Subject positions theory -- its application to understanding collaboration (and confrontation) in critical care

J Adv Nurs. 2001 May;34(3):376-82. doi: 10.1046/j.1365-2648.2001.01766.x.


Background: Doctors and nurses do not usually take a collaborative approach to the ethical challenges of the critical care environment. This leads to the stresses that produce moral anguish and burnout -- both for nursing and medical staff. A more collegial relationship between nurses and physicians should improve patient care. If we are to promote this collegiality, one way to proceed is to investigate the interactions between health care professionals in order to develop an understanding of the barriers to, and supports for collaboration.

Aim: Subject positions theory offers a method of explaining and elucidating the interactions between nurse and physician in terms of power dynamics, mutual expectations and the discourse available to each individual. This paper aims to demonstrate how subject positions theory can facilitate the interpretation of the interactions between health professionals in terms of the power dynamics influencing those interactions.

Discussion: This paper will use the example of a case study from my own research to demonstrate the application of this theory and its usefulness in the analysis of the interactions between health care professionals.

Conclusions: Application of this theory is used to demonstrate the author's argument that the current political and cultural structure of the health care system does not support the subject position - nurse advocate.

MeSH terms

  • Adaptation, Psychological
  • Attitude of Health Personnel*
  • Conflict, Psychological*
  • Cooperative Behavior*
  • Critical Care / organization & administration
  • Critical Care / psychology*
  • Decision Making, Organizational
  • Female
  • Feminism
  • Gender Identity
  • Helplessness, Learned
  • Humans
  • Job Description
  • Male
  • Medical Staff, Hospital / organization & administration
  • Medical Staff, Hospital / psychology*
  • Nursing Methodology Research
  • Nursing Staff, Hospital / organization & administration
  • Nursing Staff, Hospital / psychology*
  • Patient Advocacy
  • Physician-Nurse Relations*
  • Power, Psychological*
  • Psychoanalytic Theory*
  • Role
  • Workload