Strategies based on performance measurement and feedback are commonly used to support quality improvement among nurses. These strategies require practice change, which, for nurses, rely to a large extent on their capacity to coordinate with each other effectively. However, the levers for coordinated action are difficult to mobilize. This discussion paper offers a theoretical reflection on the challenges related to coordinating nurses' actions in the context of practice changes initiated by performance measurement and feedback strategies. We explore how Jürgen Habermas' (...) theory of Communicative Action may shed light on the issues underlying nurses' collective actions and self‐determination in practice change and the implications for the design of strategies based on performance measurement and feedback. Based on this theory, we propose differences between communicative and functional coordination according to the nature of the actions and the purposes involved. The domains of action underlying these coordination processes, which Habermas referred to as the lifeworld and the system, are then used to draw a parallel with aspects of nursing practice. Further exploration of these concepts allows us to consider the tensions between the demands of the system and the self‐determination of nurses within their practice. (shrink)

Robert Castel is an eminent figure in the social sciences because of his innovative contributions to various social and health fields. The seminal work of this poststructuralist author and social activist has influenced several research disciplines, but has not yet had a significant impact on nursing. In this article, we will present the thinking of this man, who considered himself a sociologist, philosopher and “historian of the present.” We will examine the most important issues he explored during his career, including (...) the psychiatric apparatus, the management of risk and the social vulnerability. We believe that this thinker's perspective on diverse social issues is very relevant to nursing practice and research and to the health sciences in general. The concepts he developed and utilized with finesse provide us with a critical reading of many contemporary health issues, particularly in mental health and psychiatric nursing. Castel's critical and engaged approach incites mobilization for social justice and greater protections for marginalized and vulnerable persons. These principles of advocacy and social justice are also at the heart of the nursing profession. (shrink)