On Technology and the Prospects for Good Practice in the Human Services: Donald Schön, Martin Heidegger, and the Case forPhronesisandPraxis

Information systems in nurses' work: Technical rationality versus an ethic of care

“…Following a Taylorist ideology, in HIS, care is packaged into tasks that the nurses need to conduct (Wise et al, 2017), and this packaging is centralised with nurses having very little say in the process. Although this reshaping of personal relationships with patients into defined steps and packages had started even before the wave of digitalisation (Choiniere, 2011; Emslie & Watts, 2017; Wise et al, 2017), enforcing it through digital tools has made it much more pervasive. HIS were also influencing the professional identity of the nurses (Nilsson et al, 2016): nurses felt that they were becoming computer people rather than caring people—being forced to work not according to a care rationality, but according to a technical rationality that has shown to be inadequate in work where interpersonal relations are important (Schön, 1983).…”

“…He argued that technical rationality in our society requires 'thoughtlessness', that is, that the space for individual, creative decision-making has declined. According to Emslie and Watts (2017), the neoliberal society and its governance by new public management are based on technical rationality.…”

“…The definition of the International Council of Nurses also makes it clear that it is the needs of the people cared for that are the focus of the relationship. Emslie and Watts (2017) regard present-day healthcare, however, as governed by a new managerialism and a regime in which productivity is fetishised. The task of healthcare is seen as the production of cures by means of distribution of medical interventions and care.…”

“…Neither Emslie and Watts (2017) nor Vosman and Niemeijer (2017) discuss the introduction of HIS to a hospital context in particular, but the concepts of technical rationality and ethic of care are highly relevant in the digital transformation taking place in hospital care. Hence, this study uses the concepts of ethics of care (Tronto, 1993(Tronto, , 2010 and technical rationality (Schön, 1983) to analyse nurses' experiences with HIS in a large university hospital in Sweden.…”

“…Emslie and Watts (2017) regard present‐day healthcare, however, as governed by a new managerialism and a regime in which productivity is fetishised. The task of healthcare is seen as the production of cures by means of distribution of medical interventions and care.…”