Foucault and nursing: a history of the present

While a commitment to the development of nursing theory has been a significant force in nursing scholarship, particularly in the US, the authors have noted a recent trend among nurses in different countries to develop Foucauldian interpretations of nursing. The objective of this paper is to identify those publications by nurses that employ a Foucauldian perspective and to provide a useful summative review of these works to date, which illustrate the potential contribution of a Foucauldian reading of nursing. The authors have reviewed 27 publications written by nurses which present a Foucauldian analysis. These publications were issued between 1987 and 1998 in English, Portuguese and German. The most frequent concepts treated in the literature reviewed are power/knowledge, surveillance, discourse, discipline, resistance, docile bodies, clinical gaze, and panopticon. The literature reviewed illustrates that Foucault's concepts can have a profound impact on the way we conceive of nursing as a discipline and as a profession. Nursing care becomes a political event, nursing knowledge contributes to the dissemination of regimes of truth, and nurses, rather than being powerless, are perceived as professionals who exercise power over life in society. A Foucauldian reading of nursing enables nurses to move into a broader interdisciplinary and critical scholarship.     

The perceived need for Japanese nursing faculty members to learn English: issues related to career development

In Japan, nurses are increasingly expected to use English in various settings. English language proficiency is indispensable in almost all aspects of the clinical experience and for career development of Japanese nurses. This article introduces the idea of Japanese nurses learning the English language to enhance their career development and provides succinct survey results about the perceived need for learning English, based on responses from 145 nursing faculty members across Japan. Analyses showed that most faculty members considered English language proficiency important for nursing expertise and career development. Overall, the results indicated that Japanese nurses require continuing English language education. Further study of their need to learn English and ways to implement English education programs is required.     

Development of the School of Nursing, Midwifery, and Public Health at Siriraj, Thailand 1896-1971: a historical study

This study examined the history and development of the first nursing school in Thailand. Data were collected using a historical methodology through a review of related literature, as well as interviews with senior nurses. All data were clustered and categorized by using content analysis and an historical lens. The results revealed that the School development was divided to three periods: the School development in 1896-1925 (the foundation of modern Thai nursing); 1926-1955 (the influence of American medical and nursing education); and 1956-1971 (the transfer of a hospital-based training to university-based nursing education). In the final period, there was recognition that was associated with the professionalization of nursing, as the School initiated a bachelor degree in nursing and became the Faculty of Nursing. Through this long development, the School has progressively assisted Thai nursing to become a strong profession with international standards and recognition. The results of this study add significantly to the history of nursing in Thailand, and help nurses internationally to appreciate the efforts that have continued to sustain their noble profession.     

Facilitating the transition of Asian nurses to work in Australia

takeno y. (2010) Journal of Nursing Management 18, 215–224
Facilitating the transition of Asian nurses to work in Australia Aim The purpose of the present study was to explore the perceptions of Korean and Japanese nurses’ about nursing in Australia. Background There are increasing numbers of overseas nurses entering Australian nursing. More nurses educated in Asian countries are arriving. Study design Qualitative research methodology comprised in-depth semi-structured interviews with five registered nurses, who had worked in both Australia and their home country. Results The research participants were mostly satisfied with working conditions, support and continuing nursing education in Australia. However, English language deficits, differences in culture and beliefs about the nurse’s role were found, that could create the potential for misunderstandings. They also recognized that too much help may be a form of covert discrimination. Conclusions The participants had some transition issues, particularly in adjusting to differences in the role of the nurse between Korea or Japan and Australia. This research highlights potential sources of misunderstanding and dissatisfaction which may be worth exploring in relation to other cultures. Implications for nursing management Addressing the findings of this research may help nurse managers better anticipate and address issues which may cause difficulties for overseas nurses’ adjusting to nursing in a new culture.     

The divergent opinions of nurses,nurse managers and nurse directors: the case in Lebanon

badr l., rizk u. & farha r. (2010) Journal of Nursing Management 18, 182–193
The divergent opinions of nurses, nurse managers and nurse directors: the case in Lebanon Aim The present study provides an overview of the status of the nursing profession in Lebanon and compares and contrasts the opinions of directors, nurse supervisors/managers and nurses regarding the nursing profession and the workplace. Background There are limited publications concerning the working conditions of nurses in Lebanon, and no studies on the views of directors, supervisors/managers and nurses regarding the priorities of the nursing profession. Such data are necessary to build a sound theoretical basis on which recommendations for improving the nursing profession in Lebanon are made as well as to compare and contrast cross cultural findings. Method Data were collected from 45 hospitals using a mixed methods design. Qualitative data was obtained from 45 nursing directors whereas quantitative data were collected from 64 nursing supervisors and 624 nurses. Results Similarities and differences in the opinions of nurses, nurse supervisors/managers and nurse directors regarding critical issues for the nursing profession are discussed and contrasted. Conclusions/implications Nurses are more likely to be satisfied and committed to their profession when they feel that their opinions are being heard and that their work environment promotes professional advancement.     

Growing together: a qualitative study of leading nurse scholars in Thailand

TURALE S., KLUNKLIN A. & CHONTAWAN R. (2010) Growing together: a qualitative study of leading nurse scholars in Thailand. International Nursing Review 57 , 202–210 Background: Asia‐Pacific nursing education and research is growing but little is known about the nature and development of nursing scholarship in the region. Aim: This qualitative study explored the perspectives of 14 leading Thai scholars about the development, facilitators and barriers relating to Thailand's nursing scholarship. Method: In‐depth interviews were digitally recorded, and data were subjected to content analysis. Findings: Five themes arose: (1) growing together, (2) visionary leadership, (3) external support to grow nurse scholars, (4) developing nursing through research, and (5) barriers to scholarship. A history of visionary nursing leadership was revealed, underpinned by leaders' values of growing nursing together. Resource sharing among universities, and a significant number of scholarships for study abroad were major facilitators of scholarship growth. Barriers to scholarship included high teaching loads, especially for newly graduated faculty; a low rate of research publications; not enough mentorship for research and changes to teaching practice; and a wide range of different agencies providing courses for entry to practice. Conclusions: Scholarship development in Thailand is a role model for a number of South‐East Asian countries, with inclusiveness and collaboration to facilitate the growth of nursing education inside and outside of the country as a hallmark of its character. However, against a backdrop of nursing shortages, Thai scholars are challenged, in the future, to produce meaningful research outcomes, including publications of studies; to collaborate with other health professionals; change practices to overcome high teaching loads; and provide the much needed mentorship for young scholars.     

Towards an international theory of nursing

Abstract During the latter half of the 20th century, the development of numerous nursing theories has enriched nursing scholarship and education worldwide, a movement initially led by North American scholars. Recently, nurses outside of North America have begun to reformulate these theories in order to make them relevant in other contexts. This study summarizes those movements in developing an international theory of nursing and suggests future directions for such a theory.     

Nursing workloads: the results of a study of Queensland Nurses

This paper reports the findings of a survey undertaken in Queensland, Australia in October 2001. The participants were registered and enrolled nurses and assistants in nursing who were members of the industrial body - the Queensland Nursing Union (QNU), and who were in paid employment in nursing in Queensland. Participants were selected by random sampling from each of the three major employment groups - the aged care, public and private acute sectors. Of the 2800 invited participants, 1477 responded resulting in an overall response rate of 53%. The findings indicate that over 50% of nurses in the aged-care sector, 32% of nurses in the public and 30% of nurses in the private acute sector experience difficulties in meeting patient needs because of insufficient staffing levels. The nurses in this study also believed that there was poor skills-mix, mostly caused by lack of funding, too few experienced staff or too many inexperienced staff. Many nurses in this study expressed their anger and frustration about their inability to complete their work to their professional satisfaction in the paid time available. Further, many nurses also expressed the view that because of this inability they were planning to leave the nursing profession. These findings are consistent with other research into the nursing workforce both within Australia and internationally.     

Critical thinking integration into nursing education and practice in Japan: views on its reception from foreign-trained Japanese nursing educators

The development of critical thinking (CT) abilities for clinical practices is a current emphasis in nursing education and practice in Japan. Through informal discussion with foreign educated Japanese nurses who had learnt CT, the expressed concern was that the educational concepts focusing on the development of CT skills do not appear to be successfully implemented into nursing curriculum of many faculties in Japan. The main focus of this study is to explore the views of foreign educated Japanese nursing educators on the receptivity of an alternative approach to integrate CT into nursing education and practice in Japan. Relevant literature on Japanese nursing practice and education is reviewed as it provides a background for the study and highlights potential influences concerning the participants. Heideggerian phenomenology and interpretive methods to analyse semi-structured interviews provided the analytic basis for the study. Analysis of data revealed that participants' main concerns were the lack of integration of CT teaching and learning approaches for the development of CT abilities into the current milieu of Japanese nursing education and practice. The reasons for the participants' concerns have been related to the influence of cultural and educational values shaping contemporary nursing education approaches and practices. The outcomes of this study propose how these values reverberate through teaching, learning and practice methods.     

A reflective discussion: questions about globalization and multiculturalism in nursing as revealed during a student/staff exchange programme

The purpose of this paper is to present elements of a discussion on the discipline of nursing that arose from a student–faculty exchange programme, as a reflection of the experiences the students and faculty had during the 3-year exchange. It suggests that the globalization of health and the international migration of nurses might prove to be an opportunity for nurses to learn more about nursing practice. It became apparent to the participants that the phenomenon of nursing, although understood by them all, was not easy to describe, and words used in Swedish, Finnish or British or American English were often not easy to interpret or explain. These reflections were noted by the authors when the group came together to plan the programme and design experiences for the participants. We were concerned how nursing could contribute to health-care improvement globally if it wasn't universally understood within the four countries concerned.     

Humanism and its critiques in nursing research literature

Title.  Humanism and its critiques in nursing research literature.
Aim.  This paper raises for debate the issue of how humanist ideas have been taken up by nurse scholars, particularly in research literature.
Background.  Many nurses from the mid-1970s onwards have described and promoted humanism as an appropriate philosophical basis for nursing practice and research. This has been partly in an attempt to sharply differentiate the profession from medicine, and later, managerialism, which have been represented as reductionist and failing to adequately respond to the whole patient.
Methods.  A summary of definitions of humanism and critiques of humanism in broad philosophical literature is followed by an examination and critique of literature appearing in PubMed published within nursing scholarship from 1976 to 2007 which discusses or promotes humanism in nursing practice or research.
Findings.  Writers have attempted to enhance the importance of nursing by associating it with the humanistic project of accepting responsibility for realizing our human potential. They have promoted a version of research which is qualitative and centres on understanding individual lifeworlds of research participants because of a strong valuing of the experiences and perspectives of the individual. Much of the literature on this topic describes this humanism in dualistic contrast to medico-scientific reductionism and objectivity.
Conclusion.  Some of the presentations of humanistic nursing lack rigour and can be seen as doing little more than reproducing professional ideology. Scholars and others in the field of nursing could take the trouble to submit these ideologies to proper scrutiny.     

Educating international nurses: curricular innovation through a bachelor of science in nursing bridging program

A curricular innovation was designed to provide internationally educated nurses with access to nursing licensure and employment. Through a program that includes professionally relevant English language support, mentorship, academic upgrading, workplace experiences, and clinical skills support, a mechanism has been created for internationally educated nurses to earn a bachelor of science in nursing degree and overcome barriers to practicing their profession.     

Hospital nurse administrators in Japan: a feminist dimensional analysis

BACKGROUND: Nursing administration research is scarce in Japan during a time when health care is rapidly reforming and baccalaureate and graduate nursing programmes are rapidly developing. Additionally, nursing administration content relies heavily on Western and non-nursing theories, some of which have been criticized for male bias. PURPOSE: The purpose of this article is to present key findings from a qualitative study that explored the perspectives or viewpoints of 16 Japanese senior female nurse administrators in hospitals in order to learn what was happening in their working situations and how they were managing. DESIGN AND METHODS: This feminist study used dimensional analysis strategies for data collection and analysis. Semi-structured, tape-recorded interviews were conducted by both researchers in Japanese, transcribed into Japanese, and translated into English. RESULTS AND DISCUSSION: The resulting explanatory matrix portrayed a story of 16 nurse administrators, most of whom were able successfully to enact a management role in a context of role ambiguity that was congruent with their relational values and beliefs. Important conditions influencing value-based role enactment included organization mission and purpose, organization structure, nurse-doctor relationships, participant-supervisor relationships, and personal attributes. Many participants were able to overcome barriers in these categories using strategies of tempered radicalism and consequently made positive organizational changes. CONCLUSIONS: Advanced formal education, better organizational support, and a raised consciousness among nurses that views nurses and midwives as equal partners with other professionals will enable Japanese nurse administrators to help advance patient-centred care and nursing development and empowerment.     

Job control,work-family balance and nurses’ intention to leave their profession and organization: A comparative cross-sectional survey

BackgroundThe shortage of nurses is a problem in many countries. In Japan, the distribution of nurses across different care settings is uneven: the shortage of nurses in home healthcare and nursing homes is more serious than in hospitals. Earlier research has identified numerous factors affecting nurses’ intention to leave work (e.g., job control, family-related variables, work-family conflict); however, these factors’ levels and effect size may vary between nurses in hospitals, home healthcare, and nursing homes.ObjectivesThis study measured job control, family-related variables, and work-family conflict among nurses in hospitals, home healthcare, and nursing homes, and compared these variables’ levels and effect size on nurses’ intention to leave their organization or profession between these care settings.DesignThe research design was cross-sectional.MethodsParticipating nurses from hospitals, home healthcare facilities, and nursing homes self-administered an anonymous questionnaire survey; nurses were recruited from the Kyushu district of Japan. Nurses from nine hospitals, 86 home healthcare offices, and 107 nursing homes participated. We measured nurses’ intention to leave nursing or their organization, perceived job control, family variables and work-family conflict. We analyzed 1461 participants (response rate: 81.7%).ResultsThe level of job control, family variables, and work-family conflict affecting nurses varied between hospitals, home healthcare, and nursing homes; additionally, these variables’ effect on nurses’ intention to leave their organization or profession varied between these care settings. Work-family conflict, family variables, and job control most strongly predicted nurses’ intention to leave their organization or profession in hospitals, home healthcare, and nursing homes, respectively.ConclusionsInterventions aiming to increase nurse retention should distinguish between care settings. Regarding hospitals, reducing nurses’ work-family conflict will increase nurse retention. Regarding home healthcare, allowing nurses to fulfill family responsibilities will increase nurse retention. Regarding nursing home nurses, increasing nurses’ job control will increase nurse retention.     

A community-oriented primary care nursing model in an international setting that emphasizes partnerships

PURPOSE: To present an interdisciplinary, community-oriented primary care nursing model that effectively draws upon the strengths of advanced practice nurses (APNs), both nurse practitioners and community health nurses. DATA SOURCES: Articles in professional nursing journals, international data sources, and the clinical experiences of the authors, both domestic and international. CONCLUSIONS: The model, developed domestically, was utilized successfully by APNs internationally in a medical mission endeavor in rural Haiti. Many partners, domestic and Haitian, worked as an interdisciplinary team to deliver quality health care to an impoverished population. Graduate nursing students participated in the program, which offered opportunities and challenges for both novice and expert nurses. IMPLICATIONS FOR PRACTICE: Nurse practitioners, community health nurses, and nursing faculty members can use this model to enhance their professional practice. They can learn that clients can be optimally cared for whether the community served is domestic or international. Nursing faculty can teach graduate nursing students about the value of partnerships and collaboration.     

Perceptions and expectations of Baccalaureate-prepared nurses in Jordan: Community survey

The overall purpose of this paper is to describe the process of utilizing community participation for curriculum design to develop a new school of nursing. A brief Community Needs Assessment Survey was carried out in order to explore community perceptions and expectations of Baccalaureate-prepared nurses in Jordan. The sample consisted of 152 participants who were staff nurses, nurse administrators, nurse supervisors, nurse educators, physicians, pharmacists and consumers of services. Data were collected through a self-administered survey form using open-ended questions. Participants were asked to describe their perceptions of nursing and nurses, the desired professional skills and personal characteristics of the Baccalaureate-prepared nurse, important curriculum contents and to provide suggestions or comments for improving the preparation of Bachelor of Science in Nursing (BSN) nurses. The findings indicated that nursing was viewed as a caring profession where nurses care for the person both in sickness and health. Several professional skills and personal characteristics emerged as being important for the BSN nurse, including clinical competence, the desire to continue learning, communication skills, ethical and moral character, critical thinking, assessment skills, and computer and English-language skills. The participants provided the desired curriculum contents and suggestions related to the expected skills. Implications for nursing education were discussed.     

The system of nursing in Chile: Insights from a systems theory perspective

Nursing is possible owing to a series of intricate systemic relations. Building on an established tradition of sociological research, we critically analysed the nursing profession in Chile, with an emphasis on its education system, in the light of social systems theory. The paper's aim was to explore basic characteristics of nursing education as a system, so as to outline its current evolution. Drawing on recent developments in nursing, we applied an empirical framework to identify and discuss functionally differentiated systems that are relevant to nursing and observe communications between them. We found that the dynamics of nursing as a whole develop from communications with closely related systems, including the nursing profession and the education system more broadly. While the discipline (as a system of representations) strives to control the profession (as an applied occupational field), the necessities of practicing nurses imply other forces mediating the making of the profession, a process framed by market dynamics in education and health.     

Issues and challenges in international doctoral education in nursing

Education is a driving force in improving the health and welfare of communities globally. Doctoral education of nurses has been identified as a critical factor for provision of leadership in practice, scholarship, research, policy and education. Since the genesis of doctoral education in nursing in the USA in the 1930s, this movement has burgeoned to over 273 doctoral programs in over 30 countries globally. The present article seeks to identify the issues and challenges in nursing doctoral education globally, and those encountered by doctoral program graduates in meeting the challenges of contemporary health care systems. Information was derived from a comprehensive literature review. Electronic databases and the Internet, using the Google search engine, were searched using the key words "doctoral education"; "nursing"; "International Network for Doctoral Education in Nursing"; "global health"; "international research collaboration". Doctoral education has been a critical force in developing nurse leaders in education, management, policy and research domains. An absence of consensus in terminology and of accurate minimum data sets precludes comparison and debate across programs. The complexity and dynamism of contemporary globalized communities render significant challenges in the conduct of doctoral programs. Addressing funding issues and faculty shortages are key issues for doctoral programs, especially those in developing countries, to achieve an identity uniquely their own. These challenges can also afford considerable opportunities for discussion, debate and the formulation of innovative and collaborative solutions to advance nursing knowledge and scholarship. In spite of discrete differences between countries and regions, the similarities in the issues facing the development of doctoral programs internationally are more striking than the differences. The harnessing of a global collective to address these issues will likely serve to not only forge the future viability of doctoral education of nurses but to improve the health and well-being of communities. This paper proposes international collaborative strategies to address a number of the challenges identified.