Possibilities for critical social theory and Foucault’s work: a toolbox approach The benefits and constraints of philosophical frameworks using the work of Michel Foucault and critical social theorists, such as Fay, Giroux and McLaren, are examined in the light of their traditions. The reasons nurse researchers adopt these frameworks are explored, as are the tensions between the respective theories. A complementary ‘toolbox’ approach to the research process addresses some of the theoretical and methodological challenges presented by each framework. Such an (...) approach provides distinctive insights into nursing practice that the other has ignored or missed. It is argued that by converging the two frameworks into a toolbox approach, it is possible to examine or deconstruct existing practices, whilst also providing an avenue for nurses to reconstruct or change such practices. (shrink)

In their own words: nurses’ discourses of cleanliness from the Rehoboth Mission For nurses of the nineteenth and early twentieth centuries, cleanliness was often seen as a virtue next to godliness. For missionary nurses, this analogy took on multiple meanings. This study focuses on discourses of cleanliness at one site of missionary nursing in the early twentieth century: the Rehoboth Mission and its hospital, which provided health‐care to the Navajo in the southwestern USA from 1903 to 1965. Data sources included (...) denominational publications, institutional records, correspondence, questionnaires and interviews of the Dutch–American missionary nurses who practiced at the Rehoboth Mission. Discourse analysis was conducted on references to cleanliness, hygiene and sanitation in these texts. Secondary discourses of embodiment in daily practice, initiation and assimilation, caring, ignorance, environmental factors and gendered work were identified and analyzed. The study interrogates the whiteness of the nurses’ dominant culture and sheds light on nurses’ relationships with normative discursive frames that reflect and perpetuate inequalities, discredit non‐dominant practices, and leave little room for competing discourses. It also illustrates a blurring of religion and health‐care, and the need for a reflective and informed stance as a basis for cultural competence. (shrink)

Paul Ricoeur and Michel Foucault enjoy a privileged status in nursing academia as two thinkers who influence both nursing research and philosophical explorations of nursing practice. Most nurse authors, however, focus only on the earlier works of these two philosophers and, for example, base qualitative research methodologies on Foucault's genealogy and Ricoeur's hermeneutics. In their later years, both these writers talk more explicitly about being an ethical self. Ideas from their earlier writing is evident in their writing on ethics and (...) both writers could not discuss ethics without also exploring their ideas of the self and the other. I suggest that some of their thoughts on ethics connect with or complement each other quite well. I will first give an overview of Foucault's ethics, self and the other, and then do the same with Ricoeur's thought. In the third part of the paper I will describe how Foucault and Ricoeur complement each other, and conclude the paper by briefly suggesting how these writers influence my own practice as a nurse educator. (shrink)

This paper reports on the findings of a study that considered how anxiety might function to organise nurses’ practice. With reference to psychoanalytic theory this paper analyses field notes taken during a series of nursing change‐of‐shift handovers. The handover practices analysed met all the criteria for a ritual, as understood in psychoanalytic theory, and functioned to alleviate anxiety in the short term while symbolically expressing a forbidden and unknown knowledge. We argue that the handover ritual contained certain prohibitions, yet allowed (...) some expression of the prohibited knowledge in a disguised way. The prohibition concerned how the patient affected the nurse, that is, moved the nurse to love and hate the patient. We argue that this prohibition is expressed, in disguise, via the displacement of affection for the patient onto other nurses and through negative stereotyping of some patients. We also argue that these prohibitions of the handover mirror broader prohibitions within nursing, and thus the rituals of the handover become an expression of how professional prohibitions are enacted in practice. We conclude that the important implicit function of the handover ritual is to keep anxiety at bay, thereby enabling the nurse to commence practice rather than being immobilised by the effect of potentially overwhelming anxiety. (shrink)

The nurses’ relationship to knowledge has been theorised in a variety of different ways, not the least being in relation to medical dominance. In this study, the authors report on one of the findings of a case study into nurses’ anxiety informed by psychoanalytic theory. They argue that the nurse’s subjection to the knowledge of the other health professional, inclusive of the doctor, can be a transference arising in the context of anxiety for the nurse. Grasped by anxiety, the nurse (...) finds their own knowledge insufficient and in this moment can operate a transference to their non‐nursing colleague, who obligingly, responds. This transference is not present in the change‐of‐shift handover report though, when the other’s knowledge is suspect, even open to derision. Thus, this reference to the knowledge of the other is not consistently present in nursing and can be seen to be just one way that nurses organise themselves in relation to anxiety. Therefore, those wanting to break down the medical dominance of the nursing profession might consider other ways nurses might organise themselves in relation to anxiety, so that the political dominance of the other is not reinforced via transference to that other. (shrink)

IVF as lottery or investment: contesting metaphors in discourses of infertilityThis paper reports an aspect of a poststructural feminist study in which I explored the discursive formations within which women for whom in vitro fertilisation (IVF) was unsuccessful constitute themselves. In my exploration I draw on data from interviews with women who discontinued infertility treatment, print media material and infertility self‐help books. Specifically, I highlight a metaphor of lottery in discourses of infertility, arguing that it is hegemonic and showing how (...) when women are situated as gamblers, the metaphor is instrumental in polarising them into ‘winners’ or ‘losers’ in relation to the subjectivity of motherhood. I further deconstruct these subjectivities, showing how ‘winners’ are valorised and ‘losers’ are pathologised. But importantly, I show how infertile women who are not mothers resisted locating themselves as ‘losers’ in a metaphor of lottery and instead situated themselves in a contesting metaphor of investment as diligent ‘workers’ and as active agents in choosing the best employment of their bodily and monetary resources. This paper therefore amplifies the marginalised perspective of infertile women who are not mothers. (shrink)

This paper delineates a postmodern discourse analysis that is positioned within a semiotic theory of language. This theory of language foregrounds the performative aspects of language usage and provides the theoretical space from which to theorize the interrelationship between social organizations or structure and social agents or individuals. Our version of discourse analysis contends that social structure is enacted (production and reproduction) through the employment of various vocabularies: social structure is not something outside of, behind, or underneath these performances, and (...) we argue that social organization is not produced by external structures operating upon or causing people to adopt certain behaviours. Rather, social structure is an effect of taking up practices and reproducing and modifying them. From this perspective, individuals are constituted by being recruited into and reproducing discursive practices. Hence, by looking at the actual employment of language – its tactical, practice dimensions – one can avoid the usual binary of seeing the person as either the autonomous origin of his or her experience or the ideological pawn of social determination. This methodology calls into question how the narratives or stories that individuals recount are imbricated within relational plays of power, and concomitantly, how subjects reauthorize their own positions. We assert that the methodological challenges of research addressing social injustice cannot be reduced to either: (i) interpersonal relationships between researcher and participants, or (ii) relegated to ‘social structures’ acting upon or outside of individuals. (shrink)

In this paper, we introduce the notion of ‘rupture’ from the French philosopher Michel Foucault, whose studies of discourse and governmentality have become prominent within nursing research during the last 25 years. We argue that a rupture perspective can be helpful for identifying and maintaining a critical potential within nursing research. The paper begins by introducing rupture as an inheritance from the French epistemological tradition. It then describes how rupture appears in Foucault's works, as both an overall philosophical approach and (...) as an analytic tool in his historical studies. Two examples of analytical applications of rupture are elaborated. In the first example, rupture has inspired us to make an effort to seek alternatives to mainstream conceptions of the phenomenon under study. In the second example, inspired by Foucault's work on discontinuity, we construct a framework for historical epochs in nursing history. The paper concludes by discussing the potential of the notion of rupture as a response to the methodological concerns regarding the use of Foucault‐inspired discourse analysis within nursing research. We agree with the critique of Cheek that the critical potential of discourse analysis is at risk of being undermined by research that tends to convert the approach into a fixed method. (shrink)

Discourse analysis has been introduced into nursing research as an approach which has the potential to offer new perspectives and to pose new questions to taken‐for‐granted assumptions. However, critique has arisen that when applied to nursing studies, the epistemological foundation of the discourse analysis is often overlooked. It is furthermore claimed that the methodological inspiration does not lead to any new insights and that these studies can hardly be differentiated from more traditional studies. This study supports this critique, arguing that (...) the challenges of implementing discourse analysis in nursing research reflect a dominant pattern of thought in the discourse of the nursing profession that have held sway throughout the last century. We argue that this pattern of thought stems from the Western philosophy of consciousness and the conception of the sovereign subject. By applying a discourse analytical perspective to the discourse of the nursing profession itself, this study elucidates the challenges of applying discourse analysis in nursing research. (shrink)