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This paper examines how certain care values permeate, legitimize and authorize hospitalized-older-adults’ care, technologies and practices. The purpose of this paper is to…
This paper examines how certain care values permeate, legitimize and authorize hospitalized-older-adults’ care, technologies and practices. The purpose of this paper is to expose how values are not benign but operate discursively establishing “orders of worth” with significant effect on the ethics of the care-setting.
The paper draws from a discursive ethnography to see “up close” on a surgical unit how values influence nurse/older-adult-patient care occasions in the domain of older-adults and functional decline. Data are from participant observations, conversations, interviews, chart reviews and reviewed literature. Foucauldian discursive analytics rendered values recognizable and analyzable as discursive practices. Discourse is a social practice of knowledge production constituting and giving meaning to what it represents.
Analysis reveals how care values inhere discourses like measurement, efficiency, economics, risk and functional decline (loss of capacity for independent living) pervading care technologies and practices, subjugating older adults’ bodies to techniques, turning older persons into measurable objects of knowledge. These values determine social conditions of worth, objectifying, calculating, normalizing and homogenizing what it means to be old, ill and in hospital.
Seven older adult patients and attendant nurses were followed for their entire hospitalization. The ethnography renders visible how care values as discursive practices rationalize the social order and operations of everyday care. Analytic outcomes offer insights of how dominant care values enabled care technologies and practices to govern hospitalized-older-adults as a population to be ordered, managed and controlled, eliding possibilities of engaging humanistic patient-centered care.
The purpose of this paper is to consider how meaning may be made of nursing practices by contrasting the rationalistic approach commonly used in the nursing literature…
The purpose of this paper is to consider how meaning may be made of nursing practices by contrasting the rationalistic approach commonly used in the nursing literature with Bourdieu’s theory of practice.
The data under consideration is an account of ten to 15 minutes of a larger ethnographic study of nursing practices which asks the question: how do nurses accomplish nursing within and between patients’ needs for care in the acute hospital setting? The five main sources of data were: observations of and conversations with nurse participants, as well as hospital documentation (including facility protocols and patients’ notes) and the observer’s field diary. These were woven together to provide an account of one nurse with one patient for a few moments of her day.
Although this paper makes no attempt to speak to the rest of her workload, in these few minutes the nurse accomplishes multiple moments of nursing practice. Further, while the rationalistic approach presents the nurse as a highly skilled practitioner, Bourdieu’s theory of practice not only illuminates the nurse’s role as pivotal in the acute hospital setting but is also able to address the dialectical nature of the relationship between nurses’ practices and the dynamics of the context.
The use of Bourdieu’s theory of practice makes possible the study of how nurses nurse “within and between” to illuminate the everyday practices of nurses.