Anthropology, clinical pathology and the electronic fetal monitor: Lessons from the heart

Rural perinatal nursing in Canada: A hermeneutic literature review

“…In considering the context of birthing care within small rural hospitals, two articles by Bassett (1996) and Bassett, et al (2000) explored what constitutes risk based on statistically determined parameters for length of labour and the use of technology to monitor fetal well-being. These medical anthropological studies offer insight into the ways in which these means of determining risk shape both nursing and physician practice.…”

“…This creates tension for the nurse who is bound to carry out physician orders, perhaps even in situations where interventions are thought by the nurse to be unnecessary. Basset (1996) described a labour where the physician is concerned about the perceived risk due to a patient's lengthy second (pushing) stage and considered intervening. While the physician was in the corridor discussing his concerns with a colleague, the nurse, trusting in the patient's process, assisted her to the crowning stage.…”

“…Collaboration is an important aspect of regional care networks and perhaps even more so for the care providers within any given facility. The literature reviewed presents many hints and examples of the importance of teamwork among healthcare providers and a few authors present accounts of trust and shared decision-making between nurses and physicians ( Bassett, 1996 ; Medves & Davies, 2015; Orkin and Newbery, 2014 ). Also shown is the support between nurses where some, more knowledgeable and experienced, are able to mentor others in care of perinatal patients (Medves & Davies, 2015; Orkin and Newberry, 2014 ).…”

“…The rural nurse admits the labouring patient, conducts a thorough assessment and makes immediate and ongoing judgments for the health and safety of the woman and her fetus. Based on ongoing assessment (fetal auscultation, cervical dilation, abdominal palpation, contraction intensity and effectiveness, the women's behaviour and psychological state) the nurse takes on an “embodied authority” for the labouring woman ( Bassett, 1996 , p.287). This is a different authority from that of the physician, who may only attend the labouring woman periodically during labour and who depends on reports of the nurse's assessment for management of the labour and birth.…”

“…Based on the guidelines, policies, and risk assessment standards, childbirth is couched in biomedical philosophies and discourse. As Bassett (1996) and Bassett et al (2000) have illustrated, these discourses are obstetrically related, rather than woman and birthing focused. Kelly et al (2023) demonstrate how nurses’ labour and delivery work is shaped by medicolegal texts and authority in terms of reliance on technological interpretation of labour and the documentation that is prescribed in records of women's labours and births.…”

Rural perinatal nursing in Canada: A hermeneutic literature review

“…In considering the context of birthing care within small rural hospitals, two articles by Bassett (1996) and Bassett, et al (2000) explored what constitutes risk based on statistically determined parameters for length of labour and the use of technology to monitor fetal well-being. These medical anthropological studies offer insight into the ways in which these means of determining risk shape both nursing and physician practice.…”

“…This creates tension for the nurse who is bound to carry out physician orders, perhaps even in situations where interventions are thought by the nurse to be unnecessary. Basset (1996) described a labour where the physician is concerned about the perceived risk due to a patient's lengthy second (pushing) stage and considered intervening. While the physician was in the corridor discussing his concerns with a colleague, the nurse, trusting in the patient's process, assisted her to the crowning stage.…”

“…Collaboration is an important aspect of regional care networks and perhaps even more so for the care providers within any given facility. The literature reviewed presents many hints and examples of the importance of teamwork among healthcare providers and a few authors present accounts of trust and shared decision-making between nurses and physicians ( Bassett, 1996 ; Medves & Davies, 2015; Orkin and Newbery, 2014 ). Also shown is the support between nurses where some, more knowledgeable and experienced, are able to mentor others in care of perinatal patients (Medves & Davies, 2015; Orkin and Newberry, 2014 ).…”

“…The rural nurse admits the labouring patient, conducts a thorough assessment and makes immediate and ongoing judgments for the health and safety of the woman and her fetus. Based on ongoing assessment (fetal auscultation, cervical dilation, abdominal palpation, contraction intensity and effectiveness, the women's behaviour and psychological state) the nurse takes on an “embodied authority” for the labouring woman ( Bassett, 1996 , p.287). This is a different authority from that of the physician, who may only attend the labouring woman periodically during labour and who depends on reports of the nurse's assessment for management of the labour and birth.…”

“…Based on the guidelines, policies, and risk assessment standards, childbirth is couched in biomedical philosophies and discourse. As Bassett (1996) and Bassett et al (2000) have illustrated, these discourses are obstetrically related, rather than woman and birthing focused. Kelly et al (2023) demonstrate how nurses’ labour and delivery work is shaped by medicolegal texts and authority in terms of reliance on technological interpretation of labour and the documentation that is prescribed in records of women's labours and births.…”

Rural perinatal nursing in Canada: A hermeneutic literature review

“…In considering the context of birthing care within small rural hospitals, two articles by Bassett (1996) and Bassett, et al (2000) explored what constitutes risk based on statistically determined parameters for length of labour and the use of technology to monitor fetal well-being. These medical anthropological studies offer insight into the ways in which these means of determining risk shape both nursing and physician practice.…”

“…This creates tension for the nurse who is bound to carry out physician orders, perhaps even in situations where interventions are thought by the nurse to be unnecessary. Basset (1996) described a labour where the physician is concerned about the perceived risk due to a patient's lengthy second (pushing) stage and considered intervening. While the physician was in the corridor discussing his concerns with a colleague, the nurse, trusting in the patient's process, assisted her to the crowning stage.…”

“…Collaboration is an important aspect of regional care networks and perhaps even more so for the care providers within any given facility. The literature reviewed presents many hints and examples of the importance of teamwork among healthcare providers and a few authors present accounts of trust and shared decision-making between nurses and physicians ( Bassett, 1996 ; Medves & Davies, 2015; Orkin and Newbery, 2014 ). Also shown is the support between nurses where some, more knowledgeable and experienced, are able to mentor others in care of perinatal patients (Medves & Davies, 2015; Orkin and Newberry, 2014 ).…”

“…The rural nurse admits the labouring patient, conducts a thorough assessment and makes immediate and ongoing judgments for the health and safety of the woman and her fetus. Based on ongoing assessment (fetal auscultation, cervical dilation, abdominal palpation, contraction intensity and effectiveness, the women's behaviour and psychological state) the nurse takes on an “embodied authority” for the labouring woman ( Bassett, 1996 , p.287). This is a different authority from that of the physician, who may only attend the labouring woman periodically during labour and who depends on reports of the nurse's assessment for management of the labour and birth.…”

“…Based on the guidelines, policies, and risk assessment standards, childbirth is couched in biomedical philosophies and discourse. As Bassett (1996) and Bassett et al (2000) have illustrated, these discourses are obstetrically related, rather than woman and birthing focused. Kelly et al (2023) demonstrate how nurses’ labour and delivery work is shaped by medicolegal texts and authority in terms of reliance on technological interpretation of labour and the documentation that is prescribed in records of women's labours and births.…”

Rural perinatal nursing in Canada: A hermeneutic literature review

“…In considering the context of birthing care within small rural hospitals, two articles by Bassett (1996) and Bassett, et al (2000) explored what constitutes risk based on statistically determined parameters for length of labour and the use of technology to monitor fetal well-being. These medical anthropological studies offer insight into the ways in which these means of determining risk shape both nursing and physician practice.…”

“…This creates tension for the nurse who is bound to carry out physician orders, perhaps even in situations where interventions are thought by the nurse to be unnecessary. Basset (1996) described a labour where the physician is concerned about the perceived risk due to a patient's lengthy second (pushing) stage and considered intervening. While the physician was in the corridor discussing his concerns with a colleague, the nurse, trusting in the patient's process, assisted her to the crowning stage.…”

“…Collaboration is an important aspect of regional care networks and perhaps even more so for the care providers within any given facility. The literature reviewed presents many hints and examples of the importance of teamwork among healthcare providers and a few authors present accounts of trust and shared decision-making between nurses and physicians ( Bassett, 1996 ; Medves & Davies, 2015; Orkin and Newbery, 2014 ). Also shown is the support between nurses where some, more knowledgeable and experienced, are able to mentor others in care of perinatal patients (Medves & Davies, 2015; Orkin and Newberry, 2014 ).…”

“…The rural nurse admits the labouring patient, conducts a thorough assessment and makes immediate and ongoing judgments for the health and safety of the woman and her fetus. Based on ongoing assessment (fetal auscultation, cervical dilation, abdominal palpation, contraction intensity and effectiveness, the women's behaviour and psychological state) the nurse takes on an “embodied authority” for the labouring woman ( Bassett, 1996 , p.287). This is a different authority from that of the physician, who may only attend the labouring woman periodically during labour and who depends on reports of the nurse's assessment for management of the labour and birth.…”

“…Based on the guidelines, policies, and risk assessment standards, childbirth is couched in biomedical philosophies and discourse. As Bassett (1996) and Bassett et al (2000) have illustrated, these discourses are obstetrically related, rather than woman and birthing focused. Kelly et al (2023) demonstrate how nurses’ labour and delivery work is shaped by medicolegal texts and authority in terms of reliance on technological interpretation of labour and the documentation that is prescribed in records of women's labours and births.…”