Background Drawing on the work of the late French philosophers Deleuze and Guattari, the objective of this paper is to demonstrate that the evidence-based movement in the health sciences is outrageously exclusionary and dangerously normative with regards to scientific knowledge. As such, we assert that the evidence-based movement in health sciences constitutes a good example of microfascism at play in the contemporary scientific arena. Objective The philosophical work of Deleuze and Guattari proves to be useful in showing how health sciences are colonised (territorialised) by an all-encompassing scientific research paradigm - that of post-positivism - but also and foremost in showing the process by which a dominant ideology comes to exclude alternative forms of knowledge, therefore acting as a fascist structure. Conclusion The Cochrane Group, among others, has created a hierarchy that has been endorsed by many academic institutions, and that serves to (re)produce the exclusion of certain forms of research. Because 'regimes of truth' such as the evidence-based movement currently enjoy a privileged status, scholars have not only a scientific duty, but also an ethical obligation to deconstruct these regimes of power.
Nurses in psychiatric settings have an important role to play in the application of seclusion, a measure that continues to be a frequently used intervention for the management of disturbing patient behaviours. Albeit a controversial measure, isolating patients remains a common institutional practice that has received widespread attention from a political, ethical, legal, and clinical standpoint. Although there is an abundance of scientific work on the subject, few studies have examined the experience of patients being confined. In order to improve the quality of nursing care surrounding this measure it appeared essential to obtain data on patients' perspectives, information deemed valuable in orienting nursing interventions. This qualitative study, guided by a phenomenological research design, aimed at describing and gaining a better understanding of patients with a severe and persistent psychiatric disorder who were placed in a seclusion room while hospitalized on a closed psychiatric unit. Using a semi-structured, non-directive interview format, a total of six patients participated in this study. Content analysis of participants' narratives yielded three main themes that appeared to be central to their experience of seclusion: their experience of seclusion on an emotional level, their perception of this intervention, and how they coped during their stay in the seclusion room. Major findings emerging from this nursing study centred on the following dimensions: patients' perceptions of seclusion as a punitive measure and a modality for social control and, the experience of seclusion serving as an intensification of already existing feelings of exclusion, rejection, abandonment, and isolation. In addition the findings also suggest that it is not seclusion per se that impacts on their negative perception and negative emotional experience but rather the lack of nurse-patient contact during the seclusion experience. Furthermore, whether patients coped by regressing, acting out, or taking on a more compliant stance, they appeared to be motivated by a need to connect with staff. This points to the importance of the relational aspects of nursing care when applying this restrictive measure. A need for modifying the institutional culture surrounding seclusion and transforming nursing practices are discussed as are future research endeavours.
This article presents an analysis of data from a critical qualitative study with 14 skilled black African migrant nurses, which document their experiences of nurse-to-nurse racism and racial prejudice in Australian nursing workplaces. Racism generally and nurse-to-nurse racism specifically, continues to be under-researched in explorations of these workplaces; when racism is researched, the focus is nurse-to-patient racism and racial prejudice. Similarly, research on the experiences of migrant nurses from a variety of ethnicities in Australia has tended to neglect their experiences of the social dynamics of the workplace, thus reinforcing their racialisation. When racialised, the migrant nurse becomes 'the problem' through a focus on English language competency and ensuing communication barriers. This paper applies Essed's framework of 'everyday racism' to theorise narratives of racism by black African migrant nurses in Australia. In so doing, it not only brings to the fore silenced discussions of nurse-to-nurse racism in Australia, but also exposes the subtle, mundane nature of contemporary racism. For this reason, while the data we present must be read within their context, that is, the Australian nursing workplace, it has significance for advancing a critical analysis of racialised minority groups' experiences of racism within seemingly 'race-less' nursing workplaces internationally.
No exit? Have we arrived at an impasse in the health sciences? Has the regime of 'evidence', coupled with corporate models of accountability and 'best-practices', led to an inexorable decline in innovation, scholarship, and actual health care? Would it be fair to speak of a 'methodological fundamentalism' from which there is no escape? In this article, we make an argument about intellectual integrity and good faith. We take this risk knowing full well that we do so in a hostile political climate in the health sciences, positioning ourselves against those who quietly but assiduously control the very terms by which the public faithfully understands 'integrity' and 'truth'. In doing so, we offer an honest critique of these definitions and of the systemic power that is reproduced and guarded by the gatekeepers of 'Good Science'.
The concept of bio-power offers a rich theoretical perspective for nursing, as it questions the definition of nursing care as neutral and mainly provided according to patients' best interests.
This article aims to clarify the concept of change fatigue and deems further exploration of the concept within the discipline of nursing is relevant and necessary. The concept of change fatigue has evolved from the discipline of management as a means to explore organization change and its associated triumphs and failures. Change fatigue has typically been described as one and the same as change resistance, with very little literature acknowledging that they are in fact distinct concepts. Concept clarification has highlighted the striking differences and few similarities that exist between the concepts of change fatigue and change resistance. Further exploration and subsequent research on the concept of change fatigue is needed within the discipline of nursing. The concept not only presents new and alternative perspectives on the processes of organization change, but provides opportunity for theory development that recognizes the impact organizational change has on nurses' work lives.
We argue against the hierarchical differentiation of varied research approaches so as to allow diverse methodologies to guide research and ultimately practice. The status quo is challenged, where research agendas are currently dominated by one paradigm of knowledge development; that of post-positivism in which randomized control trials are portrayed as superior evidence. There is a hazard in excluding many other venues to build nursing knowledge and in oversimplifying the complexity of clinical nursing practice. Furthermore, we argue that this preferred path of knowledge development contradicts nursing academics' efforts to distance itself from the medical model of health care provision and research.
From the seeming chaos of war zones and emergency rooms to the ritualized order of forensic psychiatric settings and sexual health clinics, nurses often experience feelings of disgust and repulsion in their practice. For these intense feelings to occur, an abject object must exist. Cadaverous, sick, disabled bodies, troubled minds, wounds, vomit, feces, and so forth are all part of nursing work and threaten the clean and proper bodies of nurses. The unclean side of nursing is rarely accounted for in academic literature: it is silenced. Using a theoretical approach, the objective of this paper is to demonstrate how fruitful the concept of abjection is in understanding nurses' reactions of disgust and repulsion regarding particular patients or clinical situations.
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