title: Politics of change: the discourses that inform organizational change and their capacity to silence.
abstract: Changes in healthcare organizations are inevitable and occurring at unprecedented rates. Such changes greatly impact nurses and their work, yet these experiences are rarely explored. Organizational change discourses remain grounded in perspectives that explore and explain systems, often not the people within them. Change processes in healthcare organizations informed by such organizational discourses validate only certain perspectives and forms of knowledge. This fosters exclusionary practices, limiting the capacity of certain individuals or groups of individuals to effectively contribute to change discourses and processes. The reliance on mainstream organizational discourses in healthcare organizations has left little room for the exploration of diverse perspectives on the subject of organizational change, particularly those of nurses. Michel Foucault's work challenges dominant discourse and suggest that strong reliance's on specific discourses effectively disqualify certain forms of knowledge. Foucault's writings on disqualified knowledge and parrhesia (truth telling and frank speech) facilitate the critical exploration of discourses that inform change in healthcare organizations and nurses capacities to contribute to organizational discourses. This paper explores the capacity of nurses to speak their truths within rapidly and continuously changing healthcare organizations when such changes are often driven by discourses not derived from nursing knowledge or experience.
authors.affiliation: Faculty of Nursing, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Kim
authors.initials: K
authors.lastname: McMillan
mesh_terms: D003695:Delivery of Health Care / Q000379:methods; D006801:Humans; D017146:Models, Organizational; D009741:Nursing Staff, Hospital / Q000458:organization & administration / Q000523:psychology*; D009936:Organizational Innovation; D010687:Philosophy, Nursing; D011057:Politics; D017009:Professional Autonomy
keywords: Michel Foucault; nursing; organizational change; parrhesia; philosophy; professional knowledge; voice