To DeZarn's commentary on Darbyshire P (2004) 'Rage against the machine?': nurses' and midwives' experiences of using computerized patient information systems for clinical information.

摘要

In her response to my paper, 'Rage against the machine' (Darbyshire 2004), DeZarn (2006) makes an important contribution to our understandings of the organizational, managerial and practice contexts within which Computerized Patient Information Systems (CPIS) are introduced. We may, however, differ as to what that importance is.DeZarn's (2006) seems the classic managerial response to workers who do not immediately fall over themselves to embrace the latest 'innovation'. That response is invariably to locate the 'problem' within clinicians and practitioners who, by their questioning, doubting, challenging or even their less-than-enthusiastic acceptance of the latest 'enhancement', demonstrate their 'resistance to change'(Darbyshire 2001). Within this managerial worldview, it is almost inconceivable that there may be something problematic about the actual 'innovation' or change itself. Its desirability and efficacy are givens. The irony is not lost on clinicians that a system which, on the one hand, demands that they be 'critical' 'reflective' and 'questioning' in relation to their own clinical practice can become decidedly uneasy when they turn this critical gaze to bear on the latest managerial 'change strategy' 're-organization' or 'new system'.