Policy is an integral part of nursing. At the organisational level, policies are constantly developed in a seemingly endless quest to provide more effective and efficient nursing services and outcomes. Such an increasing generation of policy appears to rest on the taken-for-granted assumption by nurses that policy is essential for good nursing practice. However, is it necessarily the case that the generation of policy documents advances the practice of nursing? Rather, does the apparent uncritical adoption of the role of policy by nurses actually serve to further regulate, control, and even limit the practice of nursing? This paper uses a critical perspective to explore nursing policy. In so doing it exposes the effect of policy on the construction and maintenance of everyday understandings of nursing practice.
The worldwide phenomenon of ageing populations in developed countries has led to an increased emphasis on how best to meet the healthcare needs of people aged 65 years and older. One area identified as requiring particular attention is the care provided to older people in acute settings. This paper reports on the findings of an exploratory qualitative study that investigated issues having an impact on registered nurses' ability to care for older people in a publicly funded teaching hospital in Australia. Issues identified pertain to the complexity of managing the healthcare needs of the older person with an acute illness; the acute care environment as being problematic for the older person, and maintaining continuity of care in an often fragmented and under-resourced healthcare system. It is clear from the study findings that registered nurses in the acute setting play a central and pivotal role in the multidisciplinary team caring for older people with regard to the management and coordination of care as well as in the provision of direct care. However, tensions arise from the curative focus dominant in acute care settings, which privileges and resources technically focused acute care skills and does not place as high a priority on developing appropriate knowledge, attitudes and skills specific to the care of older people. The findings provide a base from which to progress further research as well as a challenge to those working in acute settings to develop systems of care that maximise the role of the registered nurse in improving outcomes for hospitalised older people.
Collaborative research has much to offer nursing. However, the collaborative research process is fraught with issues arising from the 'politics of collaboration'. Such politics operate at the individual and institutional levels and can have debilitating effects on the research enterprise if they are not dealt with. This paper explores what is meant by collaboration and the politics of collaboration. Drawing on a critical perspective, it uses Brookfield's themes of impostorship, cultural suicide and roadrunning as the theoretical framework for the analysis. The paper uses an actual collaborative research project to ground the discussion provided.
This paper draws on postmodern thought to interrogate the literature relating to nurses and medications. An examination of the representation of a specific nursing activity in the literature-the administration of medications-reveals much about the way in which the role of the nurse is discursively constructed. This is particularly evident from an analysis of the procedures shaping that role. These procedures, which nurses themselves develop and institute as rules to guide nursing practice, can have the effect of reducing nursing work to a series of rituals which contribute to the discursive construction of the nurse's role in medication administration.
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