia, 1991-1994

Rural nurses in Australia predominantly work in an advanced practice role and their scope of practice is determined by the number and type of health professionals who work full-time or part-time in the health service. This paper presents the results of a discourse analysis, using Foucault's framework, of rural nurses in Australia, 1991-1994. It argues that the use of the statements 'extended nursing practice', 'expanded nursing practice', and 'multi-skilled nurses' continues to subjugate rural nursing practice to more dominant discourses such as medicine, pharmacy and radiography. It proposes the term advanced rural nursing practice be used to refer to the generalist scope of nursing practice in rural areas.     

Philosophy of science in doctoral nursing education revisited

Because every scientific theory and all research methods are tied to some philosophical framework, it is important that scientists within a given discipline be aware of the philosophical orientations that serve as the basis for developing theory and advancing knowledge. Nurse scientists have been challenged recently to examine the discipline's philosophical underpinnings in order to understand the evolutionary process of nursing science. The inclusion of the study of philosophy of science in doctoral nursing curriculum has remained a topic of periodic discourse. Whereas some assert that it promotes the essential process of philosophical reflection necessary for scientific exploration of relevant phenomenon, others contend that nurse scientists' preoccupation with this issue has diverted their attention from the real business of nursing science--that of knowledge development that will lead to legitimization of nursing as a discipline. Philosophy of science provides a useful frame of reference in which to appreciate the unfolding of nursing as a discipline. It should not be viewed as a distraction but rather a critical step in the transformation of the doctoral student into a productive nurse scientist. Doctoral programs remain the most logical place in which to educate future scholars regarding nursing's unique philosophical foundations and their implications for scientific inquiry and continued knowledge development. Creating and maintaining liaisons between nursing and philosophy departments--as well as requiring courses that emphasize the interrelationships among philosophy of science, nursing theory, and nursing research--are just a few of the strategies whereby doctoral programs can actively promote advancement of the discipline.     

Preliminary electrochemiluminescence studies of metal ion-bacterial diazoluminomelanin (DALM) interactions

Over the past 10 years there has been a growing body of literature on family nursing. Although the term 'family nursing' is not one which is in common use in the UK, a significant amount of literature has appeared which discusses issues relating to the nursing support of families with a member who is ill. This paper will review the concepts involved and will then discuss the appropriateness of such an approach within the specialty of intensive care. As the paper concludes that family nursing could be an appropriate approach to nursing the patient in this type of area, it would seem logical to consider what needs the family may have. The research concerning the identification of the needs of families when they have a member in intensive care is discussed in part two.     

Healthcare rationing: issues and implications

The purpose of this study is to trace a parallel between the medical discourse content and the expected and stereotyped nurses behavior at the beginning of the twentieth century. It is a historic-social approach in which authors analysed the speeches used by nurses and physicians at nursing and medicine schools. The analysis of the physicians discourse compared to nurses discourse revealed the formation of a mentality shaped by the medical power that wanted them "holy" and servile.     

Cadmium suppresses delta 9 desaturase activity in rat hepatocytes

This paper challenges contemporary portrayals in the nursing literature of the spaces within which care of patients in hospital settings is conducted. Within the wider discourse of fiscal restraint on health care spending, professional nursing has cast its disciplined eyes on details of the nurse-patient relationship for the ostensible purpose of repairing that which is treated as individual failings of nurses to practice in ways prescribed by nursing theories. Set aside in this approach to the so-called 'problems' of nursing practice has been an examination of the conditions within which nurses come in contact with patients, and a critical recognition that such contacts represent skilled accomplishments of social action. In this paper, these conditions are treated as resources available to both nurses and patients to generate accounts for the nurse's presence as well as the nurse's absence. Examples from an ethnographic study of nursing practice are used to illustrate how the spaces operating between nurses and patients are not empty voids but are social spaces through which particular meanings about nursing care can be conveyed.     

Effects of context in human sentence parsing: Evidence against a discourse-based proposal mechanism.

Carried out 2 S-paced reading experiments to examine the way in which discourse information exerts its influence in sentence comprehension. The results show that whereas prior discourse context appears to affect the way in which sentences are ultimately parsed, there is no evidence that it has any direct influence on the initial assignment of structure. These findings argue against parsing models (e.g., the referential support model) that assume that discourse factors influence the initial structural assignment. In contrast, they support models (e.g., the "garden path" model) that posit that initial structural proposals are made on a purely syntactic basis, whereas discourse effects are confined to a later set of disposal operations. These conclusions are discussed in the light of broader accounts of interactive processing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Object"? I object.

It is time for psychoanalytic discourse to retire the term “object.” The term has become ambiguous, has become anachronistic, and has misleading and even deleterious connotations. It misconstrues the process of internalization as interpreted by contemporary theories and approaches. It also contributes to the impression that psychoanalysis is unconcerned with the kinds of relational and interpersonal factors that have assumed center stage in much analytic thinking. This article addresses different ways that internalizations have been construed and described, and modern concepts of drives that do not require this syntax in order to describe processes of mental representation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A concept analysis of, and proposed new term for, challenging behaviour

While the term 'challenging behaviour' is used frequently in literature with reference to people who have learning disabilities, the concept has not been defined comprehensively and empirical indicators for the presence of the phenomenon have not been defined from the perspective of nurses for people with learning disabilities. In this paper the concept 'challenging behaviour', as used in the area of nursing people who have learning disabilities, is analysed. It is suggested that it is an ambiguous term which is unsuitable for use in the field of learning disabilities. A new term is synthesized to replace that of 'challenging behaviour' and an attempt to develop concise indicators which will demonstrate the concept's presence in individuals who have a learning disability will be undertaken. It is suggested that the proposed term is less ambiguous than 'challenging behaviour' and, as such, is more user-friendly for both nurses and other carers of people who have learning disabilities. The paper concludes with the recommendation that further refinement is required in practice to expand and define the operational indicators of the proposed new term 'problematic behaviours'.     

Profession building in the new health care system

To further the goals of greater legitimacy and power, it is necessary for nursing to abandon many of the profession building strategies it has pursued in the past. We describe the traditional framework for profession building in nursing and some reasons it is no longer effective. In contrast, a contemporary framework for profession building in nursing is presented. Because nursing, like other complex adaptive systems, is strongly anchored by its past trajectory, it will require considerable energy and resources to make the transition.     

Nursing--construction of a model based on the medical discourse

The purpose is to trace a parallel between the medical discourse contents and the expected and stereotyped nurses behavior at the beginning of the twentieth century. It is a historic-social approach in which was made use of speeches uttered by nurses and physicians at nursing and medicine schools. The analysis of physicians discourse compared to nurses discourse disclose the formation of a mentality shaped and turned docile by the medical power which wanted them holy and servile.     

Renal ATPases twenty-four hours after uninephrectomy: the role of IGF-1

The purpose of this article is to discuss the concept and phenomenon of intuition in nursing. With an overview of theories of intuition in philosophy and empirical research as the starting point, the authors discuss the conceptualization of intuition in nursing. Concept analyses, intuition as phenomenological nursing knowledge, intuition as clinical knowledge and intuition as spiritual connection are discussed. The authors conclude that the conceptions of intuition in nursing differ with respect to their philosophical underpinnings and that it can be questioned whether 'intuition' is always a proper term for the kind of knowledge investigated. Intuition is seen as an important concept in nursing, but there are still philosophical as well as empirical and practical problems to investigate.     

The discursive construction of dementia care: implications for mental health nursing

This paper sets out a new approach to dementia that may be used to underpin mental health nursing practice. The paper begins by examining the development of community care. Various models of service provision to people with dementia are then critically examined. As an alternative to these approaches a new model of dementia is developed which highlights the position of various family members in the provision of dementia care including the person with dementia and also the importance of linguistic devices such as narrative and discourse. Finally the implications of this approach upon the mental health nursing practice are examined together with various suggestions for the development of research.     

The clinical application of the nursing process in selected acute care settings: a professional mirage

The nursing process is the problem solving framework purported to be used in a multiplicity of health care settings. Although its use is widespread in educational and clinical settings, some nurse clinicians display negative attitudes towards its use and state that it is incongruent with nursing practice. To date, there has been no study cited that has examined it use within clinical settings to determine the substance of these claims. Using grounded theory methodology, this study examined the clinical application of the nursing process in acute care hospital settings. Data were obtained from semi-structured interviews with predominantly nurse clinicians (n = 27), participant field observations of nurse clinicians, and in-depth audits of patient records. Textual data were managed using NUD-IST and analysed using constant comparative method. Data generation and analysis proceeded simultaneously using open coding, theoretical coding, and selective coding techniques until saturation was achieved. Nurses in this study experienced the basic social problem of being in a state of "Unknowing" that was linked to a number of factors, such as, the existence of a fragmented and inconsistent method of determining and communicating patient care and work conditions of immense change and uncertainty. The findings revealed several problems with the clinical application of the nursing process and illustrated that the espoused theory was unable to be clinically applied.     

Children''s palliative care services: implications for everyone''s practice

When the time came for Enid to make the transition into long term care the profile of Enid with her biography and behaviour modes was passed on to staff in the nursing home, thus enabling them to start from a point of knowing Enid as an individual. During her time at Burford, Enid managed to communicate and express herself sufficiently to keep a good degree of self-agency. Her dementia mapping scores showed her to be generally in a state of well-being. This article has attempted to show how it is possible to listen and learn from people with dementia and that care staff must want to learn about and from the person with dementia if they are to care for them in a person centred way.     

Approximations of open quotient and speed quotient from glottal airflow and EGG waveforms: effects of measurement criteria and sound pressure level

A sample of speech acts in everyday discourse referring to persons or events having to do with the term mental retardation was analyzed in order to investigate the belief that language use both constructs and reflects cultural norms that define the social roles of persons reduced to object status through categorical membership. Speech acts gathered suggest four emergent themes: the discourse of category membership, the dichotomy of normal and abnormal, issues of place and space, and fear. These themes were explicated from a social constructionist perspective, displaying the way speech acts construct mental retardation and subvert individuals with the label into demeaned and ridiculed objects of cultural fear.     

White, European, Western, Caucasian, or what? Inappropriate labeling in research on race, ethnicity, and health

The request for scientifically appropriate terminology in research on race, ethnicity, and health has largely bypassed the term White. This and other words, such as Caucasian, are embedded in clinical and epidemiological discourse, yet they are rarely defined. This commentary analyzes the issue from the perspective of the epidemiology of the health of minority ethnic and racial groups in Europe and the United States. Minority groups are usually compared with populations described as White, Caucasian, European, Europid, Western, Occidental, indigenous, native, and majority. Such populations are heterogeneous, the labels nonspecific, and the comparisons misleading. Terminology that reflects the research purpose-for examples, reference, control, or comparison--is better (unlike White, these terms imply no norm, allowing neither writers nor readers to make stereotyped assumptions about the comparison populations. This paper widens the debate on nomenclature for racial and ethnic groups. Many issues need exploration, including whether there is a shared understanding among the international research community of the terms discussed.     

The many truths of postmodernist discourse.

The discourse of postmodernism proclaims with a unified voice the context-dependence or knower-dependence, the relativity or subjectivity, of all truth claims. But the discourse of postmodernism also proclaims universal truths upon which this antirealist epistemology itself rests. These constitute the very foundational claims that the postmodernist (PM) campaign, in all of its alleged antifoundationalism, strives to subvert. In this article, the author considers 3 universal truth claims of PM discourse. And because the antirealism that defines much of PM discourse is often grounded in the doctrine of social constructionism (SC), the 3 truth claims under consideration constitute the claims of SC itself, especially the claims of SC as it has been propounded within postmodern therapy circles. Each of the 3 claims is articulated, and then followed by a critique which asks whether the claim is not either (1) simply a variant of the so-called modernist paradigm that is under attack, or (2) the product of the very observational/empirical powers that PM doctrine seeks to erode in its anti-empiricist spirit. Particular attention is give to challenging the value, found within postmodern circles, of a pragmatic or utilitarian standard for acceptance of theory or discourse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)