Nursing - Theses
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ItemInternationalizing nursing education in Central Java, Indonesia: a postcolonial ethnography( 2008)Using a postcolonial ethnographic study, this thesis explores the tensions of why Indonesian nurses both desired and rejected western expertise and compliance with international standards for nursing education and practice. The dominant understanding of such ambivalence is that while all nurses accept the need for universal competencies for the contemporary, internationally mobile nurse, non-western nurses are prevented from achieving some of these competencies by virtue of inherent cultural differences from their western nursing counterparts. Drawing on postcolonial theory, this thesis deconstructs such notions of culture and difference as colonial constructions and identifies the hegemonic nature of western nursing. It deconstructs the image of the contemporary, internationally mobile nurse as historically situated and discursively constructed. It unsettles the dominant understanding of what nursing is, what nursing should be, and questions the exclusive conditions of entry into nursing as a globalized profession. Based on the need to escape dominant understandings, ethnographic techniques of observation, individual and group interviews, documentary analysis, and reflective journaling were used to explore how both local and global influences on nursing impacted on achieving international standards within everyday circumstances. Data were analyzed using key postcolonial themes including orientalism, subalterneity, ambivalence, mimicry and hybridity. Assumptions of difference influenced perceptions and judgments about the quality of Indonesian nursing education and practice. Incongruence existed between what is said and documented about nursing and actual nursing practices in Indonesia. This finding represented both passive and powerful subaltern resistance to western models. Partial resistance to western models of nursing, practice and education helped to open up hybrid spaces in which cultural differences could operate. Western models of nursing practice and education underpinning the agenda for global consistency of nursing are not universally applicable. Instead, it is a colonial assumption that all nurses should be the same regardless of the context in which they practice. This thesis shows that despite the apparent necessity for western colonization of Indonesian nursing, the acceptance of western models of nursing and transferability of western expertise are determined by the degree to which globally and locally situated definitions of best practice coincide. The findings suggest that ambivalence arises when being ‘internationally recognized’ means accepting the dominant western hegemony of nursing but rejecting locally situated meanings and practices. I propose that this ambivalence creates a hybrid space to improve Indonesian nursing and challenge the universality of western standards for nursing education and practice. I also propose that ambivalence creates a space for reconceptualizing the role of western experts in non-western settings. In this re-conceptualized role, expertise is not defined by its western foundations. Instead, expertise is defined by an ability to facilitate content knowledge that can be accepted, rejected, or incorporated into hybrid solutions.