Author: Mayumi Kako
Kako, Mayumi, 2008 From ‘uncertainty’ to ‘certainty’? A discourse analysis of nursing professionalisation in South Australia since the 1950s, Flinders University, School of Nursing & Midwifery
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This study was undertaken using Foucault’s genealogical approach to explore an aspect in the governmentality of the nursing profession from the 1950s to the present. It uses developments in the education of nurses in South Australia as a case in point, but includes, at all stages, a concomitant analysis of global trends in the profession and education of nurses. Hence, data were collected from historical documents such as government reports, professional nursing journals, nursing text books and curriculum documents across the period for analysis, from South Australia and Flinders University as a particular case. I thought of these texts as data and examples of the production of discourses about nursing education and practice influenced by the Foucauldian method of process of The Archaeology of Knowledge (1972). These discourses produced in both social and professional spheres mirror the sociological knowledge development of the professionalisation agenda that has enveloped the process of professional legitimacy since the Second World War. The interactions are described intertextuality, with each chapter in this thesis presenting the interconnectedness of a variety of discourses. The Foucauldian perspective achieved the purpose of seeking how nursing was shaped by the society and influenced society to form what constituted a nursing professional, to the present time. ‘Uncertainty’ in the nursing profession was the key concept found in the investigation. Nursing attempted to reduce uncertainty by regulating nursing education, and by setting boundaries for the practice of professional nursing. This governmentality generation process reflects other forms of surveillance developed during the late 20th century, and was used to establish the subjectivity of nurses in terms of ‘who’ has the right to define nursing and its knowledge systems. The role of the nurse and the requirements for a nurse were emphasised as personal characteristics rather than as professional behaviour when nurse ‘training’ occurred solely in the hospitals. Who defined the role of nurse and who could be a nurse was decided by medical officers and administrators rather than nurses themselves. As the description of the role of the nurse was expanded to the social sphere, the debates about the appropriate place for nursing students’ training was influential in bringing about change. Establishing nursing education in the tertiary sector facilitated the professionalisation of nursing. I explored curriculum development as an example of the internal governmentality of nursing. The historical analysis of curriculum development processes at an Australian university and its antecedent organisations, showed how nursing educators think about nursing and the role of nurse and how they reflect these requirements in the teaching of nursing students. The way of thinking about nursing and the professional nurse role was also actively observed in the discourses arguing for the use of the thinking tools of nursing such as the nursing process, other problem-solving approaches and latterly for the use of clinical reasoning. This study uncovered the process of handling uncertainty internal and external to nursing through processes of professional education. Uncertainty control was an essential in nursing education and thinking tools were key in the process for nursing educators to re-set the parameters of nursing. Professional education aims to develop both the individual nurse and the profession, as a whole, which may lead to conflicts of interest. Therefore, it is important for nurse educators to be aware of these potential conflicts of interests in their governmental strategies. It is also necessary to develop an interactive and corroborative curriculum that includes the many stakeholders interested in the development of the nursing profession.
Keywords: nursing,history,discourse analysis,professionalisation,Foucault,South Australia
Subject: Nursing thesis
Thesis type: Doctor of Philosophy
School: School of Nursing & Midwifery
Supervisor: Professor Trudy Rudge, Ms Judith Condon