Discourses of interdisciplinary health‐care are becoming more centralised in the context of global healthcare practices, which are increasingly based on multisystem interventions. As with all dominant discourses that are narrated into being, many others have been silenced and decentralised in the process. While questions of the nature and constituents of interdisciplinary practices continue to be debated and rehearsed, this paper focuses on the discourse of interdisciplinary collaboration using psychiatry as an example, with the aim of highlighting competing and alternative discourses. (...) The fundamental premise of this paper is that collaborative relationships form the basis of interdisciplinary practices in psychiatry. Through a critical engagement and a deconstructive reading of the pretext, context and subtexts of interdisciplinarity, we interrogate the concept of interdisciplinary practice within psychiatry. We contend that an important part of understanding and further conceptualising the discourse is through fracturing it. This process is illustrated in the successive stages of our conceptual map of discourse development: establishing, maintaining and developing discourses. An understanding of interdisciplinary practice is not only critical for psychiatry, but also offers important insights into the performance of collaborative failures and indeed successes across nursing and allied health professions. (shrink)

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In this article, we will consider how the regulation of populations is not just a feature of prisons, but of all institutions and organisations that control members though hierarchies, divisions and norms. While nurses and other allied health professionals are considered to be predominantly self‐regulatory, practice is guided by a code of conduct and codes of ethics that act as rules that serve to uphold the safety of the patient, whether they are a sick person in a hospital bed or (...) an inmate in a prison. The codes of conduct espouse a number of rules that to a certain extent govern the behaviour of individual and groups of practitioners through reciprocal rewards and punishments. Supervision is one method of monitoring the effectiveness of the codes of conduct and ethics while regulating both the minimum standard of individual practice and of training organisations. It is posited that one of the possible effects of clinical supervision is to make the person effectively self‐regulatory as, an autonomous practitioner. We take the view that professional autonomy is a highly problematic concept requiring closer examination. (shrink)

The concept of emotional intelligence has grown in popularity over the last two decades, generating interest both at a social and a professional level. Concurrent developments in nursing relate to the recognition of the impact of self‐awareness and reflexive practice on the quality of the patient experience and the drive toward evidence‐based patient centred models of care. The move of nurse training into higher education heralded many changes and indeed challenges for the profession as a whole. Traditionally, nurse education has (...) been viewed as an essentialist education, the main emphasis being on fitness for practice and the statutory competencies. However, the transfer into the academy confronts the very notion of what constitutes this fitness for practice.Many curricula now make reference in some way to the notion of an emotionally intelligent practitioner, one for whom theory, practice and research are inextricably bound up with tacit and experiential knowledge. In this paper we argue that much of what is described within curriculum documentation is little more than rhetoric when the surface is scratched. Further, we propose that some educationalists and practitioners have embraced the concept of emotional intelligence uncritically, and without fully grasping the entirety of its meaning and application. We attempt to make explicit the manner in which emotional intelligence can be more realistically and appropriately integrated into the profession and conclude by suggesting a model of transformatory learning for nurse education. (shrink)

This paper examines the distinction that is sometimes drawn between analysis and interpretation in the context of qualitative research, and the processes of critical analysis that underpin reflective practice. The authors consider the complementary logical processes involved in analysis and interpretation, and propose a cycle of reductive, inductive and hypothetico-deductive testing that is both rational and creative. The authors argue that the goal of critical reflection and qualitative data analysis is not to produce knowledge that can be justified in terms (...) of ‘correspondence’ to ‘reality’. Instead we propose a pragmatic, coherence view of knowledge that emphasizes the centrality of dialogue with texts, evidence, beliefs and practice. We conclude that evidence and belief are inextricably linked and that combined processes of reductive, inductive and hypothetico-deductive logic need to be used in a transparent manner to establish the credibility of an interpretation. Although there is no clear demarcation between what is found and what is constructed, a commitment to coherence is the basis of a pragmatic theory of knowledge. (shrink)

Many notions of interprofessional collaboration appear to aim for the ideal of trouble‐free co‐operative communication between healthcare professionals. This study challenges such an ideal as too far removed from the complex and contested relations of power that characterise the albeit skilful everyday social interactions which take place within healthcare practice, along with the associated pragmatic compromises made by disempowered practitioners. It is noted that these may be facilitated by modes of comforting myth and denial. To underline this point, psychiatric illness (...) diagnosis is used as an illustrative example of how a historically powerful societal discourse can become thoroughly entrenched. The influence of a paradigmatically dominant discourse is shown to extend beyond the repetition of narrative within open dialogue and debate and to continue as tacitly reflected patterns within unconsciously habituated behaviour and durable artefacts that crystallise future affordances and limitations on action. However, the authors conclude by introducing optimistic theoretical speculation around the dynamic social mechanics of reflexive awareness and creativity, as these emerge within moments of significant dissonance between dialectically interacting layers of individually internalised and contextually embedded discourse, conversation and direct experience. (shrink)

Our aim was to employ a critical analytic lens to explicate the role of nursing research in supporting the notion of caring realities. To do this, we used case exemplars to illustrate the infusion of such discourses. The first exemplar examines the fundamental concept of caring: using Florence Nightingale's Notes on Nursing, the case study surfaces caring as originally grounded in ritualized practice and subsequently describes its transmutation, via competing discourses, to a more holistic concept. It is argued that in (...) the many and varied attempts to define the dynamic concept of care, caring has now become paradoxically, a more fragmented concept despite attempts to render it more holistic and inclusive. In the second exemplar, one of the authors draws on her personal experience of the gap between theory and practice, so pronounced that it pushed the author to revisit the concept of evidence‐based practice and nursing education. In our third and final exemplar, we refer to the absence of knowledge and practice generated through natural enquiry and curiosity, an absence which has led to production of corporate led rhetoric. Drawing together the central arguments of the three exemplars, we reflect on the influential role of nursing research in enabling the deconstruction of taken for granted assumptions such as caring, evidence‐based practice and empowerment; assumptions which have been generated by discourses riddled with confusion and alienation from the reality of practice and the natural spirit of professional enquiry. (shrink)