Anticipatory vigilance: A classic grounded theory of risk reduction and management in the perioperative setting

This research aimed to investigate the main concern facing nurses in minimising risk within the perioperative setting and to generate an explanatory substantive theory of how they resolve this through anticipatory vigilance. In the context of the perioperative setting, nurses encounter challenges in minimising risks for their patients on a continuous basis. Current explanations of minimising risk in the perioperative setting offers insights into how perioperative nurses undertake their work. Currently research in minimising risk is broadly related to dealing with errors as opposed to preventing them. To date, little is known about how perioperative nurses practice and maintain safety. This study was guided by the principles of classic grounded theory as described by Glaser (1978, 1998, 2001). Data was collected through individual unstructured interviews with thirty seven perioperative nurses (with varying lengths of experiences of working in the area) and thirty three hours of non-participant observation within eight different perioperative settings in the Republic of Ireland. Data was simultaneously collected and analysed. The theory of anticipatory vigilance emerged as the pattern of behaviour through which nurse’s deal with their main concern of minimising risk in a high risk setting. Anticipatory vigilance is enacted through orchestrating, routinising and momentary adapting within a spirit of trusting relations within the substantive area of the perioperative setting. This theory of offers an explanation on how nurses resolve their main concern of minimising risk within the perioperative setting. The theory of anticipatory vigilance will be useful to nurses in providing a comprehensive framework of explanation and understanding on how nurses deal with minimising risk in the perioperative setting. The theory links perioperative nursing, risk and vigilance together. Clinical improvements through understanding and awareness of the theory of anticipatory vigilance will result in an improved quality environment, leading to safe patient outcomes.

From the demise of theory to its resurgence. A retrospective on the postmodern turn to rethink the 'desire for narrative' and the sublime untimeliness of emancipation

Cultural Marxist Theory, commonly known as theory, enjoyed a moment of extraordinary success in the 1970s, when the works of leading post-war French philosophers were published in English. After relocating to Anglophone academia, however, theory disavowed its original concerns and lost its ambition to understand the world as a whole, becoming the play of heterogeneities associated with postcolonialism, multiculturalism and identity politics, commonly referred to as postmodern theory. This turn, which took place during a period that seemed to have spelt the death of Marxism, the 1990s, induced many of its supporters to engage in an ongoing funeral wake designating the merits of theory and dreaming its resurgence. According to them, had theory been resurrected in historical circumstances completely different from those which had led to its rise, it would have never reacquired the significance that had originally connoted it. This thesis demonstrates how theory has survived its demise and entirely regained its prominence in our socio-political context marked by the effects of the latest crisis of capitalism and by the global threat of terrorisms rooted in messianic eschatologies. In its current form theory does no longer need to show allegiance to certain intellectual stances or political groupings in order to produce important reformulations of the projects it once gave life to. Though less overtly radical and epistemologically bounded, theory remains a necessary form of enquiry justified by the political commitment which originated it in the first place. Its voice continues to speak to us about justice ‘where it is not yet, not yet there, where it is no longer’ (Derrida, 1993, XVIII).

Scientism and instrumentalism After the Bomb: Dr Strangelove, End Zone, Crash and The Wire

This thesis argues that through the prism of America’s Cold War, scientism has emerged as the metanarrative of the postnuclear age. The advent of the bomb brought about a new primacy for mechanical and hyperrational thinking in the corridors of power not just in terms of managing the bomb itself but diffusing this ideology throughout the culture in social sciences, economics and other such institutional systems. The human need to mitigate or ameliorate against the chaos of the universe lies at the heart of not just religious faith but in the desire for perfect control. Thus there has been a transference of power from religious faith to the apparent material power of science and technology and the terra firma these supposedly objective means supply. The Cold War, however was a highly ideologically charged opposition between the two superpowers, and the scientific methodology that sprang forth to manage the Cold War and the bomb, in the United States, was not an objective scientific system divorced from the paranoia and dogma but a system that assumed a radically fundamentalist idea of capitalism. This is apparent in the widespread diffusion of game theory throughout Western postindustrial institutions. The inquiry of the thesis thus examines the texts that engage and criticise American Cold War methodology, beginning with the nuclear moment, so to speak, and Dr Strangelove’s incisive satire of moral abdication to machine processes. Moving on chronologically, the thesis examines the diffusion of particular kinds of masculinity and sexuality in postnuclear culture in Crash and End Zone and finishing up its analysis with the ethnographic portrayal of a modern American city in The Wire. More than anything else, the thesis wishes to reveal to what extent this technocratic consciousness puts pressure on language and on binding narratives.