A Postcolonial Feminist Perspective in Nursing Research - Essay Example

The drive towards evidence-based practice is part of a modern reflective and caring service. However there is a paradox at the heart of the notion ofevidence-based care. In order to perform any systemized examination of treatment there has to be a conscious acknowledgement of uncertainty about that treatment. This is uncomfortable and when research does find evidence in favour of a treatment, there is a relief and a return to conviction about what is the best. The paradox is that it seems the most valued research practices are predicated on generalizations about patient treatments and categories. However, nursing care is based on the notion of the uniqueness of the patient and the nurse-patient relationship. Sometimes it is necessary to address the particular and not to rush to generalizations and certainty. The psychoanalytic framework promotes a capacity to tolerate uncertainty and provides a model for understanding conflicting feelings, which can occur within the nurse-patient relationship. The author proposes the psychoanalytic observational method as an adjunct to other research methods. This method places certain kinds of evidence within the rubric of evidence-based nursing practice. The evidence collected in this method is the evidence of the conscious and unconscious experience within the nurse-patient relationship. The author will describe and argue for the place of this research method within the canon of other more widely practised methods within mental health practice. She will propose that for safe practice it is necessary to value and examine the veracity of the feelings and tacit understanding of the nurse. She contends that the current climate of excessive bureaucracy and persecutory risk management is having a damaging effect on both the research process and effective nursing care. In this article, I argue that implementing a postcolonial feminist perspective in nursing research transcends the limitations of modern cultural theories in exploring the health problems of non-Western populations. Providing nursing care in pluralist countries like Canada remains a challenge for nurses. First, nurses must reflect on their ethnic background and stereotypes that may impinge on the understanding of cultural differences. Second, dominant health ideologies that underpin nurses' everyday practice and the structural barriers that may constrain the utilization of public healthcare services by non-Western populations must be further examined. Postcolonial feminism is aimed at addressing health inequities stemming from social discriminative practices. I will draw on extant literature and data of an ongoing ethnography exploring the Haitian caregivers' ways of caring for ageing relatives at home to unveil how the larger social and cultural world has an impact on caregivers' everyday lives. Marginalized locations represent privileged sites from which health problems, intersecting with power, race, gender, and social classes, can be addressed. Postcolonial feminism provides the analytic lens to look at the impact of these factors in shaping health experiences. It also suggests redirecting nursing cultural research and practice to achieve social justice in the healthcare system. Less money spent on health services, cost-effectiveness, better productivity and more efficiency are some of the driving forces of contemporary "neo-liberalism" and political trends. How can nursing services and the profession's human values adapt in this difficult context The authors describe the newest modality of patient care delivery system: nursing case management. They examine the factors and assumptions that led up to its development and point out the validity of asking some serious questions before embarking on the euphoria of case management (sadhu, 1992). Previous notions of science as impartial and value-neutral have been refuted by contemporary views of science as influenced by social, political and ideological values. By locating nursing science in the dominant political ideology of liberalism, the author examines how nursing knowledge is influenced by liberal philosophical assumptions. The central tenets of liberal political philosophy - individualism, egalitarianism, freedom, tolerance, neutrality, and a free-market economy - are primarily manifested in relation to: (i) the individualistic focus of our science; (ii) our view of society as essentially egalitarian and equitable; (iii) our preference for politically neutral knowledge development, and (iv) an economy of knowledge development that supports rather than challenges the status quo. I argue that exposing, rather than ignoring, the liberal ideological values inherent in nursing science will render these assumptions open to debate, stimulate ongoing development of critically oriented knowledge, and increase our capacity to influence the social, political and economic determinants of health (Browne, 2001). Femisnism and Marxism Underclass, equality, prdominantly females are nurses, females tend to be undervalued in our society and nursing is an undervalued skill in terms of economic renumeration. Nurses tend to be from lower socioeconomic status, nursing could be an analogy of "undervalass" perhaps background has enhanced their awareness of the the need for help to be given to others, underclass tend to be more community focuses. Therie background does not lead them to desire higher paying jobs because they have a cultural background that is less dependant on capria, their economic group is not depedneant on access to wealth., it is not based on ididividualism and keeping up with the jonses. The means of production could be considered to be "healing" with the doctors as the elite as they are the small elite group controlling the healing, whereas nurses implement the means of production and are the large group that generate the excess ealth that the doctors benefit from. Similar ideas are at the basis of Marx's method. He too forswears the freedom' to judge existing conditions by transcendent standards. The primary purpose of his work, he insists, is to understand capitalist society and the laws of motion' governing it, rather than to criticize it according to his own chosen values, or to put forward an ideal of how it ought to be. His method does not involve bringing critical standards to bear on society from the outside. On the contrary, he portrays values and critical standards as social and historical products, as inescapably historical and relative. Marx, like Hegel, challenges this assumption. According to the dialectical approach, _existing conditions themselves_ contain the basis for a critical perspective. For the existing social order is not simple and static it contains tensions and conflicts. It includes negative as well as positive aspects: tendencies which oppose and negate it, as well as forces supporting and sustaining it. That is to say, negative and critical' tendencies are _in the world_. Critical ideas do not have to be brought from outside by a free critical consciousness, they are already contained immanently within existing conditions. This is the vital insight of the dialectical approach. A social theory of the kind Marx develops, it is argued, cannot generate a critical perspective. If ideas and values are simply the products of existing conditions, then they can only reflect and endorse those conditions in the manner of material thinking'. Criticism must involve appeal to transhistorical values. 2 Marx, like Hegel, rejects the assumptions involved in this objection. According to the dialectical approach, existing conditions themselves contain the basis for a critical perspective. The existing social order is not simple and static; it contains tensions and conflicts. It includes negative as well as positive aspects: tendencies which oppose and negate it, as well as forces supporting and sustaining it. That is to say, negative and critical' tendencies are in the world. Critical ideas do not have to be brought from outside by an autonomous critical consciousness, they are already contained immanently within existing conditions. This is the vital insight of the dialectical approach. According to the dialectical view, tension and conflict give rise to change and development. The established order is not stable or ultimate. It is destined eventually to perish and be superseded. History takes the shape of a development through distinct stages. Each stage involves characteristic conflicts and, through their working out, undergoes a process of development. As a result, the conditions for the emergence of the next stage gradually take shape within it. Thus the process of historical change is not an arbitrary succession of merely different and incommensurable forms. Each stage initially constitutes a progressive development, necessary and justified for its time and relative to the conditions which it supersedes. Yet each stage is only a transitory form which, in its turn, will ultimately perish and be replaced by the higher' and more developed' form which emerges out of it, and on the basis created by it. Marxism is, indeed, a form of naturalism; but it is not thereby fallacious. More specifically, it is a form of historicism which rejects the dualistic distinction of facts and values which this criticism presupposes. For Marxism is not a purely descriptive and explanatory theory on the model of physics or chemistry: practical ends and hence an evaluative perspective are integral to it. In this respect, a more illuminating comparison is with medicine. Medicine has a practical end: the promotion of health. This end is not an arbitrary one in medicine; it is not a mere subjective preference of doctors. On the contrary, it is an objective end which is given by the object of medicine by the human body itself as its end. Similarly, if Marx is correct in his analysis of capitalism, socialism is not merely a subjective preference of socialists; it is the objective tendency and proximate end of the historical processes at work in capitalism itself the critical outlook is tied to a theory of history, and thus made dependent on the course that history actually takes. In recent years this seems to have turned decisively against the progressive path envisaged by Marx. Indeed, it is now often said, the very idea of a post- capitalist order is illusory. Capitalism and the free market constitute the highest possible stage of social development, the end of history'. Read More