Reworking Nursing Expertise: Directors of Nursing's Tactics to (Re)Connect Knowledge and Power in Hospital Governance

Nursing Inquiry 32 (1):e12696 (2025)
  Copy   BIBTEX

Abstract

Shared governance in hospitals promotes the inclusion of nurses' expertise, knowledge and skills in organisational processes, and nurses increasingly fulfil positions in organisational hierarchies. However, incorporating nursing expertise in strategic governance structures might be complicated, as these structures are primarily linked to managerial and biomedical expertise. Drawing on a Foucauldian perspective on knowledge and power, intertwined and embedded in everyday (inter)actions, we study how newly appointed directors of nursing challenge these dominant ‘modes of knowing’. By focusing on a (Dutch) healthcare organisation, a large academic medical centre, we gained insight into how the history of director of nursing roles relates to how nursing expertise is valued. We gathered qualitative data (from multiple sources) to get close to the daily practices of these directors. In this way, we were able to highlight three tactics that enable directors to relate to new ‘knowledge‐power knots’: (1) positioning, by creating more unity; (2) profiling, by showing significance and (3) powering, by being alert and intervening. With these tactics, the directors of nursing try to embed themselves and their expertise in hospital governance. This study contributes to an everyday understanding of power and the tactics that directors of nursing employ as an ongoing practice. This provides practical starting points for embedding nursing in governance and decision‐making.

Other Versions

No versions found

Links

PhilArchive



    Upload a copy of this work     Papers currently archived: 101,597

External links

Setup an account with your affiliations in order to access resources via your University's proxy server

Through your library

Similar books and articles

Expertise in nursing practice: caring, clinical judgment & ethics.Patricia E. Benner - 2009 - New York: Springer. Edited by Christine A. Tanner & Catherine A. Chesla.
The Lived Experience of Nursing Advocacy.Robert G. Hanks - 2008 - Nursing Ethics 15 (4):468-477.

Analytics

Added to PP
2025-01-09

Downloads
0

6 months
0

Historical graph of downloads

Sorry, there are not enough data points to plot this chart.
How can I increase my downloads?