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)

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)