Governing nursing conduct: the rise of evidence‐based practice

Abstract

Drawing on the Foucauldian concept of 'governmentality' to analyse the evidence-based movement in nursing, we argue that it is possible to identify the governance of nursing practice and hence nurses across two distinct axes; that of the political (governance through political and economic means) and the personal (governance of the self through the cultivation of the practices required by nurses to put evidence into practice). The evaluation of nursing work through evidence-based reviews provides detailed information that may enable governments to target and instruct nurses regarding their work in the interest of preserving the health of the population as a whole. Political governance of the nursing population becomes possible through centralised discursive mechanisms, such as evidence-based reviews that present nursing practice as an intelligible field whose elements are connected in a more or less systematic manner. The identity of the evidence-based nurse requires the modern nurse to develop new skills and attitudes. Evidence-based nursing is an emerging technology of government that judges nursing research and knowledge and has the capacity to direct nursing practice at both the political and personal level.

Deconstructing the evidence-based discourse in health sciences: truth, power and fascism

“…In 1993, the Cochrane Collaboration, serving as an international research review board, was founded to provide clinicians with a resource aimed at increasing clinician–patient interaction time by facilitating clinicians’ access to valid research 2 . The Cochrane database was established to provide this resource, and it comprises a collection of articles that have been selected according to specific criteria 7 . For example, one of the requirements of the Cochrane database is that acceptable research must be based on the RCT design; all other research, which constitutes 98% of the literature, is deemed scientifically imperfect 6 …”

If Only “a Rose by Any Other Name Would Smell as Sweet”: A Systematic Review on the Impact of Youth Work for Young People

“…In this regard it is worth noting differences in the criticisms of the systematic review methodology with respect to the area of practice concerned. Whereas in nursing and educational fields, the criticisms are concerned with issues of professional power (Clegg 2005;MacLure 2004) and the limited scope (Winch et al 2002) of systematic reviews, criticism in the medical field, at least where scope is concerned, is often from a positivist view claiming that the Cochrane definitions are not precise enough (Fahy and Tracy 2007).…”

The Politics of Self-Craft

“…That is, they are directed at the level of the population, they constitute individuals and groups as "problems" and domains of governance needing the assistance of health promotion "experts," they are systematic, calculated and directed at defined ends, they emerge from the state but are also articulated by associated independent institutions and agencies. (Lupton, 1995, p. 49) Moreover, elements of a governmentality approach have been applied to a number of arenas of health and human welfare, including obesity and the use of the body mass index (Evans & Colls, 2009), HIV/AIDS education (Schee & Baez, 2009), learning disabilities (Gilbert, Cochrane, & Greenwell, 2005), nursing (Clinton & Hazelton, 2002;Holmes & Gastaldo, 2002;Winch, Creedy, & Chaboyer, 2002), hormone replacement therapy (Harding, 1998), mental health and psychiatry (McCallum, 1998;Tyler, 1998), and eating disorders (Eckermann, 1998).…”