Doctors' orders and the language of representation

• Published in: Nursing philosophy Vol. 14; no. 2; pp. 139 - 147
• Main Author: Pijl-Zieber, Em M.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.04.2013
• Subjects: Humans; language; nurse attitudes; Nurse's Role; nurse-physician relations; Nursing; nursing role; oppression; orders; philosophy; Philosophy, Nursing; Physician-Nurse Relations; power; Power (Psychology); Professional Autonomy; Terminology as Topic
• ISSN: 1466-7681; 1466-769X
• DOI: 10.1111/nup.12001

The term doctors' orders or physicians' orders is endemic to nurses' work, to the degree perhaps that few nurses give the term much thought. The nursing profession has progressed over its historical trajectory, from a level of considerable dependence upon physicians' directives, in its beginning, to much greater professional autonomy. However, the term order remains a stronghold in nurses' professional reality, despite the fact that this term is laden with anachronistic ideological interests that are embedded within the historical, sociopolitical and gendered contexts in which health care occurs. In this essay I consider the term order through multiple philosophical and semantic lenses. I explore the endowment of power within the word order and how this term disadvantages nurses. I examine how the word order demarcates roles and establishes perceived value of the item represented by the originator of the order. The concept of doctors' orders carries powerful meanings, affirms the power‐as‐knowledge hierarchy so entrenched in the nurse–physician relationship, and can inhibit nurses' full participation as partners in health care.