WWW.DISSERTATION.XLIBX.INFO
FREE ELECTRONIC LIBRARY - Dissertations, online materials
 
<< HOME
CONTACTS



Pages:   || 2 | 3 | 4 | 5 |   ...   | 7 |

«Nuritinga ELECTRONIC JOURNAL OF NURSING Content Discuss and critique how the body may be problematic and how nurses ...»

-- [ Page 1 ] --

TASMANIAN SCHOOL OF NURSING

www.healthsci.utas.edu.au/tson/

Nuritinga

ELECTRONIC JOURNAL OF NURSING

Content

Discuss and critique how the body may be problematic

and how nurses may accommodate and respond to

3

these issues ………………………………………………………..….

Julie Carr, BN Student, Year 1

Tasmanian School of Nursing

University of Tasmania

Is it really just a uniform 'nurse'? ………………………….. 9 Heather Ladd, BN Student, Year 3 Tasmanian School of Nursing University of Tasmania The Corner Youth Health Centre: a critical evaluation of its role in supporting child health in the community..…. 14 Dale O'Brien, BN Student, Year 2 Tasmanian School of Nursing University of Tasmania Patient Profile: 'Scott Chopping' …………………………… 19 Lisa Sydes & A. Towns, BN Students, Year 2 Tasmanian School of Nursing University of Tasmania What do nursing students need to know about research? ………………………………………………………. 34 Karen Turnbull, BN Student, Year 2 Tasmanian School of Nursing University of Tasmania Film Review: Theory of Flight ………………………………. 39 Yvette Sneddon Tasmanian School of Nursing University of Tasmania Poetry - I am Pedro's Back ………………………………….. 40 Sharyn Hope, BN RN Tasmanian School of Nursing University of Tasmania "Discuss and critique how the body may be problematic and how nurses may accommodate and respond to these issues." J. Carr Discuss and critique how the body may be problematic and how nurses may accommodate and respond to these issues.

Julie Carr, BN Student, Year 1 Tasmanian School of Nursing Nuritinga Issue 3 June 2000 Abstract This essay will explore the view that the body becomes problematic in nursing due to the dominance of the biomedical model and its representations of the body. This model effectively renders much of the work that nurses do with the body invisible. The characteristics of the biomedical model and its representations of the body will be described. The central role of the body in nursing will be established and a contemporary concept of gender discussed. I will then briefly describe the historical construction of nursing and medicine that I believe has produced the gendered and hierarchical workplace that presently exists. Cartesian dualism and the development of a dominant discourse that defines the body scientifically will be examined in greater detail. My personal experiences both as a nurse in a neonatal intensive care unit and an experience as a patient in a neurosurgical unit will be examined in the light of these issues.

The biomedical model of medicine is characterised by an institutionalised, scientific, and technologically directed approach and is derived from the positivistic philosophy of Descartes (Turner 1987: 214). The body is represented as a machine and disease is seen as a mechanical problem (Parker 1997:11). The biomedical model is also focused on cure, not care and seeks to control 'dysfunctions of the body-physical by controlling the cellular molecular level' (Watson 1999:132). While this paradigm has had success and 'led to diagnostic and therapeutic advances of stunning effectiveness' (Cassell 1992:237) it has ignored the personalised and subjective experience of embodiment.

I write from a perspective that supports the view that the body is central to nursing (Parker, 1997:

11, Fassett & Gallagher, 1998: 15, Holmes, 1994: 111) and is more than just flesh and blood, being

produced as much through historical and cultural processes as biological processes (Parker, 1997:

21, Fassett & Gallagher 1998: 14, Grosz, 1994: 20, Turner, 1992: 47). I also support 'the perspective that considers gender to be one of the most important means by which the world is structured. This gendered structure grants men and women unequal opportunities, unequal access to resources and different social statuses' (Harrington and Kunkel, 1996: 8).

Connell (1987: 139) argues that 'collectivities, institutions and historical processes' are also gendered, and this understanding can be applied to the construction of nursing and medicine. The institutionalisation of women's role as caregivers can be traced to the rise of Christianity and its appropriation of Greek philosophical ideals regarding 'the superiority of the spirit over the inferiority of the body' (Colliere 1984: 99). By the 13 th Century hospital orders had developed, with nuns providing patient care, while at the same time women's knowledge of healing outside of

–  –  –

the church was declared pagan' (Colliere 1984: 99). A gendered hierarchy that allowed women to nurse under the control of men and punished women who chose to preserve their own knowledge was clearly visible. Punishment extended to death in the witch-hunts of 14 th to 18 th Centuries (Colliere 1984: 99). This gendered hierarchy continued into modernity.

Colliere maintains that a moral and a technical perspective determined the modern training of the nurse and care of the body became so overwhelmed by procedures and treatments that it became invisible within a task oriented environment. (Colliere 1984:102-103). Caring for the body subsequently became part of a moral identity rather than work (Reverby, 1987: 5). This perspective influenced my experience as a nurse training in the 1970's. Following medical orders and collecting data for doctors were visible and important parts of my work. Care of the body was assigned the title of 'basic nursing care' and the term basic was seen to mean 'simple' rather than 'essential' or 'fundamental' (Lawler 1991: 31). Caring for the body therefore became part of my feminine





identity, shaping the stereotypes of 'ministering angel' and 'Doctors handmaiden' (Bridges 1989:

851-2) rather than being central to my work as a nurse. These stereotypes also supported the existing gendered division of labour.

While historically the church had defined the body, and nurses owed their allegiance and devotion to God, in modernity science and the biomedical model define the body, and nurses owe their allegiance and devotion to the Doctor. While women are no longer are burnt as witches 'medical knowledge is legitimated as superior to subjective observation, intuition and the skilled practical knowledge acquired over time by the nurse' (Street, 1992:157). Nursing, and care of the body, have over time become strongly associated with femininity, while science, and medicine, have been constructed using masculine images (Lumb, Strube 1992: 87, Emden 1995:31). Wilshire (1989: 94points out that culturally we extol things perceived of as male and degrade those things perceived of as female, and supports Connell's (1987: 139) view that it is not only individuals that are gendered. The historical construction of nursing has produced a gendered hierarchy that functions regardless of the gender of individual nurses and doctors and values medical and scientific knowledge at the expense of all other forms of knowledge.

"This prevailing attitude affected my experience as a nurse on a daily basis. Perhaps its biggest effect was that I internalised these attitudes and thought of my colleagues and myself as 'just' nurses. I was taught to believe that part of the role of a good nurse was obedience and subservience to medical staff and to their assessment of any situation. At the same time close contact with patients meant I was aware of an expanding knowledge base being developed from my practice. This was often at odds with the bio-medical model and its understandings of the body and was difficult to verbalise. Any knowledge gained through the practice of nursing was gendered knowledge and could therefore be legitimately devalued as 'feminine'." (Carr 2000) Western philosophical thought is characterised by dichotomous thinking and leads to hierarchies that assign advantage to one of the polarised terms (Grosz 1994: 3). The mind/body separation of Cartesian dualism is an example of this type of thinking and has been a powerful influence on perceptions of the body. Holmes (1994: 105) states Cartesian dualism has 'delineated the realm of scientific enquiry, and of rationalist understanding, as being concerned with the physical and not the spiritual or psychological aspects of persons'. This has meant that the body has increasingly become a thing to be studied and the experience of embodiment is ignored (Madjar 1997:55).

–  –  –

As a nurse I often felt as if I was working in two worlds, the patient's and the Doctor's. As Lawler states (1991: 34) 'one cannot simply nurse the body in the bed' and I found it was impossible to focus only on the medically defined problem and provide effective care. How a person defined their illness and their body could not be ignored. Their lived, embodied experiences of health could not be ignored. But they were! While the concept of embodiment was not recognised I, and other nurses, were daily working with its reality. The body I worked with was not the one in textbooks, neatly divided into body and mind. Body and mind were inextricably linked. Scheper-Hughes and Lock (1987: 10, 30) point out that even when we begin to question the notions of Cartesian dualism we are often left without a vocabulary to voice our concerns.

Martin (in Turner 1992: 51) points out while we are able to acknowledge that the language used by medicine in previous centuries is a 'symbolic representation of social ideas', modern language is seen to be an accurate description of the natural world. Language is, however, recognized to have the power to shape our understandings of the world and to inform practice (Bruni 1995: 173, Turner 1992: 52) and this extends to our understanding of the body and our role as nurses in caring for bodies (Parker 1997: 11). Foucault (in Turner 1992:52-54) argued that understandings are created by the dominant epistemology of any given time. This ability to create reality is also linked to power (Turner 1992: 52-54) and Glass (1998: 122) reminds us with Delaclour's words, 'nursing has been constructed by powerful discourses including those of medicine and gender, in which our society's dominant ideologies are enshrined'.

In what way does this make the body problematic in nursing? The body in modernity has been created by the dominant scientific discourse of modern medicine (Parker 1997: 24, Foucault in Fassett and Gallagher 1998:14) and as Silverman (in Fassett & Gallagher 1998: 22) describes it 'discursive bodies lean upon and mould real bodies' Until recently alternative ways of describing or knowing the body had been silenced or marginalised (Gray & Pratt: 173,) and I believe that nursing is one of these alternative ways of knowing the body. However it may be that the invisibility of care of the body, and of nursing, in the dominant scientific discourse has been a double-edged sword.

While it has meant that our work has been unacknowledged and assigned little value it may have also created a space for this different way of knowing the body to grow and develop unimpeded.

Since Merleau-Ponty in 1962 (Turner 1992: 43) nurses have been writing of their knowledge of the body and embodiment and the recent proliferation of papers dealing with these issues could be seen to support this view. The challenge I see, as a nurse, is to take this conceptual and subjective view of the body and build its legitimacy in both the professional and public spheres.

My experience is that this way of knowing the body is sometimes accepted and respected but on an informal basis only. 'As a neonatal intensive care nurse there were huge amounts of observations to be recorded every hour. Many of these could be recorded without ever paying any attention to the baby; it was possible to simply look at the appropriate machines. As I gained experience I learnt that while all the observations could appear normal sometimes a baby just did not look right. Over time I learnt to trust this assessment and I saw other nurses doing the same. Although there was no way to adequately express my concerns, due to their experiential and subjective nature, I learnt that if I reported my concerns to an experienced doctor they were acted on. Just as my experience informed me, the doctor's experience was that this was valuable information. This was never recorded anywhere, only what was found was recorded' (Carr 2000)

–  –  –

The biomedical model of the body may dominate health care at the moment but this dominance is not total and nurses can choose to resist this dominance. I believe that as language constitutes knowledge and is linked to power nurses could use language to promote their knowledge of the body. If we can develop a discourse that adequately describes not only what we do, but also why we do it, we could challenge this dominance and allow a different model of the body to emerge.

The difficulty of working as care givers in an environment focused on cure also makes the body problematic in nursing. Parker (1997: 16, 22) sees cure and care as 'conflicting temporalities, one directed to the present time, the other towards the future. They can also be understood as competing ideologies of health care.' I have already established that medicine and nursing are gendered and cure and care are similarly gendered. This gendering leads to care of the body being invisible and devalued in a system that is focused on cure. In such a system the experience of embodiment and even the body as a whole can become lost. Cassell ( 1992: 237) tells us how the trend towards molecularisation in modern medicine has created a situation where pain is no longer understood in terms of human suffering but as the biology of nerve transmission. The embodied experience of pain is of no interest. For nurses, focused on care, the experience of pain is what matters. How an individual manages pain, what it means to them and how it affects their life are what matters. If these two ways of understanding the experience of pain were equally valued I believe the patient would be well served, but as Cassell points out 'medical science and disease theory naturally deal with clinical events by reaching for molecular explanations even when they provide no insight into the clinical situation'.

I will end this discussion by recounting a personal experience illustrating the importance of the work of nurses in caring for the body.



Pages:   || 2 | 3 | 4 | 5 |   ...   | 7 |


Similar works:

«On the Physical Death of Jesus Christ William D. Edwards, MD; Wesley J. Gabel, MDiv; Floyd E. Hosmer, MS, AMI Jesus of Nazareth underwent Jewish and Roman trials was flogged and was sentenced to death by crucifixion. The scourging produced deep stripelike lacerations and appreciable blood loss and it probably set the stage for hypovolemic shock as evidenced by the fact that Jesus was too weakened to carry the crossbar (patibulum) to Golgotha. At the site of crucifixion his wrists were nailed to...»

«Marine Bites and Stings Author: Dr Mark Little (Department of Emergency Medicine, Sir Charles Gairdner Hospital, Perth) Topic Reviewers: Prof Bart Currie (MSHR); Mike Barnes (Gove Hospital); Primrose Underhill (RAN, Galiwin’ku Clinic) Major box jellyfish (Chironex fleckeri) sting The major box jellyfish, Chironex fleckeri, is the most dangerous jellyfish in the world. In Australia it has killed 67 people. The last 10 deaths in the NT have all been children in remote coastal communities, with...»

«International Mother Language Day 2010 Revealing How Japanese Translators view their own social roles By TANABE Kikuko, Kobe College, Japan International Symposium: Translation and Cultural Mediation, UNESCO H.Q., Feb. 23, 2010 Good morning. First of all, I would like to thank the organizers of this symposium for giving me an invaluable opportunity to talk to an international audience and to exchange ideas with people from various cultural backgrounds. My name is Kikuko Tanabe and the college...»

«Herpes Zoster: [Print] eMedicine Dermatology http://emedicine.medscape.com/article/1132465-print emedicine.medscape.com eMedicine Specialties Dermatology Viral Infections Herpes Zoster Joseph S Eastern, MD, Clinical Assistant Professor, Department of Internal Medicine, Section of Dermatology, University of Medicine and Dentistry of New Jersey Updated: Oct 25, 2010 Introduction Background Zoster is a common, predominantly dermal, and neurologic disorder caused by the varicella-zoster virus...»

«PRODUCT MONOGRAPH NASONEX® mometasone furoate monohydrate aqueous nasal spray 50 mcg/metered spray (as mometasone furoate) Corticosteroid Merck Canada Inc. Date of Preparation: 16750 route Transcanadienne July 14, 1998 Kirkland, QC Canada H9H 4M7 www.merck.ca Date of Revision: July 18, 2013 Submission Control No. 164620 and Internal Filing June 2, 2015 NASONEX® (mometasone furoate monohydrate aqueous nasal spray) Page 1 of 28 Table of Contents PART I: HEALTH PROFESSIONAL INFORMATION SUMMARY...»

«Bulletin of Environment, Pharmacology and Life Sciences Bull. Env. Pharmacol. Life Sci., Vol 3 (2) January 2014:224-228 ©2014 Academy for Environment and Life Sciences, India Online ISSN 2277-1808 Journal’s URL:http://www.bepls.com CODEN: BEPLAD Global Impact Factor 0.533 Universal Impact Factor 0.9804 ORIGINAL ARTICLE The study of the Sustainability indexes in Lahijan and its effect on the Urban Environment Reihaneh Raoufi¹, Abdolkarim Keshavarz Shokri2*, Hassan Karimzadegan³...»

«ECOO Guidelines for Optometric and Optical Services in Europe June 2013 EXECUTIVE SUMMARY The European Council of Optometry and Optics (ECOO) has developed guidelines for optometric and optical services in Europe. The aim is to establish consistent guidance on the quality of service provision that the public should expect when accessing eye care services. ECOO representatives across several countries contributed to the development of the guidelines. Note: Given the variation in healthcare...»

«LARYNGOPHARYNGEAL REFLUX Emphasis on Diagnostic and Therapeutic Considerations Viet Pham, M.D. Faculty Advisor: Michael Underbrink, M.D. The University of Texas Medical Branch Department of Otolaryngology Grand Rounds Presentation August 25, 2009 All images obtained via Google search unless otherwise specified. All images used without permission except for those provided by Dr. Underbrink. (http://www.smbc-comics.com) Outline Features  Implications  Diagnostics  Reflux Symptom Index...»

«When is fisheries management needed?a) Daniel Paulyb) Abstract Following a brief review of the global fisheries crisis, a medical concept -triage is used to distinguish three types of fisheries, those that are (a) autonomous and healthy, i.e., may not require external management inputs; (b) affected by moderate resource decline problems, or resource access conflict, or (c) impacted by resource depletion or socioeconomic ills of a magnitude beyond that which can be addressed by dealing with the...»

«ANATOMY A brief outline for non-medical staff involved in clinical audit, injury scaling or trauma audit The TRAUMA Audit & Research NETWORK DEVELOPING EFFECTIVE CARE FOR INJURED PATIENTS THROUGH PROCESS AND OUTCOME ANALYSIS AND DISSEMINATION ANATOMY Acknowledgements • The Sourcebook of Medical Illustration. Edited by P. Cull. Contributors • P Nee, Consultant in Emergency Medicine, Whiston Hospital • M Woodford, National Coordinator, The Trauma Audit and Research Network • N Zoltie,...»

«THE IMPACT OF DIABETIC FOOT ULCER ON HEALTH RELATED QUALITY OF LIFE (HRQL) AND EMPLOYMENT AMONG RURAL DIABETIC POPULATION IN SOUTH KERALA Sithara S Pillai Dissertation submitted in partial fulfillment of the requirement for the award of the degree of Master of Public Health Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology Thiruvananthapuram, Kerala, India October 2012 Acknowledgments I am grateful to God Almighty for giving me...»

«A Quick Guide to Common Childhood Diseases Ministry of Health and Ministry Responsible for Seniors Canadian Cataloguing in Publication Data British Columbia. Community Care Facilities Branch. A Quick Guide to Common Childhood Diseases ISBN 0-7726-7648-8 Table of Contents Introduction 1 How to reduce or prevent the spread of communicable disease.................................... 2 Diseases spread by person-to-person contact....................»





 
<<  HOME   |    CONTACTS
2016 www.dissertation.xlibx.info - Dissertations, online materials

Materials of this site are available for review, all rights belong to their respective owners.
If you do not agree with the fact that your material is placed on this site, please, email us, we will within 1-2 business days delete him.