Nursing, technology and the millennium.

Abstract

At the turn of the twentieth century, the first trained nurses encountered technology as a robust physical presence in largely embodied relations ‘behind the screens’. 1 At the turn of the twentieth-first century, professional nurses encounter technology as a virtual reality in increasingly hermeneutic relations in front of screens. (Post)Modern electronic/computer technology entails a virtual reality, neither accessible to direct sensation, nor comprehensible by common sense notions of space and time. As Alexandra Chasin observed, ‘the materiality of electronic machines is so elusive … it’s as though there’s no there there’ (p. 75). 2 Indeed, technology and nursing share this common legacy and fate to be simultaneously there and not there. Nursing has historically been characterized by its physical ubiquity and cultural invisibility. Anyone attempting to understand either technology or nursing is standing on shifting ground, trying to seek a purchase on two complex and elusive realities. The American, Australian, British, and Canadian scholars whose work comprises this special issue have risked these shifting sands. Indeed, what ties their individual papers together is the laudable effort to address the meaning and meaningfulness of technology, as opposed to its substance, or physical nature, per se. Opening with Heidegger’s controversial claim that the ‘essence of technology is by no means anything technological’, Purkis seeks to explain the ‘ordering of nurses’ interests in documenting patient care’ by conceiving the computerized patient record as an actor that both transformed, and was transformed in, practice. Barnard and Gerber seek to explicate the qualitatively different conceptions of technology surgical nurses held beyond common notions of it as ‘machinery and equipment’. Conceiving wound care as a ‘technology of healing’, ‘technology of skin’, and as a ‘technoscience’ of nursing, Rudge seeks to disentangle their ‘webs of meaning’. While Rudge explores whether and how these technologies constituted a means to, or source of power for nurses, Fairman and D’Antonio examine the ‘virtual power’ in the American nurse practitioner movement, an empirical site in which the gender-technology relation is particularly well illuminated. Both Traynor, in his exposition on ‘textual technologies’ and the ‘technology of evidence’ in scientific reading and writing practices, and I, in my ‘semiotic’ history of the nursing/technology relation, explicitly link text to technology. All of these papers comprise what Jensen described as studies of technology-as-culture, or the investigation of technology as a ‘realized signifying system’ (p. 297). 3 Adapting Peirce’s triadic sign-model to the semiotic study of technology, Jensen 3 proposed that technologies can have three different semiotic functions: as object (or the ‘second thing’ to which one refers), but also as representamen (or the ‘first thing’ that stands for a ‘second thing’) and as interpretant (or the ‘third thing’ through which the ‘first thing’ can be understood to refer to the ‘second thing’) (pp. 298–299). Accordingly, technologies occupy meaningful positions as cultural artefacts, cultural signs, and as themselves culture. Indeed, the authors of the papers in this issue show technology at work in the way we language technology (or the way we conceive and talk about it) and in the use of language as a technology to effect goals and acquire or maintain power. As these authors engagingly show, technology is ‘context dependent’ in both ‘speech and in the world’ (p. 152). 4 To think about and through technology is to think about and through history and culture: that is, to engage technology as both ‘fact and symbol’. 5 For us nurses, to think about and through technology is to think about and through the ‘devices’ that have shaped and constituted our collective ‘desire’ for knowledge, autonomy, visibility and power. 6