Elucidating the Ruling Relations of Nurses' Work in Labor and Delivery: An Institutional Ethnography

Glob Qual Nurs Res. 2023 May 2:10:23333936231170824. doi: 10.1177/23333936231170824. eCollection 2023 Jan-Dec.

Abstract

Obstetrics is a well-known area for malpractice and medical-legal claims, specifically as they relate to injuries the baby suffers during the intrapartum period. There is a direct implication for nurses' work in labor and delivery because the law recognizes that monitoring fetal well-being during labor is a nursing responsibility. Using institutional ethnography, we uncovered how two powerful ruling discourses, namely biomedical and medical-legal risk discourses, socially organize nurses' fetal surveillance work in labor and delivery through the use of an intertextual hierarchy and an ideological circle.

Keywords: Canada; ideological circle; intertextual hierarchy; nurses’ work; obstetrics; patient safety incidents.