Learning Objective #1: Understand the complexity of making nursing practice visible in nursing records

Learning Objective #2: Have a sociological appreciation of the wider influences on what nurses document about their practice

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This paper is based on a discourse analysis of the nursing records of 45 patients and explores how nurses represented aspects of their practice within such records. The analysis suggests that the nursing documents analysed were dominated by biomedical components of care, with psychosocial elements receiving much less attention. That biomedicine dominates contemporary nursing practice has long been acknowledged among nursing leaders. However, we present explanatory insights for the preponderance of biotechnical aspects of care by drawing on the work of the German critical theorist, Jurgen Habermas. Habermas distinguishes between two components in society, the system and the lifeworld. The system depicts the realm of society associated with technical-scientific rationality, and is mediated by power and strategic action, and invokes a purposive rationality. The lifeworld, by contrast, represents a value-orientated rationality aimed at reaching understanding through communicative action. While Habermas (1984) accepted the need for purposive-rational action, he expressed concern about the expansion of technological and scientific expertise that served to undermine rules of conduct based on value-orientated ethical considerations. This he referred to as the colonisation of the lifeworld, where the system, with its purposive rationality, penetrates the lifeworld, inhibiting its communicative potential. In analyzing the documentation, we draw parallels between Habermas' notion of the colonization of the lifeworld by the system, in particular, because of the biocentric status of nursing records and the simultaneous suppression of ‘the voice of nursing' in the texts.