Nursing as Body Work
The current “Editor’s Pick ” article from the current ANS issue is titled “Critical Perspectives on Nursing as Bodywork,” authored by Karen Anne Wolf, PhD, APRN-BC, DFNAP. In this thought-provoking article, Dr. Wolf calls for nurses to reject the objectification of the body and instead reclaim body work as integral to a holistic perspective.
Dr. Wolf shared this message about her work for ANS readers:
Nursing as work is the focus of my scholarship. In past work, I have explored the larger structural issues in the collective history of nursing. In this paper I explore the paradoxical nature of nursing as bodywork. Scratching beneath the surface of the issues of status and power opens a window on the variety of factors that shape the work of nurses in relation to their patients. The nurse-body relationship is so fundamental to nursing work that we are blind to its social impact. This results in contradictory images and experiences. For example, nurses are revered as “most trusted” and angelic in many countries yet exposed to persistent degradation within the media and in public discourse.
Nursing work continues to be viewed as low status despite professionalization efforts. The social discomfort with the human body contributes to the paradoxes in nursing as bodywork. The relational boundaries between nurses and patients blur ordinarily taboo spaces. The intimacy of providing physical care carries the stigma of nursing as dirty work. Yet this same intimacy throughout the sacred rituals of birth, death, and vulnerability contributes to the entrusted relationship. De-stigmatizing nursing as bodywork begins with accepting our bodywork relationship. Without such an acceptance, there is a tendency to distance nursing from the body through the increasing use of ancillary nursing workers or technology. Recognizing the paradox of nursing as bodywork is a critical to the future of the profession. I would suggest that we consciously claim and embrace the relational care for the body rather than reject it. Nurses must be mindful and respect the power inherent in their privileged and intimate relationship with patients.
Download your copy of Dr. Wolf’s article at no cost while it is featured on the ANS web site! We welcome your thoughts and comments in response!
Wolf’s article is the most comprehensive critical description and analysis of “body” relative to nursing that I have seen. She effectively discusses the patient as body, nursing work as bodywork, nurses as bodies and embodiment as the basis and context for life as well as skills acquisition (Benner). I think that it is long overdue, and is accessible to all nurses, practitioners as well as academics (I know they need not be separate).
One thing that could be said in Wolf’s contextual space about bodies, is that nursing could embrace other forms of so-called alternative or complementary bodywork and bodyworkers, including massage therapists, physical therapists, physical therapists, etc. They enhance and in some cases replace nursing’s body work, and the lack of inter professional contact in this area is worth exploring. They do some things differently, and this is not the same as nursing handing over intimate body care to ancillary workers (such as minimally educated medical assistants or CNAs. And on that note, I think it is just what it is now in terms of having the nurse move away from the body of the patient and into the world of electronics and data gathering. As long as market and profit drive health care, we will see this trend increase. The ACA has challenged the profit motive (if ever so slightly) that there is hope on this horizon. Speaking of the US, those who have found respectful treatment of their body as self because of nurses appreciate care as given, as performed, and I see a major transformation when that happens. Nurses are then considered indispensable to the patient. Yet one bad experience of being treated as an “appendage of the hospital bed,” by nurses can engender the image of Nurse Ratched. Media imagery is important, but there are roots of truth that hold some of it together, and here I refer to the violence of bullying in nursing. If nurses are being bullied, patients are then being bullied, in turn. This always makes me skittish about centering nursing on caring: it is tempting to believe then that simply being a nurse or becoming one, assures some level of empathy or compassion. Not always there. Safety and security first. And use the term caring (as empathy) cautiously.
Returning to Wolf, the references to the work of Foucault and Bourdieu are essential. Because nurses are also part of the “discipline” of bodies, a way that the “habits” works. We cannot see ourselves as powerless when realizing how much we actually govern bodies in a Nursification” (I made that up) similar to medicalization. When the governing of bodies left the religious sphere of the confessional, others took up the control, including teachers, physicians, nurses and policemen, to name a few. We discipline in the actual touching we do (we show the correct way to position, etc.) and in the education we do (instructing patients, teaching future nurses, etc.)
Wolf’s article is a landmark piece. I hope many read it and press on with the revolution.
I appreciate the thoughtful comments as they further the extent the potential critique and analysis of “Nursing as Body Work”. Nurses ambivalence about the body pervades our clinical practice and academic work. Alienation from the body has fueled a growing interest in other forms of body work, such as massage, reiki and therapeutic touch. Reclaiming the body is not necessarily the same as Nursification- but I thought the term an apt parallel to medicalization. Control is a central concern within institutions where nurses work- yet they are also concerned to demonstrate positive patient outcomes, reflective of “caring” practice. A recent trend in health professions education is the research on how to build compassion and caring practice. What is disciplinary matrix that hold nursing together? Where does the body fit into the matrix? I am hopeful that my paper will continue to raise questions and comments on the nurse-body relationship.
Thank you both for these thoughtful and thought-provoking comments! this kind of exchange is exactly what I envision for this blog! So thank you for starting this conversation!