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Aim: Through a review of philosophical and theoretical constructs, this paper offers insight and guidance as to ways in which nurse leaders may operationalize advocacy and an adherence to nursing's core ethical values. Background: The US health care system works in opposition to core nursing values. Nurse leaders are obliged to advocate for the preservation of ethical care delivery. Evaluation: This paper draws upon the philosophies of Fromm, Foucault, and Deleuze and Guattari to critically review the functions of nurse leaders within a capitalist paradigm. Key issue: Key emergent issues in the paper include health care and capitalism and the nurse leader's obligations towards advocacy. Conclusion: The nurse leader acts as parrhèsia in viewing truth telling as a duty critical to improving the lives of patients. Ramifications of the decisions by those in power have even greater impact in institutions that serve those with little to no political agency. Implications for Nursing Management: The nurse leader has a freedom and platform that their patients do not and must take the courageous risk of choosing to speak. This paper serves as a call to action for nurse leaders to urgently address the current state of US health outcomes.
The knowledge culture of psychoanalysis relies heavily on the practical wisdom of competent psychoanalytic clinicians. In order to become competent analysts, analysts in training should not content themselves with trusting in their supervisors’ intuition and expertise. There is a need for supervisors and supervisees to explicate implicit theories of interpretive and supervisory techniques in psychoanalytic supervision by raising the question >Where does it come from?< with regard to three too often neglected issues. First, both the supervisor and the analyst in training should actively and constantly try to make transparent the process of contextualization, that is, the methodology of inferring latent meaning from manifest content through privileging certain pieces of information over others. Second, it should become an ongoing task in supervision that concrete (recommendations about) technical interventions are embedded in and reflect the application of a particular theory of technique. This facilitates an understanding that goes beyond the interpretation in a concrete situation and helps to generalize learning into a gradually expanding, integrated technical framework. Third, we should reflect and explicate the (predominant) supervisory approaches we are using in order to remain flexible with regard to both supervisory material and ways of reacting to it. Discussing these issues will enable analysts in training to develop their own psychoanalytic identity and integrated frame of reference for their practice that they critically and deliberately reflect upon and actively acquire rather than passively and seemingly intuitively absorb and adopt. Examples for illustrating the explication of theories of interpretive and supervisory techniques are provided.