Governing nursing conduct: the rise of evidence‐based practice Drawing on the Foucauldian concept of ‘governmentality’ to analyse the evidence‐based movement in nursing, we argue that it is possible to identify the governance of nursing practice and hence nurses across two distinct axes; that of the political (governance through political and economic means) and the personal (governance of the self through the cultivation of the practices required by nurses to put evidence into practice). The evaluation of nursing work through evidence‐based reviews (...) provides detailed information that may enable governments to target and instruct nurses regarding their work in the interest of preserving the health of the population as a whole. Political governance of the nursing population becomes possible through centralised discursive mechanisms, such as evidence‐based reviews that present nursing practice as an intelligible field whose elements are connected in a more or less systematic manner. The identity of the evidence‐based nurse requires the modern nurse to develop new skills and attitudes. Evidence‐based nursing is an emerging technology of government that judges nursing research and knowledge and has the capacity to direct nursing practice at both the political and personal level. (shrink)

The notion that history is a record of continuous improvement has come to dominate the Western view of the world. This paper examines how nursing has embraced this ‘Enlightenment project’ and continues to be guided by a faith in ‘history as progress’ despite the fact that its structural position remains one of subordination and struggle. Faith in progress is manifested in nursing historiography and contemporary nursing literature, in the basic tenet of nursing orthodoxy, that professionalization is both inevitable and desirable, (...) in the alignment of nursing with medical science and technology and the belief that Western nursing is the model for nursing world wide. It is argued that this uncritical faith in a continuously improving future has obscured nursing's vision for the future and rendered it powerless in the face of rapid global economic and social change. (shrink)

This paper will examine the concepts of integrity and moral residue as they relate to nursing practice in the current health care environment. I will begin with my definition and conception of ethical practice, and, based on that, will go on to argue for the importance of recognizing that nurses often find themselves in the position of compromising their moral integrity in order to maintain their self‐survival in the hospital or health care environment. I will argue that moral integrity is (...) necessary to a moral life, and is relational in nature. When integrity is threatened, the result is moral distress, moral residue, and in some cases, abandonment of the profession. The solution will require more than teaching bioethics to nursing students and nurses. It will require changes in the health care environment, organizational culture and the education of nurses, with an emphasis on building a moral community as an environment in which to practise ethically. (shrink)