In recent decades there has been an intense discussion and research conducted on reflection, reflective practitioners and reflective practices within education and work life. One such educational practice where special attention in research has been directed at reflection is within nursing literature. Many of these publications take reflection as granted, as something good which will enhance the capacity of nurses within their work practice (cf. Boud et al. 1985, 2006, Heath 1998, Johns 1999, 2000, Kim 1999, Rolfe et al. 2001, Rolfe et al. 2001). What they to a large extent neglect to point out and make explicit is how power operates in practices of reflection. By arguing for reflection as a solution to certain challenges or problems as done in such publications, certain kinds of subjectivities are shaped and governed. Such processes need to be problematised. Therefore, this paper aims at making such operations of power visible by analysing reflection as discourse and a technology of confession which produces certain subjectivities within nursing practice. The specific practice analyzed is nursing homes for elderly people with a specific focus on how care workers’ prior learning and experience are recognized at work within the frames of an in-service training programme. Through such programme, care workers were ‘promoted’ to assistant nurses. I have conducted 30 semi structured interviews with 42 care workers, assistant nurses, supervisors and local managers at six nursing homes where the aim was to see how they perceived their participation and work within the project. A discourse analysis has been conducted based on the Foucauldian concepts of governmentality and technologies of the self (cf. Foucault 1983; 2003a), where the interview transcripts have been seen as text. In this text, the concepts of governmentality and technologies of the self are used as an analytical framework (for a more elaborated discussion see Fejes & Nicoll 2008). Governmentality focuses on the way the population and the individual citizen are being governed. The concept covers ‘the whole range of practices that constitute, define, organize, and instrumentalize the strategies that individuals in their freedom can use in dealing with each other’ (Foucault 2003a, p. 41). Freedom is a prerequisite for government, where those who try to control and limit the freedom of others, are themselves free individuals (Burchell 1996). More specifically, what is analysed in a governmentality analysis are liberal rationalities of governing. Questions asked are: What is the ‘thing’ to be governed, how is governing to be practiced, what is the teleos of government and what rationality of governing is creating and is being created by the discourses analysed (cf. Dean 1999, Fejes & Nicoll 2008, Foucault 1983)? In other words, I’m interested in analysing what desirable nurse is being fabricated and how such subjectivity is fostered. More precisely, the focus will be on the technology of confession as it operates within discourses on reflection.

Confession was one of the central technologies of the self studied by Foucault and it is closely related to Christianity and the idea that we all must confess ours sins. To be able to disclose one’s self (to show the truth about oneself), one had to renounce oneself. One of these techniques was verbalization. Through the human sciences, verbalization has become even more important. It has been inscribed in different practices so as to constitute a new self, without the need to renounce oneself. Foucault argues that ‘to use these techniques without renouncing oneself constitutes a decisive break’ (Foucault 2003a, p. 167). Confessional practice today is related to what Foucault (2003b) calls pastoral power. Such power emerged with Christianity, and the aim was to secure individual salvation in the next world. Pastoral power cannot be exercised without knowing the souls and the innermost secrets of each individual. Thus, pastoral power is salvation oriented and individualizing - it produces the truth about the individual. However, pastoral power as it emerged within Christianity has changed its form. The institutionalized form of pastoral power within the church has lost its vitality, while the function of pastoral power has spread throughout the entire social body. Pastoral power of today is not focused on salvation in the next world. Instead, the focus is on salvation in this world in the form of realising ones desires such as good health, good standard of living etc. (Foucault 2003b).

The analysis shows how reflection operates as a confessional practice as to shape the desirable nurse. Through the use of techniques such as learning conversations, log-books and appraisals, the care workers will for reflection is being fostered. The will for reflection is interrelated with an ethos of enterprise (cf. du Gay 1996, Zemblyas 2006). According to texts concerning the project analysed, there is a need for organisational change within the care work sector for elderly people if the constantly changing needs of the future is to be met. To meet such a changing future, an ethos of enterprise is fostered in which a reflective, active and a change ready subjectivity is fabricated. Here, work-based learning discourses have brought together the personal and organizational in a way which makes the individual associate her/his own learning with the goals of the organization. The above analysis will also be problematised as a neo-liberal governmentality, which operates and governs at a distance. A Foucauldian approach has made possible an analysis that shows how practices of reflection, so often spoken of as positive within practices of nursing and other educational practices, are induced by power, which, in the case analysed, governs and shapes a desirable nurse subjectivity. As such practices are often seen as empowering and more democratic than other kinds of practices, educators, supervisors and managers in the health care sector need to be attentive to the discursive work reflection does. By doing so, reflection might be redefined into a practice that counters the fostering effect of the governing discourse, and moves it in another direction.