Biomedical subjects

Christine Ceci

Publications and source records attributed to Christine Ceci.

6 recordsLinked to original sources

PubMed2006

'What she says she needs doesn't make a lot of sense': seeing and knowing in a field study of home-care case management.

Foucault's preoccupation with the visual, specifically his positing of a sort of 'positive unconscious of vision', offers an entry point for examining data generated through a field study of home-care case management practice. In Foucault's work, our attention is directed not so much to what is seen but to what can be seen and to the effects of practices of knowledge and power in constituting these particular realities. Knowledge emerges as a matter of what it is possible for knowers, for nurses, to see and to say, as well as the conditions that constitute these specific possibilities for seeing and saying in a given context. Given the significance of practices of seeing in case management - seeing clients, seeing situations - examining how possibilities for understanding are constituted through ways of seeing helps us to 'see' the limits of currently possible practice. In the case examined in this paper, these limits constitute a gap between what a client may actually need and what it is possible, in the context of current practice, to provide. To change practice it seems important, if only as a first step, to recognize the constraints of thought in what we see.

Aged, 80 and over↗

PubMed2006

Impoverishment of practice: analysis of effects of economic discourses in home care case management practice.

Home care is a health sector under increasing pressure. Demand is often said to be outstripping capacity, with constant change and retrenchment distinguishing features of the current context. This paper takes a reading of the current conditions of home care using data gathered during a field study of home care case management practices conducted in 2004. As economic discourses become increasingly influential in determining responses to client situations, case managers (and their managers) find themselves with limited capacity to exercise control over their practices. A growing gap between professionally influenced discourses--those presumably intended to guide practice--and organizational priorities creates a dissonance for case managers as the political-ethical dimensions of their practices are displaced by budget "realities." For front-line workers, such displacement cannot be sustained in their face-to-face encounters with clients, leading to a growing sense of frustration and powerlessness among these highly skilled practitioners.

Anthropology, Cultural↗

PubMed2004

Nursing, knowledge and power: a case analysis.

This paper is concerned with events that were the subject of an inquest (The report of the Manitoba pediatric cardiac surgery inquest: an inquiry into twelve deaths at the Winnipeg Health Sciences Centre in 1994, Provincial Court of Manitoba, Winnipeg) into the deaths of 12 children who died while undergoing or shortly after having undergone cardiac surgery at the Winnipeg Health Sciences Centre, Man., Canada, during 1994. A notable finding of this inquest was that nurses involved with the pediatric cardiac surgery program were concerned about the competence of the surgeon and made sustained efforts throughout 1994 to have these concerns addressed. That the nurses' concerns were not taken seriously is the central problem of this paper. The work of Foucault is used to set out a ground for thinking about this problem. In this case, knowledge practices, specifically those concerning who can claim status as a credible knower, produced limits for nurses. Such limits are neither good nor bad in themselves, but rather have effects with which we must be concerned. In this case, the limits produced by certain knowledge practices had the effect of rendering the nurses' concerns irrelevant and this is significant in itself and also because it was an important part of how patient care was allowed to be compromised.

Cardiac Surgical Procedures↗

PubMed2004

Gender, power, nursing: a case analysis.

This paper is concerned with events that were the subject of an inquest into the deaths of 12 children who died while undergoing or shortly after having undergone cardiac surgery at the Winnipeg Health Sciences Centre, Manitoba, Canada, during 1994. A notable finding of the Sinclair Inquest was that nurses involved with the pediatric cardiac surgery program were concerned about the competence of the surgeon and made sustained efforts throughout 1994 to have these concerns addressed. That the nurses' concerns were not taken seriously is the central problem of this paper. Essentially, the position articulated is that gendered and gendering discourses constituted a form of power that structured the field of nurses' possible actions. These discourses constituted a resource to make nurses knowable, to produce them as certain forms of the person, and were therefore part of what governed nurses everyday conduct. Though neither simply good nor bad in themselves, in this case, these discourses had constraining effects on how nurses were able to conduct themselves.

Adult↗

PubMed2003

Midnight reckonings: on a question of knowledge and nursing.

The paper contrasts understandings of knowledge grounded in Enlightenment norms with the departures from those norms taken by some strands of feminism and hermeneutics, as well as the contributions made by the writing of Michel Foucault. A reading of Foucault's writings on knowledge, power and the discursive constitution of self and world is offered as a potentially useful frame within which to raise questions about nursing, nurses and knowledge.

Feminism↗

PubMed2002

Language and power: ascribing legitimacy to interpretive research.

More than merely describing what constitutes a good or truthful interpretation, all judgments about the legitimacy of knowledge claims can be understood as enacting relations of power. That is, our understanding of what it means to make a reasonable claim to knowledge is already caught up in relations of power that privilege some perspectives and marginalize others. Language, understood as productive rather than reflective of meaning, both enables and constrains the kinds of statements we are entitled to make. Competing discourses do not exist equally in the world but rather differ in terms of what they are held to explain and what effect they have. The authors explore these issues and suggest that evaluating interpretive research involves not only epistemological issues but also questions of value and power.

Communication↗