Mental Health Nursing articles
Kris has written the following piece for the network about record-keeping. In it he raises and discusses a number of questions which we hope the network will find useful to open further conversations about something which nurses frequently talk about but is hitherto not addressed on this website. As ever, please feel free to comment or ask questions, which Kris will read.
When Bulwer-Lytton wrote that the pen is mightier than the sword, he could not have predicted that one day many nurses would gladly apply a sword to electronic record devices! In contemporary mental health care communication does not exist without it being objectified through inscription – as the judicial adage goes – an event has not occurred unless it is written. How did such necessity occur? And what if the act of writing, in particular following instructions to fill the blank spaces of electronic records, is itself becoming the performance of our daily professional actions? We need to ask,
Question 1: Has record keeping about our nursing work replaced our nursing work?
Record-keeping has been around for millennia, famous texts such as the Domesday Day book saw records intrinsically related to the fiscal, in this case tax losses of William the Conqueror. Such practices assisted later with medieval feudalism (Mutch, 2006), whereby for military service, a person gained land that was divided and distributed to assist localised governing. The Bayeux Tapestry which depicted William’s triumphs strengthened the trend to capture history, and perhaps to not allow the truth to get in the way of a good story. ‘Truth’ becomes dependent on which writings survive. As Walter Benjamin said, ‘History is written by the Victors’, suggesting the investigation of what is excluded is as important as what is read. We need to ask,
Question 2: As nursing records become increasingly framed through the boxes of computer databases, what is excluded and why?
What if ‘how’ history is written becomes more important? Critique of Westernised positioning on using specific knowledges to make sense of the world may have a bearing. The theory ‘Coloniality of Power’ originates from the work by Anibal Quijano (Quijano, 2000). Quijano argues that the dominance of westernised colonisation is still being felt today, especially as knowledge is constructed within hierarchies to enact power over others (Alcoff, 2007). Partly this originated from plantation owners need to categorise and ultimately dehumanise slaves to maximise profit. Slaves were not asked how they constructed themselves individually or culturally, but were observed and placed into categories that aided highest yield of crops (Quijano, 2007). Thus age, height and proficiencies were important, not slave’s personal identities. 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