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Re-valuing Nursing Expertise. Nursing Directors’ Tactics to (Re)work Knowledge and Power in Hospital Governance towards a Person-Centred Perspective. Passed

Wednesday May 15, 2024 14:30 - 15:13 Poster Arena

Presenter: Dieke Martini

Track: Equity, Posters

Poster can be found in location 97.

Shared governance in hospitals promotes the inclusion of nurses’ expertise, knowledge and skills in organisational processes. Although, historically, nurses have been structurally excluded from power hierarchies, governance structures, and decision-making venues, they increasingly fulfil (hierarchical) organisational positions in hospitals1. This is partly due to a growing consensus that a person-centred approach - in which, among others, providing holistic care, engagement and shared decision-making are key- is necessary to face the burdens that healthcare systems face2. Theoretically, shared governance increases nurses’ influence in shaping policy and practice. However, incorporating nursing expertise in governance structures might be complicated, as these structures are largely based on managerial and biomedical expertise as the dominant modes of knowing3,4. Drawing on a Foucauldian perspective on knowledge and power5, intertwined and embedded in everyday practices and interactions, we study what happens when ten newly appointed nursing directors in a large university medical centre challenge dominant modes of knowing by emphasizing person-centredness as crucial nursing expertise. We conducted a (historical) document analysis to gain insight into how the history of nursing director roles relates to how (s) in which nursing expertise is/might be valued presently in healthcare organisations.  Furthermore, following the so-called learning history method, we gathered qualitative data (coming from multiple sources) to explore nursing directors’ practical tactics to become part of new ‘knowledge-power knots’ that support person-centredness. Data analysis shows three main tactics: 1) profiling, 2) positioning and 3) powering. By 1) becoming visible, 2) being taken seriously, and 3) exerting influence, nursing directors try to embed themselves and their expertise in hospital governance. This study contributes to a socially embedded everyday understanding of power and empowerment in nursing and provides academic and practical starting points for strengthening person-centred nursing in hospital governance.   

Language

English

Seminar type

Poster

Conference

GCPCC

Authors

Dieke Martini, Jet Spits, Hugo Schalkwijk, Pieterbas Lalleman

Lecturers

Profile image for Dieke Martini

Dieke Martini Presenter

PhD Researcher - RN
Fontys University of Applied Sciences

I am a registered nurse and anthropologist. As a PhD researcher, I create learning histories about differentiated nursing practices. My aim is to instigate dialogue and reflection on the definition of 'nursing work', differentiated nursing practices, leadership, and positioning of nurses in hospitals.