Biomedical subjects
Patricia D'Antonio
Publications and source records attributed to Patricia D'Antonio.
History for a practice profession.
This essay explores the meaning of history for a practice profession. It argues that our clinical backgrounds suggest particular kinds of historical questions that colleagues with different backgrounds would not think to ask. This essay poses three possible questions as examples. What if we place the day after day work of caring for the sick - that which is nursing - at the center of an institution's history? What if we were to embrace a sense of nurses and nursing work as truly diverse and different? What if we were to analytically engage the reluctance of the large number of nurses to formally embrace feminism? This essay acknowledges that these are not the only possible questions and, in the end, they most likely will not even be the important ones. But this essay does argue that we, who are both clinicians and historians, need to more seriously consider the implications of our questions for disciplinary practice and research. It argues, in the end, that the meaning of history to a practice profession lies in our questions: questions that are different than those raised by other methods, and questions that may escape notice in the press of daily practice and research.
Relationships, reality, and reciprocity with therapeutic environments: a historical case study.
This historical case study considers the reciprocity between interpersonal relationships and the immediate, structural, and demand-laden therapeutic environment in which they occur. This study draws its data from the daily diaries kept between 1814 and 1840 by the lay superintendents of the Friends Asylum for the Insane in Philadelphia. The demands of a therapeutic environment for stability and productivity, in addition to demands for safety and healing, fundamentally altered the nature of the individual relationships between patients and staff. Therefore, current practitioners must not assume the stability of their later 20th century formulations about therapeutic relationships. Rather, they must perform a careful calculus of risks and rewards as they consider the intersection of relationships, reality, and therapeutic environments.
Moments when time stood still: nursing in disaster.
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Women, nursing, and baccalaureate education in 20th century America.
PURPOSE: To analyze the social meaning of the American system of education for nursing practice. METHODS: Historiographical analysis to compare and contrast the relative educational level of different self-reported groups of American women with that of nurses in the later decades of the 20th century. FINDINGS: Early 20th century social support for efforts to improve the overall educational level of some nurses planning careers in education, administration, or public health nursing lent credence to the belief in nursing as a vehicle for upward social mobility. This promise of mobility was particularly apparent in the educational backgrounds of African American, Hispanic, and Asian American nurses. However, the late 20th century decreased average educational level of U.S. nurses relative to that of all U.S. women jeopardizes the clinical and social roles of the profession. CONCLUSIONS: The language of class and community status is needed in addition to that of science, knowledge development, and clinical excellence to increase social and political support for educational initiatives.
Organizing practice: nursing, the medical model, and two case studies in historical time.
The medical model of clinical practice has long presented rather awkward challenges to the discipline of nursing. This study explores this challenge within nursing practice more deeply by examining two moments in the history of nursing practice: that before and that after the late 19th century professionalizing of the discipline. The first historical case study looks to the experiences of lay men and women staff caring for insane patients at the Friends Asylum in early 19th-century Philadelphia. This case study explores the workings of particular clinical encounters in day-today clinical practice. The second historical case study looks to the organizational efforts of pediatric nurse practitioners in the 1970s. This case study, set during a time when heuristic value of the medical model was already well-established, explores the tensions exerted by organized medicine and by organized nursing on the practicing nurse, and the efforts of both organizations to cloak their concerns surrounding professional legitimacy and control in the rhetoric of patient care and safety. These two seemingly disparate case studies suggest that the medical model has historically worked as an effective framework to contain the turmoil and turbulence that inevitably comes with the realities of both clinical practice and more organizationally focused disciplinary strategies. This study argues that the medical model has been an effective tool for thinking about all kinds and models of care for the sick. nurses appropriated the model to free them to do what they did best both before and after the development of modern models of practice. Hence, this study re-conceptualizes the medical model as both a source of power in nursing, and as a multidisciplinary, multidimensional organizational model of clinical and organizational practice.