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Deconstructing Clinical Pathways: Mapping the Landscape of Health Care

Georges, Jane M. PhD, RN, CNOR; McGuire, Sister Sharon PhD, OP, APRN-BC

Articles

Grounded in a critical feminist methodology, this article undertakes a deconstructive discourse analysis of a newly emergent discourse within nursing care management, “clinical pathways.” Using a Foucaultian approach to deconstructive discourse analysis, the power relations inherent in the “clinical pathways” discourse are identified and the underlying philosophical assumptions informing the discourse are explored. The metaphors of “map” and “landscape” are employed to examine the power relations within the discourse of “clinical pathways.” Finally, an alternative, praxis-based approach to transforming the discourse of “clinical pathways” from a focus of social control to one of situated engagement and community is proposed.

From the Hahn School of Nursing and Health Science, University of San Diego, San Diego, Calif.

Corresponding author: Jane M. Georges, PhD, RN, CNOR, Hahn School of Nursing and Health Science, University of San Diego, 5998 Alcala Park, San Diego, CA 92110 (e-mail: jgeorges@sandiego.edu).

© 2004 Lippincott Williams & Wilkins, Inc.