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Discourse analysis of an `observation levels' nursing policy


Horsfall, J and Cleary, M, Discourse analysis of an `observation levels' nursing policy, Journal of Advanced Nursing, 32, (5) pp. 1291-1297. ISSN 0309-2402 (2000) [Refereed Article]

Copyright Statement

Copyright 2000 Blackwell Science Ltd.

DOI: doi:10.1046/j.1365-2648.2000.01601.x


The practice of special observation (or constant observation) is widely used in inpatient psychiatric facilities for the care of people who are suicidal. In this study, the policy of special observation was examined using a discourse analysis method to discern prevailing ideas and practices highlighted within the policy. After reading, studying and analysing the special observation nursing policy, the authors brieŻy describe the document and outline the terms and phrases prevalent within the document. These recurrent ideas are then organized into ®ve categories: professional responsibilities, suicidality, the patient's immediate context, the patient's observable behaviour and the nursing checklist. In discussion of the policy document, the invisibility of the authors, target audience and patients is noted. The authors attempt to elicit evidence for the therapeutic nurse±patient relationship in the document. In the analysis of patient, nurse and doctor roles and responsibilities, it is evident that the policy document reinforces the traditional medical hierarchy of power relations. Some assumptions that underpin the document are postulated. Questions regarding the nature of risk assessment and the evidence base for the medical prescription of special observation are raised. As well as ideas and themes evident in the document, the absence of some relevant issues is explored. While the need for succinctness and clarity in policy documents is acknowledged, the fact that patient rights, therapeutic processes and ethical dilemmas are absent is deemed signi®cant.

Item Details

Item Type:Refereed Article
Keywords:discourse analysis, mental health nursing,
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:Mental health services
Objective Division:Health
Objective Group:Public health (excl. specific population health)
Objective Field:Mental health
UTAS Author:Cleary, M (Professor Michelle Cleary)
ID Code:108467
Year Published:2000
Web of Science® Times Cited:26
Deposited By:Health Sciences
Deposited On:2016-04-19
Last Modified:2016-08-15

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