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creating the Trust Reflective Model showed there is a tendency to cut to
the chase, crunch your 30 seconds in as Amy called it, so bypassing
deeper and more meaningful learning. I now see this as a clash of the
fields and habitus of learning and expectations between the university and
practice and the philosophy underpinning critical reflexivity. But surely this
is understandable if patients are put at the centre of the caring process;
our focus should be on them? This is another contradiction I suggest,
because whilst nurses claimed and probably thought they were patient
centred from my observations they often were not; a tone of voice, a bossy
command, knowing what was best for the patient, not telling the patient
what they were doing, ignoring the buzzer because they were doing
something more important such as paperwork. Shouldn‘t nurses‘ learning
assume second place to doing nursing?
My argument is that through embodying reflexivity it can become
integrated during care- giving, allowing nurses to have more choice about
how they practise, and encouraging a collaborative and relational process
that reduces unnoticed power between themselves and their patients.
There has been a lot of media attention recently focusing on nurses‘ lack
of compassion and dignity with their patients. Reports such as the King‘s
Fund (2008) have suggested a move away from rigid target setting to
recognising the caring aspects of nursing. The historically embodied
dispositions are unlikely to change the emphasis in practice around care-
giving unless the culture is addressed, which is no easy task. How do
organisations give legitimate cultural capital to patients‘ hygiene and
emotional support needs when the wider field of society does not and
historically has not valued these functions? A systemic inquiry through all
levels of the organisation could begin to address the lack of legitimacy and
capital given to nursing procedures. This is not a phenomenon just related
to Britain, Salvage (2006) argues that nurses‘ work is trivialised and
undervalued across all continents. Increasing staffing levels and attention
to the environment nurses work in may help in some areas, but this is not
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