Virtual reality or real virtuality: the space of flows and nursing practice

Abstract

The use of virtual environments for the provision of health-care is on the increase, and with each new development brings debates about their impact on care, nursing and nursing practice. Such environments offer opportunities for extending care and improvements in communication. Others believe these developments threaten aspects of nursing they hold sacrosanct. This paper explores the development of an assemblage of computer networks, databases, information systems, software programs and management systems that together work to manage health-care in Australia, namely casemix. We contend that spatial theories on network society show how this assemblage co-ordinates and operates to manage care. We discuss how this assemblage affects care and suggest that changes in organisation may be a part of the shift in how bodily organisation occurs more generally, but more specifically in health-care. We also suggest how nurses are enrolled in and by such networks, leading to transformation in nurses' practices. Finally, we argue that using spatial forms of analysis allows an interpretation of such assemblages that may account for their strengths and their shortcomings.

Dilemmas, Tetralemmas, Reimagining the Electronic Health Record

“…All these authors, to various extents, unpack and challenge the erroneous assumption of "the principally neutral foundation of technology," 8(p182) where technology means "inputs (machines, bureaucratic procedures, management strategies) organized to achieve specified outcomes." 21(p459) Although Barnes and Rudge, 20 Betts, 8 and Mechanic 21 do not directly talk about the EHR, it is possible to interconnect their texts as highly relevant to the present discussion. Mechanic elucidates the link: "managed care seeks to bring organized processes to bear in making cost-effective treatment decisions using sophisticated information systems, real time communication among providers and managers, evidence-based medicine, and scientifically based practice guidelines."…”

Geographical thinking in nursing inquiry, part one: locations, contents, meanings

“…Meanwhile, further studies have investigated the two-way dynamics between (1) placesincluding their constitutive microspacesand nurse-patient decisions, ethics, interactions, emotions, and relationships (Liaschenko, 1994(Liaschenko, , 1996a(Liaschenko, , 1996b(Liaschenko, , 1997(Liaschenko, , 2000(Liaschenko, , 2001(Liaschenko, , 2003Purkis, 1996;Edwards, 1998;Peter, 2002Peter, , 2003Bucknall, 2003;Malone, 2003;Peter & Liaschenko, 2004;Andrews & Peter, 2006;Shattell et al, 2008;Andrews & Shaw, 2010, 2012Liaschenko et al, 2011;Seto-Nielsen et al, 2013;Rowland, 2014). (2) Between places and intra-and interprofessional exchanges and relationships (Sandelowski, 2002;Halford & Leonard, 2003, 2006a, 2006bBarnes & Rudge, 2005;Brodie et al, 2005;West & Barron, 2005;Oandasan et al, 2009;Mesman, 2012;Kitto et al, 2013). (3) Between places and the nature and outcomes of healing and care, including specific types of clinical and caring interventions Angus et al, 2003;Hodnett et al, 2005Hodnett et al, , 2009Marshall, 2008;Mesman, 2009Mesman, , 2012.…”

Geographical thinking in nursing inquiry, part two: performance, possibility, and non‐representational theory

“…Current alignments with such thinking in nursing research are quite focused, concerned with how technologies bridge physical distances – thus compressing space‐time – and create new virtual cyber spaces for nursing education and practice (Barnes & Rudge, ; Mugavin, ). Questions arise including how lacking physical co‐presence, online education might involve a different – perhaps lesser – interactive energy and interpersonal ‘fizz’.…”