In this article I attempt to transcend the mainstream conception of health care ethics, including nursing ethics, by bringing into the foreground a tension between a sense of life and an industrial-bureaucratic style of health care, with its emphasis on the systematic and procedural work culture necessary for mass production. I use the concept of ‘a sense of life’ to draw attention to the wisdom, sensitivity and responsibility that is necessary for the authentic care of others to be given a (...) chance in the development of modern health care. I emphasize the mindfulness that the professional requires for genuine care, and how the systematic organization of modern health care, on the whole, ignores, obstructs and even suppresses such mindfulness. (shrink)

Exploring nursing expertise: nurses talk nursing It has become increasingly important for practitioners to articulate their expertise in modern healthcare settings that demand high levels of accountability and evidence‐based practice. The material presented within this article has been interpreted drawing from discourse analysis1 to help explore the discourses that shape and influence understandings of nursing practice. What we present are extracts from four of the 35 participant nurses who applied to take part in the Royal College of Nursing Institute's Expertise (...) in Practice (pilot) Project (EPP). The material presented is used to provide a starting point for exploring how nurses talk about and construct expertise in nursing practice. The four nurse participants’ clinical practice areas cover palliative care, mental health, intensive care and fertility care. The material reveals high levels of intensity in the nurse–patient relationship, ‘maverick’ nursing practices and ongoing reflexivity. All of these aspects appear to capitalize on expertise as a ‘catalyst’ that alters treatment pathways and maximizes patient‐centred outcomes. Exploring a discourse of nursing expertise exposes the tacit situated nature of professional practice that is heterogeneous and most difficult to articulate and explain. It is proposed that expertise tends to be understood from traditional and dominant discourses of medicine, management and technology. Explaining expertise in practice exposes non‐conventional practice that in itself can be isolating and challenging to the status quo of contemporary health‐care. (shrink)