Kirsten Frederiksen

Uddannelse til ordentlighed - at lære sygepleje genenm 200 år: - en ph.d.-afhandling

Research output: Book/anthology/dissertation/reportPh.D. thesis

 

The dissertation begins by examining the process whereby the sick person at the beginning of the nineteenth century becomes a hospital patient whose care comes to require a formalized nursing education from the person who nurses him. Subsequently, it explores how this nursing education came into being in Denmark and how caretakers have been educated for the past 200 years by examining the conceptions and ideas that have made themselves felt in respect to the question of who should nurse the ill, how this person who cares for others should be, and, not least, the ways in which it has been attempted to arrive at the goal of the good caretaker.

The study is based on an analytical framework elaborated in the light of an interpretation of parts of Michel Foucault's work, with emphasis on Foucault's conception of his own work late in life as explorations of forms of problematisation.

Based on Foucault's analyses of the rise of modern medicine as a social medicine, the dissertation examines the process that begins sometime around the turn of the nineteenth century whereby hospitals change from being places for people unable to support themselves to institutions whose purpose is to restore ill people to health. Through this change poor relief becomes a state-regulated area with its own field of study that produces knowledge about, for instance, pedagogy and medicine, and later nursing as well. With the state regulation of poor relief and the hospital changing from a hospital for the poor to a hospital for patients, the paupers are separated from the incurable patients and those who can become fit to work and contribute to the welfare state, while those who can be restored to health are transformed from paupers into hospital patients and simultaneously made scientific objects. Joining this group are the townspeople, who begin to seek out the doctors who now make their entry into the hospitals.

The dissertation shows the ways in which the untrained nurse's lack of culture is problematicised, and it is suggested that she should be replaced by a woman of culture, who is assumed to possess certain qualities that make her better able to comply with the doctor's need for a helper.

The dissertation shows that the rise of nursing as an independent discipline and field of knowledge, for which a formalized education is required, takes place through certain developments in which first nursing is separated as an independent field of knowledge that can be formulated from the position of the doctor, and then the untrained nurse is replaced by educated women of culture in a gradual transition in which many of the forms of problematisation concerning the untrained nurse's relationship to herself are carried over into nursing education. Subsequently, through a study of textbooks, applications, written observations, students' notes from their nursing studies, nurses' recollections about their studies, as well as a variety of pictorial material, the dissertation demonstrates that in the period from the time when nursing education was established in the nineteenth century up to the beginning of the 1970s, the nursing student is embedded in a regime of knowledge and practice. The outlines of what the dissertation identifies as a figure of orderliness appear in this regime, assuming the shape of a strategy through which it is attempted to shape the nursing student's relationship to herself so that she maintains order, creates system and behaves properly. In this figure of orderliness, religious moorings, charity and the future nurse's motivation for her choice of profession play an essential role.

Using a metaphor from one of the textbooks, the dissertation demonstrates how the nursing student has to adapt to a role like a wheel in a big machine, revealing some of the ways in which the student is educated to become a nurse, who is characterized by being thrown into work as a student, always having busy hands, bearing a heavy responsibility, and being reprimanded when she does something wrong. In addition to revealing these ways of being educated, it shows the ways in which the students resist allowing themselves to be educated to orderliness.

Subsequently, the dissertation diagnoses modern society as a post-disciplinary, individualizing society, showing how demands on the worker are formulated in terms of competencies, in which it is imagined that all of a person's potentials are exploitable on the labour market. Finally, the dissertation takes a look at some examples from the period around 1990 up to 2000. These examples show how parts of the figure of orderliness can still be identified in the regime of knowledge and practice of nursing - for instance, in the form of demands for operational goal systems and qualification profiles and a preoccupation with the future nurse's relationship to herself, and it shows how in this period guidance comes to replace reprimands as the way in which it is attempted to regulate the future nurse's relationship to herself.

Original languageDanish
Place of publicationCVU Midtjylland
PublisherForlaget PUC
Edition1
Number of pages349
ISBN (Print)87-91562-07-4
Publication statusPublished - 2005
Externally publishedYes

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