Constructing standards: a study of nurses negotiating with multiple modes of knowledge

摘要

Purpose - The aim of the paper is to explore how multiple modes of knowledge play out in the consolidation of nursing procedures in construction of "local universality". The paper seeks to explore processes where nurses negotiate universal procedures that are to become local standards in a hospital. Design/methodology/approach - The paper is based on a case study design. Working group sessions, where the activity was to consolidate different versions of nursing procedures were observed and videotaped. For this paper, transcribed videotaped observations, where tension-laden situations were identified, are subject to interaction analysis. Findings - In the negotiations to construct standards, multiple modes of knowledge play out; personal experience, collective expertise and formalized knowledge. The paper demonstrates the contributions these modes of knowledge make in a process of standardization. This shows that standards, as such, do not stay universal for very long, but are constructed as "local universalities". Research limitations/implications - The study elaborates on discursive negotiations of procedures to illustrate how local universality plays out in processes to constitute standards. It is a limitation because how the local universality plays out in clinical work, or make claims about practice transformation, cannot be described. Originality/value - The paper shows the necessity of confronting standardized procedures through multiple modes of knowledge. The paper exemplifies productive interactions in the construction of local universality, and how professionals account for practice when facing formal and standardized procedures.