Critical emancipatory reflection on a practice-based issue in relation to the working relationship between doctors and nurses in China
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摘要
Objective: Reflection is viewed as the most significant skill and should be advocated for lifelong learning. In order to grasp the process of reflection and embrace the reflective skill, one of the authors of this paper reflects on a practice-based issue in relation to the communication between doctors and nurses, to gain new understanding and thus improve the authors' clinical practice.Methods: Smyth's framework with four stages is utilized as an ideal framework to guide the author's reflection on the practice-based issue to free the author from her entrenched assumptions and the oppressive forces that limit her practice.Results: The espoused and enacted theory, together with the critical reflection theory, are used to explore the values and beliefs that essentially govern the author's practice and how these are distinct from the author's worldviews. Following this, critical emancipatory reflection is undertaken to explore the dominant power structures within the author's workplace. Furthermore, given the hegemonic and chaotic working context of this issue, hegemony and symbolic interaction theory are applied to unearth the various hidden constraining and oppressive forces. Additionally, socialization theory is utilized to help the author achieve professional identity.Conclusions: Reconstructing the practice-based issue empowers the author to realize that in the future, she should act as a reflective practitioner, creating a daily habit, staying alert to practice, seeing things freshly, finding support systems, improving communication skills, conducting reflective research, and reifying reflective practice. Ultimately, the author will be sufficiently equipped to be able to transform her practice and change its outcomes.
Objective: Reflection is viewed as the most significant skill and should be advocated for lifelong learning. In order to grasp the process of reflection and embrace the reflective skill, one of the authors of this paper reflects on a practice-based issue in relation to the communication between doctors and nurses, to gain new understanding and thus improve the authors' clinical practice.Methods: Smyth's framework with four stages is utilized as an ideal framework to guide the author's reflection on the practice-based issue to free the author from her entrenched assumptions and the oppressive forces that limit her practice.Results: The espoused and enacted theory, together with the critical reflection theory, are used to explore the values and beliefs that essentially govern the author's practice and how these are distinct from the author's worldviews. Following this, critical emancipatory reflection is undertaken to explore the dominant power structures within the author's workplace. Furthermore, given the hegemonic and chaotic working context of this issue, hegemony and symbolic interaction theory are applied to unearth the various hidden constraining and oppressive forces. Additionally, socialization theory is utilized to help the author achieve professional identity.Conclusions: Reconstructing the practice-based issue empowers the author to realize that in the future, she should act as a reflective practitioner, creating a daily habit, staying alert to practice, seeing things freshly, finding support systems, improving communication skills, conducting reflective research, and reifying reflective practice. Ultimately, the author will be sufficiently equipped to be able to transform her practice and change its outcomes.
Objective: Reflection is viewed as the most significant skill and should be advocated for lifelong learning. In order to grasp the process of reflection and embrace the reflective skill, one of the authors of this paper reflects on a practice-based issue in relation to the communication between doctors and nurses, to gain new understanding and thus improve the authors' clinical practice.Methods: Smyth's framework with four stages is utilized as an ideal framework to guide the author's reflection on the practice-based issue to free the author from her entrenched assumptions and the oppressive forces that limit her practice.Results: The espoused and enacted theory, together with the critical reflection theory, are used to explore the values and beliefs that essentially govern the author's practice and how these are distinct from the author's worldviews. Following this, critical emancipatory reflection is undertaken to explore the dominant power structures within the author's workplace. Furthermore, given the hegemonic and chaotic working context of this issue, hegemony and symbolic interaction theory are applied to unearth the various hidden constraining and oppressive forces. Additionally, socialization theory is utilized to help the author achieve professional identity.Conclusions: Reconstructing the practice-based issue empowers the author to realize that in the future, she should act as a reflective practitioner, creating a daily habit, staying alert to practice, seeing things freshly, finding support systems, improving communication skills, conducting reflective research, and reifying reflective practice. Ultimately, the author will be sufficiently equipped to be able to transform her practice and change its outcomes.
引文
1. Hatton N, Smith D. Reflection in teacher education:towards definition and implementation. Teaching and Teacher Educ. 1995;11:33-49.
2. Smyth J. Developing and sustaining critical reflection in teacher education. J Teacher Educ.1989;40:2-9.
3. Taylor B. Reflective practice for healthcare professionals:a practical guide. 3rd ed. Berkshire:McGraw-Hill Education. 2010.
4. Duke S. Continuing the journey with reflection. In:Butman C, Schutz S, eds. Reflective Practice in Nursing. 4th ed. Blackwell:Oxford. 2008:195.
5. Yuan S. China should reduce the overuse of intravenous infusion. BMJ. 2014;348. http://search.proquest.com/openview/076abaceb617023170fd2114af6a197e/1?pq-origsite=gscholar&cbl=2040978.Accessed May 11, 2018.
6. Health Service Executive. Guiding framework for the implementation of nursing and midwifery quality care-metrics in the health service executive Ireland. Ireland:Health Service Excusive. http://www.hse.ie/eng/about/Who/ONMSD/news/GFQCM.pdf.Accessed May 31, 2018.
7. de Vries J, Timmins F. Care erosion in hospitals:problems in reflective nursing practice and the role of cognitive dissonance. Nurse Educ Today.2016; 38:5-8.
8. Darbyshire P, Ralph N, Caudle H. Editorial:nursing's mandate to redefine the sentinel event. J Clin Nurs. 2015;24:1445-1446.
9. McCance T, McCormack B, Dewing J. An exploration of person-centredness in practice. Online J Issues Nurs. http://dx.doi.org/10.3912/OJIN.Vol-16No02Man01. Accessed May 25, 2018.
10. Priest H. Effective psychological care for physically ill patients in hospital. Nurs Standard. 2010;24:48-56.
11. Somerville D, Keeling J. A practical approach to promote reflective practice within nursing. Nurs Times, 2004; 100:42.
12. Chen M, Wang L, Chen W, Zhang L, Jiang H, Mao W. Does economic incentive matter for rational use of medicine? China's experience from the essential medicines program. Pharmacoeconomics. 2014;32:245-255.
13. Rashid Al-Abri MD. Managing change in healthcare. Oman Med J. 2007; 22:9-10.
14. Zwarenstein M, Goldman J, Reeves S. Interprofessional collaboration:effects of practice-based interventions on professional practice and healthcare outcomes. Cochrane Database Syst Rev.2009;3:CD000072.
15. Schon DA. Educating the reflective practitioner. San Francisco:Josseybass. 1995.
16. Fook J, Gardner F. Practicing critical reflection:a resource handbook. Berkshire:McGraw-Hill Education. 2007.
17. Fook J. Reflective practice and critical reflection. In:Lishman J, ed. Handbook for practice learning in social work and social care. Basingstoke:Athenaeum Press. 2007:363-375.
18. White S, Fook J, Gardner F. Critical reflection in health and social care. Berkshire:McGraw-Hill Education. 2006.
19. Jasper M. Beginning reflective practice. Cheltenham:Nelson Thornes. 2003.
20. Fook J, Askeland GA. The"critical"in critical reflection. In:White S, Fook J, Gardner F, eds. Critical reflection in health and welfare. Maidenhead:Open University Press. 2006:40-53.
21. Shahriari M, Mohammadi E, Abbaszadeh A, Bahrami M. Nursing ethical values and definitions:a literature review. Iran J Nurs Midwifery Res.2013;18:1-8.
22. Coombs M, Ersser SJ. Medical hegemony in decision-making-a barrier to interdisciplinary working in intensive care? JAdv Nurs. 2004;46:245-252.
23. Freeman M, Miller C, Ross N. The impact of individual philosophies of teamwork on multi-professional practice and the implications for education. J Interprofessional Care. 2000;14:237-247.
24. Barine AK, Minja D. Transformational corporate leadership, Wask Forest, NC:Integrity Publisher.2012.
25. Street A. From image to action:reflection in nursing practice. Deakin University. 1991.
26. Zhou H, Long LR. Combined morality and authoritarian and applied benevolence to convince followers:a review of paternalistic leadership. Adv Psych Sci. 2005;13:227-238(in Chinese).
27. Ma L, Tsui AS. Traditional Chinese philosophies and contemporary leadership. Leadership Quarterly.2015;26:13-24.
28. Xiao MZ, Wu XH. Chinese leadership:culture and Confucianism. Public Integrity. 2014;16:165-172.
29. Qian WQ, Gao YY. The"Three Roles"of leaders in hospital culture construction. JiangSu Health Care Manag. 2015; 26:71-72(in Chinese).
30. Whitehead D, Davis P. The issue of medical dominance(hegemony). J Orthopaedic Nurs.2001;5:114-115.
31. Zelek B, Phillips SP. Gender and power:nurses and doctors in Canada. Int J Equity Health. 2003;2:1.
32. Coburn D. Medical dominance then and now:critical reflections. Health Sociol Rev. 2006;15:432-443.
33. Gair G, Hartery T. Medical dominance in multidisciplinary teamwork:a case study of discharge decision-making in a geriatric assessment unit. J Nurs Manag. 2001;9:3-11.
34. Molleman E, Broekhuis M, Stoffels R, Jaspers F.How health care complexity leads to cooperation and affects the autonomy of health care professionals. Health Care Anal. 2008;16:329-341.
35. Moss M, Good VS, Gozal D, Kleinpell R, Sessler CN. An official Critical Care Societies Collaborative statement-burnout syndrome in critical care health-care professionals:a call for action. Chest.2016;150:17-26.
36. Baggs JG, Norton SA, Schmitt MH, Dombeck MT,Sellers CR, Quinn JR. Intensive care unit cultures and end-of-life decision making. J Crit Care.2007;22:159-168.
37. Blumer H. Symbolic interactionism:perspective and method. Oakland:University of California Press. 1986.
38. Bleakley A. Working in"teams"in an era of “liquid”healthcare:what is the use of theory? J Interprofessional Care. 2013;27:18-26.
39. Bassett S, Westmore K. How nurse leaders can foster a climate of good governance:in the first of a four-part series on corporate responsibility, Sally Bassett and Kathryn Westmore explore the importance of workplace culture and leadership. Nurs Manag. 2012;19:22-24.
40. Sheer B, Wong FKY. The development of advanced nursing practice globally. J Nurs Scholarship.2008;40:204-211.
41. Yun H, Jie S, Anli J. Nursing shortage in China:state,causes, and strategy. Nurs Outlook. 2010;58:122-128.
42. Pelzang R. Time to learn:understanding patientcentred care. Br J Nurs. 2010;19:912.
43. Zolnierek C. The importance of knowing the patient. Issues Ment Health Nurs. 2011;32:392-393.
44. Bach S, Grant A. Communication and interpersonal skills in nursing. 3~(rd)ed. London:Open University in assoc. with Sage. 2015.
45. Tachimori Y, Iwanaga H, Tahara T. The networks from medical knowledge and clinical practice have small-world, scale-free, and hierarchical features. Physica A. 2013;392:6084-6089.
46. Young MN, Peng MW, Ahlstrom D, Bruton GD,Jiang Y. Corporate governance in emerging economies:a review of the principal-principal perspective. J Manag Studies. 2008;45:196-220.
47. McCormack B, Dewing J, McCance T. Developing person-centred care:addressing contextual challenges through practice development. Online J Issues Nurs. http://dx.doi.org/10.3912/OJIN.Vol-16No02Man03. Accessed May 31,2018.
48. Dewey J. How we think:a restatement of the relation of reflective thinking to the educative process.Boston:D C Heath&Co. 1933.
49. Forneris SG, Peden-McAlpine CJ. Contextual learning:a reflective learning intervention for nursing education, Int J Nurs Educ Scholarship.2006;3:1254.
50. Epp S. The value of reflective journaling in undergraduate nursing education:a literature review. Int J Nurs Studies. 2008;45:1379-1388.
51. Pope JE. Complications of spinal cord stimulation. Reducing risks and complications of interventional pain procedures. Philadelphia:Saunders.2012;5:3-10.
52. Manias E, Street A. Nurse-doctor interactions during critical care ward rounds. J Clin Nurs.2001;10:442-450.
53. Kelly J. Barriers to achieving patient-centered care in Ireland. Dimens Crit Care Nurs. 2007;26:29-34.
2. Smyth J. Developing and sustaining critical reflection in teacher education. J Teacher Educ.1989;40:2-9.
3. Taylor B. Reflective practice for healthcare professionals:a practical guide. 3rd ed. Berkshire:McGraw-Hill Education. 2010.
4. Duke S. Continuing the journey with reflection. In:Butman C, Schutz S, eds. Reflective Practice in Nursing. 4th ed. Blackwell:Oxford. 2008:195.
5. Yuan S. China should reduce the overuse of intravenous infusion. BMJ. 2014;348. http://search.proquest.com/openview/076abaceb617023170fd2114af6a197e/1?pq-origsite=gscholar&cbl=2040978.Accessed May 11, 2018.
6. Health Service Executive. Guiding framework for the implementation of nursing and midwifery quality care-metrics in the health service executive Ireland. Ireland:Health Service Excusive. http://www.hse.ie/eng/about/Who/ONMSD/news/GFQCM.pdf.Accessed May 31, 2018.
7. de Vries J, Timmins F. Care erosion in hospitals:problems in reflective nursing practice and the role of cognitive dissonance. Nurse Educ Today.2016; 38:5-8.
8. Darbyshire P, Ralph N, Caudle H. Editorial:nursing's mandate to redefine the sentinel event. J Clin Nurs. 2015;24:1445-1446.
9. McCance T, McCormack B, Dewing J. An exploration of person-centredness in practice. Online J Issues Nurs. http://dx.doi.org/10.3912/OJIN.Vol-16No02Man01. Accessed May 25, 2018.
10. Priest H. Effective psychological care for physically ill patients in hospital. Nurs Standard. 2010;24:48-56.
11. Somerville D, Keeling J. A practical approach to promote reflective practice within nursing. Nurs Times, 2004; 100:42.
12. Chen M, Wang L, Chen W, Zhang L, Jiang H, Mao W. Does economic incentive matter for rational use of medicine? China's experience from the essential medicines program. Pharmacoeconomics. 2014;32:245-255.
13. Rashid Al-Abri MD. Managing change in healthcare. Oman Med J. 2007; 22:9-10.
14. Zwarenstein M, Goldman J, Reeves S. Interprofessional collaboration:effects of practice-based interventions on professional practice and healthcare outcomes. Cochrane Database Syst Rev.2009;3:CD000072.
15. Schon DA. Educating the reflective practitioner. San Francisco:Josseybass. 1995.
16. Fook J, Gardner F. Practicing critical reflection:a resource handbook. Berkshire:McGraw-Hill Education. 2007.
17. Fook J. Reflective practice and critical reflection. In:Lishman J, ed. Handbook for practice learning in social work and social care. Basingstoke:Athenaeum Press. 2007:363-375.
18. White S, Fook J, Gardner F. Critical reflection in health and social care. Berkshire:McGraw-Hill Education. 2006.
19. Jasper M. Beginning reflective practice. Cheltenham:Nelson Thornes. 2003.
20. Fook J, Askeland GA. The"critical"in critical reflection. In:White S, Fook J, Gardner F, eds. Critical reflection in health and welfare. Maidenhead:Open University Press. 2006:40-53.
21. Shahriari M, Mohammadi E, Abbaszadeh A, Bahrami M. Nursing ethical values and definitions:a literature review. Iran J Nurs Midwifery Res.2013;18:1-8.
22. Coombs M, Ersser SJ. Medical hegemony in decision-making-a barrier to interdisciplinary working in intensive care? JAdv Nurs. 2004;46:245-252.
23. Freeman M, Miller C, Ross N. The impact of individual philosophies of teamwork on multi-professional practice and the implications for education. J Interprofessional Care. 2000;14:237-247.
24. Barine AK, Minja D. Transformational corporate leadership, Wask Forest, NC:Integrity Publisher.2012.
25. Street A. From image to action:reflection in nursing practice. Deakin University. 1991.
26. Zhou H, Long LR. Combined morality and authoritarian and applied benevolence to convince followers:a review of paternalistic leadership. Adv Psych Sci. 2005;13:227-238(in Chinese).
27. Ma L, Tsui AS. Traditional Chinese philosophies and contemporary leadership. Leadership Quarterly.2015;26:13-24.
28. Xiao MZ, Wu XH. Chinese leadership:culture and Confucianism. Public Integrity. 2014;16:165-172.
29. Qian WQ, Gao YY. The"Three Roles"of leaders in hospital culture construction. JiangSu Health Care Manag. 2015; 26:71-72(in Chinese).
30. Whitehead D, Davis P. The issue of medical dominance(hegemony). J Orthopaedic Nurs.2001;5:114-115.
31. Zelek B, Phillips SP. Gender and power:nurses and doctors in Canada. Int J Equity Health. 2003;2:1.
32. Coburn D. Medical dominance then and now:critical reflections. Health Sociol Rev. 2006;15:432-443.
33. Gair G, Hartery T. Medical dominance in multidisciplinary teamwork:a case study of discharge decision-making in a geriatric assessment unit. J Nurs Manag. 2001;9:3-11.
34. Molleman E, Broekhuis M, Stoffels R, Jaspers F.How health care complexity leads to cooperation and affects the autonomy of health care professionals. Health Care Anal. 2008;16:329-341.
35. Moss M, Good VS, Gozal D, Kleinpell R, Sessler CN. An official Critical Care Societies Collaborative statement-burnout syndrome in critical care health-care professionals:a call for action. Chest.2016;150:17-26.
36. Baggs JG, Norton SA, Schmitt MH, Dombeck MT,Sellers CR, Quinn JR. Intensive care unit cultures and end-of-life decision making. J Crit Care.2007;22:159-168.
37. Blumer H. Symbolic interactionism:perspective and method. Oakland:University of California Press. 1986.
38. Bleakley A. Working in"teams"in an era of “liquid”healthcare:what is the use of theory? J Interprofessional Care. 2013;27:18-26.
39. Bassett S, Westmore K. How nurse leaders can foster a climate of good governance:in the first of a four-part series on corporate responsibility, Sally Bassett and Kathryn Westmore explore the importance of workplace culture and leadership. Nurs Manag. 2012;19:22-24.
40. Sheer B, Wong FKY. The development of advanced nursing practice globally. J Nurs Scholarship.2008;40:204-211.
41. Yun H, Jie S, Anli J. Nursing shortage in China:state,causes, and strategy. Nurs Outlook. 2010;58:122-128.
42. Pelzang R. Time to learn:understanding patientcentred care. Br J Nurs. 2010;19:912.
43. Zolnierek C. The importance of knowing the patient. Issues Ment Health Nurs. 2011;32:392-393.
44. Bach S, Grant A. Communication and interpersonal skills in nursing. 3~(rd)ed. London:Open University in assoc. with Sage. 2015.
45. Tachimori Y, Iwanaga H, Tahara T. The networks from medical knowledge and clinical practice have small-world, scale-free, and hierarchical features. Physica A. 2013;392:6084-6089.
46. Young MN, Peng MW, Ahlstrom D, Bruton GD,Jiang Y. Corporate governance in emerging economies:a review of the principal-principal perspective. J Manag Studies. 2008;45:196-220.
47. McCormack B, Dewing J, McCance T. Developing person-centred care:addressing contextual challenges through practice development. Online J Issues Nurs. http://dx.doi.org/10.3912/OJIN.Vol-16No02Man03. Accessed May 31,2018.
48. Dewey J. How we think:a restatement of the relation of reflective thinking to the educative process.Boston:D C Heath&Co. 1933.
49. Forneris SG, Peden-McAlpine CJ. Contextual learning:a reflective learning intervention for nursing education, Int J Nurs Educ Scholarship.2006;3:1254.
50. Epp S. The value of reflective journaling in undergraduate nursing education:a literature review. Int J Nurs Studies. 2008;45:1379-1388.
51. Pope JE. Complications of spinal cord stimulation. Reducing risks and complications of interventional pain procedures. Philadelphia:Saunders.2012;5:3-10.
52. Manias E, Street A. Nurse-doctor interactions during critical care ward rounds. J Clin Nurs.2001;10:442-450.
53. Kelly J. Barriers to achieving patient-centered care in Ireland. Dimens Crit Care Nurs. 2007;26:29-34.