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In order to be able to provide informed, effective and responsive mental health care and to do so in an evidence-based, collaborative and recovery-focused way with those who use mental health services, there is a recognition of the need for mental health professionals to possess sophisticated critical thinking capabilities. This article will therefore propose that such capabilities can be productively situated within the context of the work of the French philosopher Michel Foucault, one of the most challenging, innovative and influential thinkers of the 20th century. However, rather than focusing exclusively upon the content of Foucault's work, it will be suggested that it is possible to discern a general methodological approach across that work, a methodological approach that he refers to as 'the history of the present.' In doing so, Foucault's history of the present can be understood as a productive, albeit provisional, framework in which to orientate the purpose and process of critical thinking for mental health professionals by emphasizing the need to both historicize and politicize the theoretical perspectives and therapeutic practices that characterize contemporary mental health care. [ABSTRACT FROM AUTHOR]

Interdisciplinary research assumes that teams of highly specialized scientists develop new knowledge by bridging their respective horizons. Nurse educators preparing nursing doctoral students to conduct interdisciplinary research need insight into how members of interdisciplinary research teams experience knowledge horizons in these complex contexts. Based on the work of the philosopher Bernard Lonergan, this pilot study uses Transcendental Method for Research with Human Subjects to explore interdisciplinary researchers' experiences with and attitudes toward interdisciplinary research. Results reveal the overarching conceptual category of “engaged interdisciplinary inquiry” which includes six themes: (i) valuing interdisciplinary engagement; (ii) direct engagement; (iii) interior engagement; (iv) disengagement; (v) facilitated engagement and (vi) engaged researcher development. Results also suggest engagement depends on vigorous “back and forth”, or dialogue, with self and others, and demonstrate the study method is fruitful for cognitive inquiry. This pilot supports expanded study to inform preparation for and conduct of interdisciplinary research involving nurses and raises important questions about how the trend toward interdisciplinary research affects nursing science. [ABSTRACT FROM AUTHOR]

Changes in healthcare organizations are inevitable and occurring at unprecedented rates. Such changes greatly impact nurses and their work, yet these experiences are rarely explored. Organizational change discourses remain grounded in perspectives that explore and explain systems, often not the people within them. Change processes in healthcare organizations informed by such organizational discourses validate only certain perspectives and forms of knowledge. This fosters exclusionary practices, limiting the capacity of certain individuals or groups of individuals to effectively contribute to change discourses and processes. The reliance on mainstream organizational discourses in healthcare organizations has left little room for the exploration of diverse perspectives on the subject of organizational change, particularly those of nurses. Michel Foucault's work challenges dominant discourse and suggest that strong reliance's on specific discourses effectively disqualify certain forms of knowledge. Foucault's writings on disqualified knowledge and parrhesia (truth telling and frank speech) facilitate the critical exploration of discourses that inform change in healthcare organizations and nurses capacities to contribute to organizational discourses. This paper explores the capacity of nurses to speak their truths within rapidly and continuously changing healthcare organizations when such changes are often driven by discourses not derived from nursing knowledge or experience. [ABSTRACT FROM AUTHOR]

In crisis situations, the authority of the nurse is legitimised by legal powers and professional knowledge. Crisis stakeholders include those who directly use services and their families, and a wide range of health, social service and justice agencies. Alternative strategies such as therapeutic risk taking from the perspective of socially inclusive recovery policy coexist in a sometimes uneasy relationship with mental health legislation. A critical discourse analysis was undertaken to examine mental health policies and guidelines, and we interviewed service users, families, nurses and the police about experiences of accessing services. For those who attempt to access services early in crisis, as is suggested to lead to a better outcome, provision of services and rights appear to be reversed by an attempt to exclude them through practices that screen them out, rather than prioritising a choice in access. [ABSTRACT FROM AUTHOR]

In this paper, we reconsider the context of Barbara Carper's alternative ways of knowing, a prominent discourse in modern nursing theory in North America. We explore this relative to the concepts of realism, non-realism and nominalism, and investigate the philosophical divisions behind the original typology, particularly in relationship to modern scientific enquiry. We examine forms of knowledge relative to realist and nominalist positions and make an argument ad absurdum against relativistic interpretations of knowledge using the example of Borge's Chinese Emporium of Benevolent Knowledge. We propose a contentious postpositivist practical classification for nursing knowledge that demonstrates and supports the idea that knowledge has both individual and subjective components. This classification supports the practical application of nursing knowledge within the paradigm of realist postpositivist science. [ABSTRACT FROM AUTHOR]

Health-care and public sector institutions are high-risk settings for workplace bullying. Despite growing acknowledgement of the scale and consequence of this pervasive problem, there has been little critical examination of the institutional power dynamics that enable bullying. In the aftermath of large-scale failures in care standards in public sector healthcare institutions, which were characterised by managerial bullying, attention to the nexus between bullying, power and institutional failures is warranted. In this study, employing Foucault's framework of power, we illuminate bullying as a feature of structures of power and knowledge in public sector institutions. Our analysis draws upon the experiences of a large sample ( n = 3345) of workers in Australian public sector agencies - the type with which most nurses in the public setting will be familiar. In foregrounding these power dynamics, we provide further insight into how cultures that are antithetical to institutional missions can arise and seek to broaden the debate on the dynamics of care failures within public sector institutions. Understanding the practices of power in public sector institutions, particularly in the context of ongoing reform, has important implications for nursing. [ABSTRACT FROM AUTHOR]

The metaparadigm concept of person as a core emphasis for nursing theorizing has attracted considerable attention in western literature, but has received less attention in the context of eastern philosophical contexts. In this philosophical inquiry, we sought to clarify the concept of what it is to be a human being according to ideas deriving from Islamic tradition, drawing on concept analysis as general approach to advance an understanding of how nursing within an Islamic context might operationalize metaparadigm conceptualization. Specifically, we considered person as human being on the basis of its definition, attributes/characteristics and boundaries to explore the anatomy of the concept in this context. Our analysis revealed that Islamic thought is relevant to two distinct understandings of the holistic concept of human being. Reciprocal interaction worldview organizes the dimensions of being human (cognitive, emotion, social and spiritual) into a whole. Simultaneous action worldview emphasizes that the human is a coherent and unified creature in harmony with the universe. In Islamic thought, these two worldviews are integrated and operate concurrently. Nurse-patient interactions arising from an integrated perspective that aligns both of these worldviews will allow for informed applications of knowledge to practice and enhanced patient care. [ABSTRACT FROM AUTHOR]

NAIRN S. Nursing Inquiry 2012; 19: 6-17 A critical realist approach to knowledge: implications for evidence-based practice in and beyond nursing This paper will identify some of the key conceptual tools of a critical realist approach to knowledge. I will then apply these principles to some of the competing epistemologies that are prevalent within nursing. There are broadly two approaches which are sometimes distinct from each other and sometimes inter-related. On one side, there is the view that all healthcare interventions should be judged on the principles of randomised controlled trials and the other is a preoccupation with language in which healthcare interventions are subjected to a discursive interrogation. These debates are configured through the idea of a hierarchy of knowledge that is accorded uncritical acceptance by some and virulent distaste by others. I will argue that the notion of hierarchy is problematic and is largely argued for in unproductive epistemological terms. What is required is a shift towards a theory that emphasises the contextual nature of the ways that knowledge is produced and disseminated. In other words, there is no single hierarchy of knowledge, but there are multiple hierarchies of knowledge. [ABSTRACT FROM AUTHOR]

CRUICKSHANK J. Nursing Inquiry 2012; 19: 71-82 Positioning positivism, critical realism and social constructionism in the health sciences: a philosophical orientation This article starts by considering the differences within the positivist tradition and then it moves on to compare two of the most prominent schools of postpositivism, namely critical realism and social constructionism. Critical realists hold, with positivism, that knowledge should be positively applied, but reject the positivist method for doing this, arguing that causal explanations have to be based not on empirical regularities but on references to unobservable structures. Social constructionists take a different approach to postpositivism and endorse a relativist rejection of truth and hold that the task of research is to foster a scepticism that undermines any positive truth claim made. It is argued that social constructionism is a contradictory position. [ABSTRACT FROM AUTHOR]

There is an enduring debate in nursing regarding the art–science dualism, involving an articulation of two distinct 'kinds' of disciplinary knowledge: objective/scientific and subjective/artistic. Nursing identifies both as necessary, yet unbridgeable, which creates problems in constructing a coherent disciplinary knowledge base. We describe how this problem arises based on an ontological assumption of two different kinds of 'stuff' in the world: that with essential determinate properties and that without essential properties. We experiment with a solution by ontologically understanding the world as made from a single kind: That the most irreducible element of the world is process, in that reality is a continuous construction whereby subject and object are products, not independent constituents, of reality. Process philosophy overcomes nursing's ontological bifurcation and enables nursing's art–science dualism to be re‐conceptualized as a cohesive logic of skilled reality production. An unavoidable implication of a process turn in nursing philosophy is that the disciplinary goal no longer becomes a privileged 'body of knowledge' that authorizes, which has always been a defining challenge in nursing. Rather, and more productively perhaps, the aim is for greater sophistication and plurality in its ongoing commitment to attuning to reality in ways that shape disciplinary attainment. [ABSTRACT FROM AUTHOR]