While health promotion is widely acknowledged as a practice field where multidisciplinary teamwork is important, within nursing's discipline‐specific literature, a strong argument can be discerned regarding the profession's belief that it has a clear and unique role to play in that field. Yet rarely is this unique role, how it arises, and specifically how its effects are to be demarcated, attended to within the discipline‐specific literature. Two philosophical perspectives on science are presented and we demonstrate the extent to which these (...) two perspectives influence nursing scholarship, including nursing practice within the field of health promotion. We then go on to argue that, for nurses to sustain their claim to a unique and important contribution within health promotion, clear articulation of the philosophical premises underpinning practice methodologies is warranted. Specifically we argue the importance of such clarity within the context of an analysis of the discourse of multidisciplinary practice as a strategy for avoiding confronting the ways in which bio‐medical authority has already significantly demarcated how health promotion practice can proceed. (shrink)

This paper addresses the notion of wound care as a technology of skin and other skins imbued with the combined power of technology and science. It presents the discourses of wound care evident in the accounts of patients and nurses concerning this care, and discussions about wounds in wound care interest groups, journals, and advertising material about wound care products. The discussion focuses on wounds and wound dressings as effects immanent in the power relations of discourses of wound care. These (...) effects colour and influence nurses’ responses to wounds and wound care products. Moreover, the discourses that portray these practices are evidence of the complex articulation between technoscience and gender. Nurses and patients are fascinated by wound technoscience and lured towards it by its potential for mastery and control over wounds. Such seductions are evident in the texts of nurses, patients, and pharmaceutical advertisements for wound care products. Finally, the ways that these representations are used to talk about and market wound care products are shown as exemplifying the finer points of wound management as a nursing technoscience. (shrink)

SCHOFIELD I, TOLSON D and FLEMING V. Nursing Inquiry 2012; 19: 165–176 [Epub ahead of print]How nurses understand and care for older people with delirium in the acute hospital: a Critical Discourse AnalysisDelirium is a common presentation of deteriorating health in older people. It is potentially deleterious in terms of patient experience and clinical outcomes. Much of what is known about delirium is through positivist research, which forms the evidence base for disease‐based classification systems and clinical guidelines. There is little (...) systematic study of nurses’ day‐to‐day practice of nursing patients with delirium. The aim was to uncover the kinds of knowledge that informs nurses’ care and to explicate the basis of that knowledge. Critical Discourse Analysis is underpinned by the premise that powerful interests within society mediate how social practices are constructed. Links were made between the grammatical and lexical features of nurses’ language about care in interviews and naturalistic settings, and the healthcare context. Care focused on the continuous surveillance of patients with delirium by nurses themselves or vicariously through other patients, and containment. Nurses influenced by major discourses of risk reduction and safety, constructed patients with delirium as risk objects. The philosophy of person‐centred and dignified care advocated in nursing literature and government policy is an emerging discourse, though little evident in the data. The current dominant discourses on safety must give space to discourses of dignity and compassion. (shrink)

The 1991 film The Silence of the Lambs tracks the fictional pursuit of an American serial killer by a Federal Bureau of Investigation trainee, via the assistance of another incarcerated serial killer. It features psychologically disturbing themes, such as corpses, the mutilation of skin and monstrous persons. Incidentally, these are all themes regularly encountered by nurses in their day‐to‐day practices, including forensic mental health nurses. Despite regular encounters with these themes and phenomena, nurses continue to find them disturbing and troubling, (...) but, at the same time, clinically fascinating. This paper will mobilize Kristeva's poststructuralist, psychoanalytic concept of abjection to relate the encounters in The Silence of the Lambs to those of nurses, to reconceptualize feelings of both disgust and fascination and to consider how vulnerability may benefit nursing practice. Of particular relevance are the breakdown of skin encountered in nursing practice, encounters with corpses and work with forensic patients considered monstrous. The film provides opportunity for nurses to conceptualize abjection in their own practice and to consider how a reconceptualization of boundaries and vulnerability may prove productive. (shrink)