Description:
Although the idealisation of nurses as advocates is popularised in nursing literature and supported within nursing frameworks, codes and standards, there has been little critical examination of these ideas within contemporary Australian healthcare settings and nursing practice. The Australian Healthcare system is a complicated system of interacting service providers and consumers. Institutions that regulate healthcare professionals and organisations normalise understandings of nursing and nursing practice, including conceptualisations of the importance of autonomy and advocacy and how each is to be supported and/or practised. This study used the perceptions of practising Registered Nurses (RNs) to examine the actualities of advocacy and support for autonomy as they are carried out within clinical practice, and to highlight, problematise and then analyse differences between the rhetoric and realities of practice. Firstly, a phenomenological lens, including an ethnographic model of observation, was used to thematically map and examine the RNs’ lived experience of their practice, paying particular attention to their conceptions of and responsibilities toward advocacy and autonomy. This thematic analysis brought to the fore a range of assumptions that, although clearly normative within nursing practice, are in evident tension with one other. These were then re-examined using a range of Michel Foucault’s concepts concerning the construction and maintenance of regimes of truth. Designed to unpack the operations of power and knowledge, and to make visible the techniques of disciplinarity and governmentality that inform and support them, an engagement of these concepts has allowed this thesis to critically examine the normative constructions and enactments of nursing practice with regards to ideas and practices concerning advocacy and autonomy. What this thesis provides is a detailed examination of the contrasting constructions of power and knowledge within nursing practice in relation to advocacy and autonomy, how and why these concepts have been operationalised within nursing practice, and how they could be re-visioned into the future.
Description:
Although the idealisation of nurses as advocates is popularised in nursing literature and supported within nursing frameworks, codes and standards, there has been little critical examination of these ideas within contemporary Australian healthcare settings and nursing practice. The Australian Healthcare system is a complicated system of interacting service providers and consumers. Institutions that regulate healthcare professionals and organisations normalise understandings of nursing and nursing practice, including conceptualisations of the importance of autonomy and advocacy and how each is to be supported and/or practised. This study used the perceptions of practising Registered Nurses (RNs) to examine the actualities of advocacy and support for autonomy as they are carried out within clinical practice, and to highlight, problematise and then analyse differences between the rhetoric and realities of practice. Firstly, a phenomenological lens, including an ethnographic model of observation, was used to thematically map and examine the RNs’ lived experience of their practice, paying particular attention to their conceptions of and responsibilities toward advocacy and autonomy. This thematic analysis brought to the fore a range of assumptions that, although clearly normative within nursing practice, are in evident tension with one other. These were then re-examined using a range of Michel Foucault’s concepts concerning the construction and maintenance of regimes of truth. Designed to unpack the operations of power and knowledge, and to make visible the techniques of disciplinarity and governmentality that inform and support them, an engagement of these concepts has allowed this thesis to critically examine the normative constructions and enactments of nursing practice with regards to ideas and practices concerning advocacy and autonomy. What this thesis provides is a detailed examination of the contrasting constructions of power and knowledge within nursing practice in relation to advocacy and autonomy, how and why these concepts have been operationalised within nursing practice, and how they could be re-visioned into the future.
Description:
Background: Nurses worldwide are expected to take a leading role in caring for older people. Considerable literature dedicated to the range and application of assessment skills used by nurses vary. There is limited knowledge of registered nurses' (RNs) views of their assessment of older adults.Aim: The aim of this project was to explore RNs current perceptions of nursing assessment, and the core skills they identified as necessary.Design: A qualitative descriptive design study was conducted in three inpatient units in one regional hospital in Victoria.Method: Date were collected through participant observation of RNs (n = 13) followed by 1:1 semi-structured interviews. Data were analysed thematically.Conclusion: This research has illuminated that an ill-defined repertoire of skills was used by RNs when assessing older persons. Skills identified appeared to be based on years of personal-professional experience. Differences were noted between the descriptions nurses gave and what was observed during interactions with older persons.