Grayce M. Sills (1926-2016)

Guardian of the Discipline

Thank you to Sharon Tucker, PhD, RN, FAAN
and Christina Nyirati, RN, PhD
for their contributions to this post (see bios below).

Grayce M. Sills, circa 1986 while serving as Acting Dean of the Ohio State University School of Nursing. Photo by Charlene Eldridge Wheeler, featured for month of April, 1987 “Everyday Sheroes” Calendar

Grayce Sills, RN. PhD, FAAN, is widely recognized as a “pioneer . . . and supporter . . . of psychiatric mental health nursing . . . a champion for improving care for the chronically mentally ill . . .  [and] a pioneer in interdisciplinary collaboration among health care professionals” (Parrish, 2016, pp. 155-156).

Grayce Sills was born in Bremen, a small town in southeast Ohio. She was raised by her grandparents and extended family from the age of 2 years, after her mother died. Grayce began her undergraduate education with a liberal arts concentration at Ohio University in Athens, close to her family home. Following her sophomore year, Dr. Sills took a federally funded training job in New York to prepare as a psychiatric aide, hoping to raise enough money to complete her college degree. The psychiatric nurses impressed Grayce with their specialized skill. She was particularly impressed by the head nurse, Betty Oliver, who seemed more able than the physicians to soothe and comfort patients by just being present. Inspired, she began her nursing education at Rockland State Hospital School of Nursing in Orangeburg, New York, where she received her diploma in 1950. Grayce then attended the baccalaureate completion program at Teachers College Columbia University in New York from 1950 to 1951 but did not complete the program.

While at Teachers College, Grayce met Hildegard Peplau, just as Dr. Peplau was completing what many consider the first middle range nursing theory, Interpersonal relations in nursing (Peplau, 1952). Many year later Dr. Sills shared stories about the Peplau seminars with The Ohio State University Ph.D. nursing students who were grappling with theory; Dr. Sills admitted to also being initially confounded by Dr. Peplau’s theoretical inquiries. Timidly curious, yet somewhat intimidated, Grayce left New York to return to her Ohio home. She finally received a baccalaureate nursing degree from the University of Dayton in 1956. Fortunately for our discipline in general and psychiatric nursing in particular, Dr. Peplau was invited to present a nursing workshop at Dayton State Hospital in 1957, where Grayce was working. Explaining how her perspective then shifted profoundly, she stated:

“I owe [a large debt to] Hildegard E. Peplau for bringing me a new perspective, a new approach, a theoretically based foundation for nursing practice, for therapeutic work with patients in those problematic settings. Imagine the excitement of making sense out of a patient’s hallucinatory experience through collaborative work! Imagine the joy that came from discovering that a delusion could be dealt with and satisfactorily eliminated through effective verbal work with patients, a new day had dawned! Theory was used to guide nursing practice. Theory was tested in the real world of practice.” (Sills, 1978, p. 122)

Dr. Sills earned a master’s degree in sociology from The Ohio State University (OSU) in 1964, and began teaching in the OSU School of Nursing that same year. She completed a PhD in sociology, also from OSU, in 1968.  At that time, the PhD in Nursing was not yet offered. Dr. Sills described herself as a “tourist” in the discipline of sociology, grateful for a conceptual perspective complementary to nursing, but convinced that nursing knowledge was necessary for nursing practice. With this conviction, Dr. Sills made major contributions to the nursing programs at OSU, including a graduate clinical nurse specialist program in psychiatric mental health nursing. She also chaired the Department of Family and Community Nursing and served as Director of Graduate Studies.

As the first OSU Nursing Acting Dean, by 1985 Dr. Sills had managed to re-position Nursing in the academic structure of OSU by establishing the College of Nursing with its own budget and self-governance. This, she believed, was the necessary foundation for creating a community of nurse scholars who would advance nursing education and nursing scholarship. Self-governance, she reasoned, would contribute significantly to the power of nursing to develop the scholarly discipline, as well as the practice profession of nursing. Her conviction that borrowed knowledge from established disciplines was useful to nursing – although that knowledge was not  nursing knowledge – influenced her vision for the Ph.D. Program in Nursing at OSU, established in 1985.

Dr. Sills retired from OSU College of Nursing in 1993 as Emeritus Professor. She holds the rare distinction of receiving three awards from OSU: a Distinguished Teaching Award, a Distinguished Service Award, and an honorary doctorate in public service. She also was awarded honorary doctoral degrees from Indiana University and from Fairfield University.

Dr. Sills’ contributions expanded beyond OSU. She chaired the Study Committee on Mental Health Services for Ohio and, in 1986, was chosen as a Woman of Achievement by the Columbus YWCA. As a past chair of the OSU Hospitals Board of Trustees, she was instrumental in gaining board support for magnet hospital status, achieved in 2005. Beyond Ohio, she held visiting professorships at several universities throughout her career and provided international consultation for community based mental health nursing in Italy, Japan, and South Korea. Dr. Sills was a founder of American Psychiatric Nursing Association and the American Nurses’ Association (ANA) Commission on Human Rights. She was elected to the American Academy of Nursing (AAN), and in 1999, was designated as an AAN Living Legend.  She received several other awards, including the ANA Hildegard Peplau Award.

Dr. Sills record of scholarly work includes more than 60 journal articles and book chapters. One of many innovations put forth by Dr. Sills in the idea of nurse corporations. She explained,

“The conceptual key to the corporation proposal is that it changes the fundamental nature of the social contract. The professional nurse would no longer be an employee of the hospital or agency, but rather a member of a professional corporation which provides nursing services to patients and clients on a fee‑for-service basis. . . . Such a change in the nature of the social contract is, it seems to me, fundamentally necessary for the survival of nursing as a profession rather than an occupational group of workers employed by other organizations.” (Sills, 1983, p. 573)

Inasmuch as nurse corporations would operate on a fee-for-service basis, the corporation would determine the costs of nurses’ work, which changes the economics of practice in a profound way. Furthermore, nurse corporations are a solution to the problem of collective bargaining by nurses, such that contracts are between the nurse corporation, which is a professional entity rather than a union, and individuals or organizations (Sills, 1983).

Christina Nyirati recalls that when she was a student at OSU several years ago, Dr. Sills had championed nursology as the name for our discipline.  Peggy Chinn recalls that at an American Nurses’ Conferene of many years ago, Dr. Sills was among the first nurse leaders to propose that the “doctor’s orders” be changed to the “physician’s prescriptions,” to serve as a parallel to the nurse’s prescriptions. ”One wonders what Dr. Sills now would think about the“nursologist’s prescriptions” or the “patient’s self-directed prescriptions”?

Given Dr. Sills’ substantial contributions to our discipline, it is not surprising that she was “affectionately referred to as ‘Amazing Grace’ by everyone who knew her” (Parrish, 2016, p. 166). See this video of an interview of Dr. Sills by Jeanne Clement:

References

Parrish, E., (2016). Remembering a pioneer of psychiatric mental health nursing. Perspectives in Psychiatric Care, 52, 155-156.

Peplau, H.E. (1952). Interpersonal relations in nursing: A conceptual frame of reference for psychodynamic nursing. New York, NY: G.P. Putnam’s Sons. [Reprinted 1989. London, UK: Macmillan Education Ltd. Reprinted 1991. New York, NY: Springer.] (Translated into nine languages) .

Sills G. (1978). Hildegard E. Peplau: Leader, practitioner, academician, scholar and theorist. Perspectives in Psychiatric Care, 16, 122–128.

Sills, G. M. (1983). The role and function of the clinical nurse specialist. In N.L. Chaska (Ed.), The nursing profession: A time to speak (pp. 563–579). New York: McGraw‑Hill.

About our guest Contributors

Christina Nyirati, RN; PhD
Photo retrieved from http://www.heritage.edu/faculty-staff/directory/staff-bio/

Christina Nyirati, PhD, RN – 

Professor, Department of Nursing, Chair and BSN Program Director, College of Arts & Sciences, Heritage University, Toppenish, WA.

Grayce Sills became Christina’s mentor when she was admitted to the first OSU PhD nursing cohort in 1985 after several years of experience as a family nurse practitioner (FNP). At their initial meeting Dr. Sills questioned whether, as an FNP, Christina had disavowed her nursing knowledge. Dr. Sills ventured Christina would have to work a little harder than her classmates to question her assumptions about the Discipline of Nursing. Christina recalls Dr. Sills spoke be-musingly about Drs. Paterson and Zderad, Sills’ former OSU faculty colleagues, who had referred to themselves as Nursologists. At a recent American Association of Colleges of Nursing (AACN) Dean’s meeting, Christina reminisced with erstwhile PhD classmate, Dr. Janet Fulton, (now Professor and Associate Dean for Graduate Programs at Indiana University-Purdue University) about their seminars with Dr. Sills, who, with a twinkle in her eye, challenged the doctoral students to ponder nursing as a discipline rather than an applied discipline, and to consider Nursology the organizing concept for our discipline.

Throughout her career Dr. Nyirati has endeavored to fulfill her mentor’s admonition. When she became the founding director of the FNP program at OSU she integrated nursing theory with primary care concepts into the curriculum. Dr. Nyirati challenges FNP educators to consider nursing knowledge as the essential component of the FNP program as the Doctor of Nursing Practice (DNP) evolves and becomes requisite for entry into advanced practice [See article by Nyirati, C. M., Denham, S. H., Raffle, I., & Ware, J. (2012). Journal of Family Nursing, 18, 378-408).

Now as BSN program director at Heritage University on the Yakama Reservation in Washington State, Christina honors Grayce’s legacy as she prepares nurses in a curriculum faithful to the epistemic foundation of nursing. BSN students develop their reflective practices from The Fundamental Patterns of Knowing in Nursing  (See article by Carper, B. A. (1978). Advances in Nursing Science, 1(1), 13-24.) Before her death in 2016, Dr. Sills used to Skype with the first cohort of Heritage BSN students, reminding them to recognize and use their powerful nursing knowledge to correct the inequities in their communities.

Sharon Tucker, PhD, RN, FAAN
Photo retrieved from https://nursing.osu.edu/faculty-and-staff/sharon-tucker

Sharon Tucker, PhD, RN, APRN-CNS, F-NAP, FAAN – 

Grayce Sills Endowed Professor in Psychiatric-Mental Health Nursing, College of Nursing; Translational/Implementation Research Core Director, Helene Fuld Health Trust National Institute for EBP; Nurse Scientist, Wexner Medical Center, The Ohio State University

Faculty and staff at OSU are privileged to continue to advance the work of the amazing Dr. Sills through an endowed professorship established in her name by a generous gift from Dr. Sills and her family. Dr. Tucker was hired in 2017 as the Grayce Sills Endowed Professor of Psychiatric Mental Health Nursing. She has practiced, taught, and conducted research in behavioral and mental health interventions and outcomes for decades. She was recognized in 1997 with an Award for Excellence in Research by the American Psychiatric Nurses Association, at which time Dr. Sills was recognized with the Psychiatric Nurse of the Year Award.

Dr. Tucker seeks to advance Dr. Sills’ work in promoting independent nursing practice (she is a board certified Advanced Practice Psychiatric Clinical Nurse Specialist), teaching interpersonal and health coaching skills, studying mental health assessment strategies and behavior change interventions, and advocating for individuals living with mental illness who are underserved and undertreated.

 

 

 

 

 

 

 

Moving Towards the Next Fifty Years Together

We are delighted to welcome guest bloggers representing the  Nursing Theory Collective
formed March 2019 Case Western Reserve
Nursing Theory Conference:
Chloe Littzen, Jane Hopkins Walsh  and Jessica Dillard Wright

I. Introduction

Chloe Littzen

Jessica Dillard-Wright (L) and Jane Hopkins-Walsh (R)

In March 2019, 130 nurses from all over the world gathered at Case Western Reserve University Frances Payne Bolton School of Nursing in Cleveland, Ohio for Nursing Theory: A 50 Year Perspective, Past, and Future, a landmark conference to celebrate the history of nursing theory and elicit discussion for the future of nursing. The attendees were diverse, comprised of seasoned nursing theorists and doctoral students in equal measure, participating in lively and thoughtful conversation across many domains. The future of nursing theory quickly emerged as a critical issue as nurses working at all levels of expertise expressed their concern over the loss of nursing theory at the institutional level, both academic and clinical. What is at stake in this erosion is discipline-specific nursing knowledge, in particular at this 50-year juncture as the great theorists of nursing like Drs. Peggy Chinn, Joyce Fitzpatrick, Pamela Reed, Callista Roy, Marlaine Smith, and many others approach the end of their illustrious careers. The question resonated, “who will carry the nursing theory torch forward?”

To advance the discipline of nursing, the next wave of nursing theorists and thought leaders must actively engage to advance nursing theory, improve nursing praxis, and articulate nursing’s identity leading our profession into the future. This is the rallying cry that led to the blog post you are reading today. In follow-up to this conference, doctoral student Chloe Littzen engaged other students who attended to embark on a collaborative effort to articulate our vision for the future of nursing theory. What follows is a brief discussion of our course so far, the background, plan, and desired outcomes for convening a nursing theory working group as we envision the next fifty years of nursing theory and beyond.

lI. Background

After the landmark conference concluded, a collaborative effort ensued to form a theory working group focused on promoting nursing theory and advancing nursing’s identity. This group is comprised of both scholars and students and is open to all nurses practicing in all settings. Our first meeting was held online via video-conferencing on May 18th, with a total of six participants from Arizona, Massachusetts, and West Virginia. This first meeting was an experimental think-tank where we considered ideas about the future of nursing and our professional identity. Below, we outline our mission and vision for this nursing theory working group.

III. Plan

The primary mission, as established by our working group, is to promote nursing theory and advance the identity of nursing through knowledge development for all nurses in all settings, including practice, education, research, and policy. As a group, we believe that nursing and nursing theory are dynamic and evolving to meet the needs of an increasingly complex healthcare landscape and global environment. In order to keep nursing theory and nursing relevant and current, thinking about theory must be on-going and iterative, with a continuous cycle of critique, testing, and scholarship. Failure to seriously engage these questions has dire consequences for nursing theory and the profession as nursing as it slowly cedes its identity to the economic pressures of the healthcare environment and the supremacy of biomedicine.

The following bullets summarize our discussion and desired outcomes from the first nursing theory workgroup meeting:

  • Discussion Points:
    1. We need a plan to sustain and evolve nursing theory and nursing’s identity with discipline-specific knowledge.
    2. Nursing theory must be derived from and applicable to the practice environment, not just academia.
    3. The purpose of nursing theory must be clarified for nursing practice, education, research, and policy.
    4. Nurses in clinical practice must have an educational foundation grounded in nursing theory that empowers the application of theory in practice.
    5. Nursing students must be educated and mentored in nursing theory, beginning at the pre-licensure level.
    6. This discussion must include considerations of how nursing theory is taught in the academic environment and how that can be linked to and informed by nursing practice.
    7. The need for nursing theory is global, making this an international, even planetary problem.
  • Desired Outcomes:
    1. To write a manuscript demystifying nursing theory for the nurse in the practice environment.
    2. Write a second manuscript demystifying nursing theory for the nurse educator in academia.
    3. Explore the potential of a future study identifying and describing the barriers and facilitators for using nursing theory in practice, education, research, and policy settings.
    4. Share the discussions, experiences, and findings with the community at Nursology.net.

IV. Invitation – Join us!

While we are a new workgroup, we welcome and encourage all nurses, both advanced scholars and novice theorists alike, to consider joining us in this journey in promoting nursing and nursing theory into the future. We currently meet monthly over Zoom video-conferencing. If you are interested, please contact form below to be placed on the email list for future meetings and content.

If you are planning to go to the 2019 Collaborative K.I.N.G. conference in Washington D.C. from November 14th-15th, we are planning an in-person meeting to take place. We hope to see you there as we drive nursing and nursing theory into the future. Join us!

With optimism and gratitude for the future,
Nursing Theory Collective
(Final group name pending vote at next meeting)

Footnotes:

See more information on the King Conference here.

See more information on the landmark theory conference at Case Western Reserve University Frances Payne School of Nursing here.

Please use this form to contact us if you want to join us, or for more information!

Who IS the First!

This blog is a follow up to the Who Will Be First? blog posted on May 21st. We now have an answer to that question!

St. Mary’s College Campus (from http://www.st-mary.ac.jp/about/)

I recently learned from Sr. Callista Roy  that a research center in her name included the word, nursology, in the center title. The title is: Roy Academia Nursology Research Center. This research center was founded in 2018 at St. Mary’s College School of Nursing in Kurume, Japan (http://www.st-mary.ac.jp/english/).

Professor Tsuyako Hidaka, of St. Mary’s College School of Nursing in Kurume, Japan, provided this description of the research center:

“The Roy Academia Nursology Research Center aims to explore Mercy, Caring, and Love through the avenues of both practice and education, which are executed across three departments: educational program development, postgraduate education, and continuing education.

1. The educational program development department facilitates education, practice, and research based on the Roy Adaptation Model, conducts activities for the Japan Chapter of the Roy Adaptation Association of Japan (RAA-J), and develops programs that enhance nursing skills for undergraduate and graduate students.

2. The postgraduate education department works with a wide range of students, from those planning to continue their research post-graduation, to those conducting activities as certified nurse specialists (CNS). Faculty members also assist students with research as well as offer counseling to undergraduates interested in pursuing a graduate degree.

3. The continuing education department is responsible for developing the curriculum for use in the wards at St. Mary’s Hospital, and continues to reform the currently-used clinical ladder education program to include elements for which nurses can continue earning education credits. The department also offers a continuing education program for nurses who work in community-based settings.”

The nursology.net management team members congratulate Professor Hidaka, her colleagues, and the St. Mary’s College administrators on being the very first entity to include nursology in the title of their research center. We look forward to learning of many other entities that will follow their lead and include nursology in the title of schools and colleges, departments, programs, and centers.

Callita Roy and Jacquiline Fawcett visiting St. Mary’s College (photo from http://www.st-mary.ac.jp/education/)

Why Nursology?: The Perspective of an International PhD Student

Guest contributor: Toqa Alanby

Toqa Alanby

Hello, my name is Toqa Alanby MSN, BSN, RN, from Saudi Arabia, a full-time nursing PhD student in Christine E. Lynn College of Nursing at Florida Atlantic University. I have chosen to begin the pursuit of my academic career in Nursing with a sense of determination. Through my B.Sc. in Nursing from Umm Al-Qura University (Mecca, Saudi Arabia), my English program at INTO University of South Florida (Tampa, Florida, US), and my M.Sc. in Nursing from Trinity College Dublin, University of Dublin (Dublin, Ireland), I have dedicated my life to advance my nursing knowledge and skills.

I was introduced to the Nursology website by Dean Marlaine Smith, my advisor, as she said, “websites are vehicles to assist us in coming to know an organization.” The Nursology website is a quantum leap in nursing. Nurse scholars, nurses in clinical settings, and postgraduate students, all of them, can be involved by joining or just by browsing this site. It was designed and maintained by nurse scholars with sufficient experience who can enrich the nursing profession throughout the world. For me as an international PhD student who came from a different background, I found it as a repository for sources about nursing conceptual models, grand theories, middle-range theories, and situation-specific theories, philosophies and related methodologies. It is momentous to nursing practice, education and scientific research because it is a guide to what is already known and what further knowledge and skills are required. Also, I found it as a station that can connect to the pioneers of the nursing profession, a link to enable us to communicate with them easily.

Exploring the website, gave me a better understanding about the history of nursing in the United States. Furthermore, it reminded me of how nursing started in Saudi Arabia. In both cases war had an impact on the development of nursing. For instance, the first mention of nursing in Saudi Arabia was during the time of the Prophet Muhammad in the service of the Muslim armies during periods of war. Women accompanied veterans as companions and caretakers. According to Jan (1996) nursing activities carried over into peacetime when the women served as midwives and continued to nurse the sick and dying.  Subsequently nursing concepts emerged to inform this practice.

Nurses, nursing students and other health professionals understand and view nursing differently. Many definitions have been used to define the concept of nursing. Sapountzi-Krepia (2013) justifies this diversity due to different educational backgrounds, cultures and experiences. Now that nursing is based on the interaction with others, caring appears as one of its central concepts. The concept of care emerged during the decade of the 1950’s; however many factors hampered its progress. It was not until two decades later that not only the first National Caring Research Conference but also the publication of Leininger’s and Watson’s theories stimulated the interest of researchers in the concept (Brilowski & Wendler, 2005). Caring seems to be inherent to nursing practice and originates from respect and concern for the patients, which is a skill that evolves with experience. As for my culture, caring from the Islamic perspective refers to a critical, reflective analysis of what we think we know about our universe and ourselves. Saeed (2006) mentioned that the Islamic philosophy is rooted in the attempt to understand reality rationally. The Qur’an, the Holy book of Muslim faith, and the Sunnah, which documents the life and practices of the prophet, built the Islamic belief system.

Outside of the nursing community, when I talk about nursing science, I always have been asked what distinguishes nursing science from other disciplines? Cowling, Smith & Watson. (2008) answered this question by stating that there are 3 fundamental concepts which are wholeness, consciousness, and caring singled out and positioned in the disciplinary discourse of nursing to distinguish it from other disciplines. In my opinion, nursing implies an intentional activity, attitudes and feelings that shape the professional interaction established between nurses and patients.

Having an understanding of these perspectives will inform health professionals to achieve cultural competence and deliver care that is culturally sensitive (Rassool, 2014). Individualized, holistic care can be achieved by apprehending culture, beliefs and ethnicities, and a display of cultural competence. I saw Dr. Sadat Hoseini’s model on the Nursology website as a model that comes from a Muslim perspective. It is wonderful and informative. However, there is a great diversity of cultural, tribal and linguistic groups among Muslim societies, each of which has its own cultural characteristics and worldview of well-being and sickness. Delivering nursing care to Muslim patients means having an insight of Islamic faith and Islamic beliefs. Thus, what goes on in Saudi Arabia is totally different from what Dr. Hoseini’s model looks for. She is from a different culture, country, and doctrine.

Based on my experience, non-Muslim nurses who work in my country are not able to utilize the existing knowledge and framework of health from Islam to enhance the nursing profession. The inability to shape nursing practice, education, and policy from an Islamic perspective can be attributed to multiple factors such as social status of nursing in the country, professional identity of nurses, and societal approval and recognition (Ismail et al., 2015). Therefore, the professional development of nursing among Muslim nurses is based on utilizing Western practice, education, and ethical models instead of integrating the holistic view of Islam (Gharaibeh & Al-Maaitah, 2012). The curricula of our colleges in Saudi Arabia still follow the theories that come from the United States (F. AlShaibany, personal communication, April 25, 2019). Though, in general, the development of nursing theories and models are almost neglected in Saudi Arabia, whether in education or practice. While nursing students know about nursing theories, they most likely don’t see them as a part of their practice. They also tend more to use theories from other disciplines such as change theories instead of nursing theories.

I was eager to explore nursing from another perspective and the Nursology website was a vehicle to achieve this purpose.  The Western concept is the most visible and distinctive in the site. I believe this site will be a real connection for other nurses around the world to the study of Western nursing. Thus, I hope one day to join the great scholars here to advance Nursology forward and perhaps contribute by sharing my theoretical work from a different cultural point of view. My goal is to embark on an academic career and to conduct research.  In other words, scholars absorb and integrate information coming from the world around them as they create their own work. The role they play calls for the development and maintenance of collective learning and comprehension. A scholar’s work, according to Boyer’s (1990) definition, calls for taking a step backwards from the investigation, searching for connection, and bridging the gap between theory and practice while having one’s knowledge communicated effectively (p.16).

Being able to comprehend and associate with nurses of different cultures is vital for nursing advancement. Understanding cultural differences among nursing perspectives is essential. By educating ourselves about different cultures through communication with diverse nurses in conferences, organized meetings, and engagement with a website like Nursology can prepare us well to broaden our perspectives on nursing knowledge from all over the world in multiple cultures.

References

Boyer, E. L. (1990). Scholarship reconsidered. Princeton, NJ: The Carnegie Foundation for the Advancement of Teaching.

Brilowski, A., & Wendler, C. (2005). An evolutionary concept analysis of caring. J Adv Nurs (50), 641-50.

Cowling, W.R., Smith, M.C. & Watson, J. (2008). The power of wholeness, consciousness, and caring: A dialogue on nursing science, art, and healing. Advances in Nursing Sciences, 31(1), 41-51.

Alshaibany, F. (2019, April 25). Personal Interview.

Gharaibeh, K. & Al-Maaitah, R. (2012). Islam and Nursing, in Religion, Religious Ethics, and Nursing. Spinger New York, NY. p. 229-249.

Ismail, S., Hatthakit, U., & Chinawong, T. (2015). Caring science within islamic contexts: a literature review. Nurse Media Journal of Nursing, 5(1), 34. doi:10.14710/nmjn.v5i1.10189

Jan, R. (1996). Rufaida Al-Asalmiya, the first Muslim nurse. Image: Journal of Nursing Scholarship, 28, 267-268.

Rassool, G. H. (2014). Cultural competence in caring for Muslim patients. Palgrave Macmillan.

Saeed, A. (2006). Islamic Thought: An Introduction. New York, USA: Routledge.

Sapountzi-Krepia, D. (2013). Some thoughts on nursing. Int J Caring Sci (6), 127-133.

Student response to a doctoral “Knowledge Development in Nursing” course

The University of Wisconsin-Madison School of Nursing PhD program offers a required course entitled Knowledge Development in Nursing. In the Fall 2018 semester, the course was co-taught by Dr. Anne Ersig and Dr. Danny Willis. The course examines the history of knowledge development in the discipline of nursing. PhD students are prepared to understand nursing philosophical perspectives; scientific thinking; conceptual models; conceptual analysis; grand, middle-range, and situation-specific theory; the nature, sources, syntax, and development of knowledge in the discipline.

One of the major strengths we witnessed in co-teaching the Knowledge Development in Nursing course together is the diversity of perspectives and ways of knowing that the students were exposed to given our complementary ways of approaching our phenomenon of interest (see more about our own approaches below). We were inspired every time the course met. The students enrolled in our course represented life experience and perspectives from around the world – China, Jordan, South Korea, Turkey, Uganda, and the United States. It was such a wonderful experience! We were particularly moved by Yuanyuan Jin’s reflection on her learning journey through the Knowledge Development in Nursing course and felt compelled to ask her to share her story with Nursology.net. When we asked YuanYuan, she commented to Dr. Willis that she hopes to be one of the future professors and leaders in nursing theory and knowledge development for the future. We could not have been prouder to hear this as it offers hope for the future of our discipline. Enjoy Yuanyuan’s reflection as much as we did!!

Question: Reflect on how your thinking about your identity as a nurse scholar and researcher has evolved over this semester. How do you think this might influence your future as a nurse scholar?

Yuanyuan Jin, MSN, RN, PhD student

For me, this was a very short but intensive semester. I guess I will never say that the 4-year nursing PhD program is too long again!

I greatly appreciated the learning experience in N815 (Knowledge Development in Nursing) during the 15 weeks. In short, it was like a journey. Dan and Anne took us to a place where we have heard of and never been there before. We were curious about everything we saw during this journey. Local people in that place communicated with each other by using a language we were not familiar with and sometimes we even had difficulty understanding their dialogue. But Dan and Anne were very good guides and interpreters, they gave us a lot of important resources and information to help us understand the history of this place, where the local people came from, what they are doing there, and where they are heading to.

The place we went to is called Nursing Knowledge Development, the local people were the theorists like Dr. Fawcett, Dr. Chinn, Dr. Roy, Dr. Rogers, Dr. Johnson and many other nursing scientists who have/had dedicated themselves to nursing knowledge development. The language we had difficulty understanding including metaparadigm, paradigm, philosophies, conceptual models, theories, empirical indicators, ontology and epistemology, etc. The resources and information Dan and Anne gave to us were readings before the class, explanations during the class and summaries after the class. The history of Nursing Knowledge Development was that nursing used to be a task-oriented occupation, subservient to medicine with little autonomy and had no place in the academic setting. During the mid-twentieth century and the years that followed, nursing leaders in the US saw theory development as a means of firmly establishing nursing as a profession. Therefore, they are developing a unique body of nursing knowledge and using nursing theory to guide professional practice and making contribution to the health and wellbeing of people.

I like the analogy of journey because firstly, not every nurse/nursing student has the chance to go on this kind of trip (i.e., he/she is not exposed to nursing theory development), and secondly, when we are back from our trip, we can always share our experience with those who have been or have never been to that place. One big new thing I learned from this course is that we do need theory to guide our research intervention, and also how to select an appropriate theory and how to integrate theories if we are using more than one theory — this is very important. In the future, I still need to dig into how to align the theory with research question and research design and how to correctly synthesize different concepts in different theories.

Therefore, the end of the course of N815 is the very beginning of my nursing scholarship. I will be more eager and open to discussions about nursing knowledge development; I will take the responsibility to reduce people’s stereotype that nurses are just assistants of doctors; I will de-mystify theory and sensitize people to the significance of theory in their research and practice; and I will carry on nursing theorists’ lifelong learning spirits and cultivate my own academic expertise so as to contribute to the nursing knowledge development.

About the Professors’ Research

Dr. Willis has a program of research focused on explicating mental health, wellbeing, and healing for boys and men in the aftermath of experiencing traumatic and marginalizing situations of violence and abuse, primarily using qualitative approaches to knowledge development.  Dr. Willis positions his work in the central unifying focus of the discipline/values of humanization, meaning, choice, quality of life, and healing in living and dying (Willis, Grace, & Roy , 2008). In terms of nursing conceptual models and theories, his work is closely aligned with Watson’s Unitary Caring Science (Watson, 2018) and Rogers’ Science of Unitary Human Beings (Rogers, 1992). Within nursing paradigms, he locates his work within the unitary-transformative perspective (Newman, 1997) with its focus on pattern recognition and caring-healing for unitary human beings in mutual process with their environments.

Dr. Ersig’s program of research focuses on chronic stress among children, adolescents, and young adults with chronic health conditions, including biological stress and genetic influences on the human response to stress. Dr. Ersig aligns her work with Roy’s Adaptation Model. She identifies strongly with Roy’s delineation of the physiological, self-concept, role function, and interdependence modes. Roy’s model provides essential support for Dr. Ersig’s inclusion of physiological, biological, and genetic measures in her work. To obtain a more holistic view of individuals, families, and the broader social context, Dr. Ersig also incorporates measures of psychological and behavioral responses to stress.

 

Who Will be the First? More Random Thoughts of a Sleeper Awake

Once again, with apologies to J. S. Bach, composer of Cantata no. 140, Sleepers Awake, these are my random thoughts of “Who Will be the First?” among nursology leaders while I was a sleeper awake one very early morning (see our first “sleepers awake” post: What if?). Here are my random “Who will be the first?” musings:

  • Who will be the first dean/director/chairperson to re-name the college/school/department/ program nursology?
  • Who will be the first Chief [Nursology] Officer to re-name the clinical agency department nursology?
  • Who will be the first journal editor to re-name the journal … Nursology or Journal of … Nursology?
  • Who will be the first “edge runner” or other nursologist recognized for innovative work to be referred to as a nursologist?
  • Who will be the first president or executive officer to re-name the association/academy/ council [Country or State] Nursology Association or [Country] Academy of Nursology or International Council of Nursology?

Again inspired by imagining these possibilities, I asked other Nursology.net management team members!

Adeline Falk-Rafael

  • Who will be the first newscaster/journalist to refer to nursologists or Nursology In the media?

Margaret Dexheimer Pharris

  • Who will be the first political leader to propose a Universal Access to Nursologists system for a country, state/department/region, city, and/or community?

Danny Willis

  • Who will be the first nursologist to lead peace, social justice, caring, and healing efforts throughout the world toward universal wellbeing/wellbecoming for all of humanity?

Rosemary William Eustace

  • Who will be the first nursologist to theorize “task shifting of nursing services and roles” in advancing nursing knowledge and the future of nursing as a profession within other “traditional” and “emerging” disciplines in health care?

Marian Turkel

  • Who will be the first academic dean to say we are advancing the discipline and profession of nursology by preparing nursologists? Nursologists practice nursology through the lens of nursological theory and the multiple patterns of knowing, with a focus on holistic practices such as mindfulness, centering, healing arts, aromatherapy, and coming to know the patient and family as person. The clinical practice sites for nursologists would expand beyond the hospital into healing centers, physician practices, and community centers.

Marlaine Smith

  • Who will be the first to graduate with a PhD in Nursology?

We invite all readers of this blog to contribute their own random thoughts–whether generated as a sleeper awake or during another phase of living–of “Who Will be the First?”

Tribute to our Nurse Friends!

We welcome this guest post by Shannon Constantinides, MSN, NP-C, FNP, UCHealth Primary Care,  PhD Student, Florida Atlantic University.  Shannon also contributed the content on Jane Georges’ Theory of Emancipatory Compassion

Shannon Constantinides

In trying to explain to my husband (an osteopathic physician) why Nurses’ Week is an important week, I asked him, “Do you ever notice that I have my “friends” … but that I also have my “nurse friends?” He looked back at me, a bit quizzically, shrugged his shoulders and said, “yeah…? I guess so?” In a conversation a day or so later, he said, “Now that you’ve mentioned it, I guess I have heard you mention your Nurse Friends.” He then gave me a somewhat perplexed look and said, “I have friends who are physicians, but I don’t think I have Physician Friends. At least not in the way you talk about your Nurse Friends.” You’re right, my dear, you don’t.

From the inception of the profession, nurses have been working together, side by side in the figurative and literal “trenches.” Whereas our physician colleagues are trained to be the lone wolves, or as I’ve heard it described, “the captain of the ship,” nurses are from the onset of training, trained to work as part of a team.

This Nurses’ Week, I set an intention to celebrate and honor all my Nurse Friends. To me, Nurses’ Week is a reminder about the joy we find in work – not just the experiences that arise from patient care – but also joy we find from the relationships we’ve built with one another along the way.

In 2018, I had the honor and privilege to interview Dr. Jane Georges, Dean of the Hahn School of Nursing at the University of San Diego and the author of the Emancipatory Theory of Compassion. During the course of our conversation, we got onto the topic of finding joy in work and Nurse Friends. Until Dr. Georges pointed it out, I hadn’t given much thought to the concept of Nurse Friends. My mom, a 30-year NICU RN, had Nurse Friends. Dr. Georges’ mother was also a nurse who had Nurse Friends. “NurseFriends” was simply a word we’d always known, because we both grown up with the knowledge that there are two kinds of friends: your friends, and your NurseFriends.

In discussing ways in which we can recapture joy in work and joy in nursing, Dr. Georges circled back to the concept of NurseFriends and the deep connection nurses share with one another; the connection that allows us to find so much meaning in what we do. “I call it the nurse-nurse bond,” Dr. Georges said, “It’s knowing that we can’t do it alone, which is one of the most beautiful parts of nursing.” In recalling some of the most healing environments in which she’d worked, Dr. Georges commented on the presence of joy, respect, and connection with other nurses.

“We just had this crew,” I mentioned as I reminisced about a group night-shift NurseFriends I worked with during my tenure working in an emergency department. Dr. Georges agreed, “I think the idea of the nurse-nurse bond, or NurseFriends, is worth exploring… how do we build back that community where we’re not adversarial to each other?” I think that the answer lies within ourselves and within the community of our discipline: building up our NurseFriends to strengthen one another, to strengthen the profession, to strengthen ourselves, and ultimately, to strengthen the care we give our patients.

Two years ago, I had to tell a NurseFriend who’d become my primary care patient that I’d found lymphoma on her MRI. That was one of the worst days of my professional career. I remember sitting in my office, sick to my stomach. Delivering bad news to a patient is never easy; delivering bad news to a NurseFriend will break your heart.

This NurseFriend is doing great. Her cancer is in remission. She’s healthy. She’s now the clinical manager of my primary care office. I’m lucky: we caught her cancer early, got her great treatment, and I get to see her smiling face every day.

To all of my NurseFriends, thank you for sharing your light with me. You are my heros not just during Nurses’ Week, but every week!

Inspired by Virginia Henderson

Henderson when she was a research associate at Yale (from https://nurseslabs.com/virginia-henderson/)

I first met Virginia Henderson when I was a student at Yale School of Nursing. She was a guest in one of our courses, and she started the class by saying, “I’m a million years old and deaf as a doornail, so speak up!” She was a force, and I loved her from the start. I had the opportunity to meet with Virginia at her home in New Haven, CT, where she showed a group of us her porcelain box collection. She even gave me one! Virginia was at our graduation from YSN in 1993 – in full academic regalia. The last time I saw Virginia was at her home in a retirement community in Connecticut. I consider myself fortunate to have spent time with such an influential nurse. Although I had no idea at the time, her work and thoughts on nursing shaped my own. Her definition of nursing

The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge. And to do this in such a way as to help him gain independence as rapidly as possible.

resonates with me because in my work with people who have diabetes I see the need to help people toward independence. Diabetes and other chronic diseases require knowledge, skills, and understanding so that people can make daily decisions and perform daily tasks to manage their disease and live well. There are times when people need more – education, direct care, or support – and times when they can function independently. The goal is always to help people toward independence and away from a mentality of “compliance” or “adherence.” I think Virginia would support the language movement in diabetes, where we are working hard to get away from judgmental, provider-centric language and move toward person-centered and strengths-based messages.

I also identify with Virginia’s beliefs on nursing as a discipline with a distinct body of knowledge and her emphasis on nursing education and nursing research. Ironically, I was a student at Yale School of Nursing and now teach at Teachers College Columbia University. Both schools had an impact on and were influenced by Virginia Henderson. It’s amazing to me that I have felt her presence throughout my career, despite not being directly connected to her work.

I sometimes wonder what Virginia would think if she were alive today. Is her definition of nursing being upheld? What would she think of nursing practice, nursing education, and nursing research? Are we honoring her legacy in our work today? It’s important for nurses to be aware of those who’ve gone before us, their work, and their influence on our discipline. Some of those nurses are still with us, and my hope is that we will learn from them and be shaped by them as we move nursing forward. When we practice, teach, and study, how often do we think about our own definition of nursing? Are we being true to that definition?

Honoring our Heritage, Building our Future

Today we are adopting a new nursology.net tag line “Honoring our Heritage, Building our Future” in concert with the annual focus in May of each year on nursing and nurses, anchored around  Florence Nightingale’s birth date – May 12, 1820. Almost 100 years later, nursology theorist Martha E. Rogers was born on the same date in 1914.  These two giants of nursology history, and many others, have built the foundation from which we move forward in the quest to understand human health experiences.  We have asked members of our nursology.net management team to share particular “heritages” that stand out for them as significant. Here are our responses:  

Leslie H. Nicoll – The Nursing Editors History Project

Leslie Nicoll

A few years ago, Peggy Chinn and I had an “Aha!” moment when we realized there was no archive or complete listing of the women and men who have served as editors of scholarly nursing journals. We believe this is a serious omission and sought to create such a resource and thus, the Nursing Editors History Project (NEHP) was born. The NEHP is a venture between the Dolan Collection at the School of Nursing at the University of Connecticut; along with Peggy and me, Carol Polfroni is providing leadership to the project. You can visit the site at nehp.uconn.edu.

If we consider Florence Nightingale to be the founder of nursology, then our profession is relatively young, spanning less than 200 years. There has always been a focus on education and scholarship in nursology; the first disciplinary journals were published starting in the 1880s. In the US, the American Journal of Nursing published its inaugural issue in 1900. It has been published continuously ever since. Other journals with long and distinguished histories include Sygeplejersken (“The Nurse,” in Danish, since 1901); the Canadian Nurse (Canada, 1905); Nursing Times (United Kingdom, 1905); Kai Tiaki Nursing New Zealand (1908); and the Philippine Journal of Nursing (1926).

Editors of professional journals play an important role as gatekeepers of practice innovations, research findings, and other information that is disseminated through the published literature. The impact of the editor is profound and influential. Given that, you might think that an easy-to-use listing of editors would have been maintained over the years–but it has not. In the absence of such a list, you might think you could go to the online home of a journal and search through the digitized collection to find editor information. Go ahead and try to do that. You will find, as we did, that journal archives include that published articles but they do not include the “front matter,” that is, the pages that list the editor, associated editorial staff, editorial board members, and information about the publisher. Thus, the archive for a journal represents just one dimension of the publication. What is missing is the knowledge of the people who were in charge, in particular, the editor–whose voice was important, influential, and must be heard.

The NEHP has been growing slowly. At present, it includes 34 journals with publishing histories ranging from 100+ years to 9. We have learned that tracking down editor information–especially for some of the older journals–takes time and effort. Finding pictures is even harder! This realization has impressed upon us the importance of the NEHP and the need to capture this information before it disappears completely. Our goal is to be comprehensive, both at the individual journal level as well as in the breadth of nursology journals that are included in the NEHP. We welcome submissions to the NEHP from editors, publishers, and librarians. When submitted information is comprehensive and accurate we are able to quickly list the journal in the database. You can read more about the process here: https://nehp.uconn.edu/submissions/

Florence Nightingale was a meticulous data collector, prodigious correspondent, and author of books and articles. As far as I can determine, she was never a journal editor, but I am sure she held the editors those journals published in her life in high esteem–as we should. The NEHP truly “honors our heritage” by capturing essential information about the leaders of scholarly publication in nursology.

Adeline Falk-Rafael – Returning to our Roots

Adeline Falk-Rafael

It is only fitting that we honor nursing’s past each year around the time of Florence Nightingale’s birthday.   She was a remarkable woman and visionary. In many ways, she reflected the thinking of her day, i.e., that social, economic, and political factors greatly influenced (often adversely in vulnerable populations) the potential to be healthy. She believed that compassion, therefore, must include social and political activism focused on changing laws and the conditions that adversely affected health for many and  led by example (Falk Rafael 1999). Many examples have been documented and extend beyond policies in the UK to international efforts (Falk-Rafael 2005).  Nightingale’s focus on promoting the health of populations was evident in the first nursing program she established, in which one entire year was dedicated to health nursing of communities.

Her model of health nursing, including social and political advocacy influenced early nursing leaders elsewhere in the world, as well.  I know first hand of her influence in Canada, e.g, in the work of the Victorian Order of Nurses, and the U.S., in the work of Lillian Wald who added the word public to health nursing. She and other nurses of the Henry Street Settlement (more information here)  followed Nightingale’s example in advocating for social and political reform to create conditions that were more conducive to health (Falk-Rafael 2005) .  I hope nurses from other parts of the world will add  further examples of Nightingales influence on nursing elsewhere.

Finally, honoring our heritage  must, I believe include those women who provided nursing and health care before or during Nightingales time. Mary Seacole, was a Jamaican nurse who also cared for soldiers in the Crimean War. In Canada, centuries before Nightingale, women in religious orders and pioneer women, such as Jeanne Mance in the 17th and 18th century provided nursing care to communities. They also understood the necessity of advocating for laws and societal reforms to move toward social justice and health equity.  And, I think of the nurses who fought for womens rights and the abolition of slavery like Sojourner Truth  and Harriet Tubman. Many others are also profiled on the Nurse Manifest Gallery of Activism Inspirations.

Our heritage is nursing practiced from a nursing paradigm before the rise of a dominant biomedical model that can shape and limit our conceptualizations of health and its promotion. We can learn from the examples of those who have gone before. I believe that Nursology, by making visible the nursing science which informs nursing practice can help nurses reclaim their authentic nursing identity.

Jacqueline Fawcett – Florence Nightingale’s Contributions to Martha E. Rogers’ Thinking and Development of the Science of Unitary Human Beings

Jacqueline Fawcett

Martha E. Rogers (1992) contributed a marvelous essay to the Commenorative edition of Florence Nightingale’s classic book, Notes on nursing: What it is and what it is not. She began her essay with these words:

Florence Nightingale’s Notes on Nursing is an exciting and far-reaching compendium of ideas and statements concerning the purposes and scope of nursing, the essentials of good nursing practice, and the variety of providers of nursing that existed in her purview. With consummate skill and cogent humor, she decries the fallacies of health practices and the superstitions that existed among the public and in particular health workers. (p. 58)   

Rogers went on to point out that much of what Nightingale wrote is as relevant today as it was in the middle 1800s. She noted that Nightingale’s vision of the need for “human compassion, a broad knowledge base, intelligent reasoning, and understanding” (p. 58) were particularly relevant in the 1990s, and I will add, are even more relevant—indeed crucial—in the 21st century.    

Furthermore, Rogers (1978, 1992) traced her own dual concern with human beings and their environments to Nightingale. She explained, “Rogerian science of irreducible human beings provides a framework rooted in a new reality and directed toward moving us from what might be called a pre-scientific era to a scientific era. Certainly Nightingale laid a firm foundation for this kind of an approach to nursing knowledge and its use” (Rogers, 1992, p. 61).

oward the end of her essay, Rogers (1992) further emphasized the importance of Nightingale’s work for all of us today. She wrote that Nightingale’s ideas not only are meaningful today but also provide a firm foundation as nurses move forward in the development of nursing as a science in its own right, and make way for knowledgable directions that enable nurses to practice based on their own phenomena of concern. It is the uniqueness of nursing that makes it important, not the ways in which it is like other fields.

Rogers (1992) concluded that section of her essay by exhorting us to carefully consider Nightingale’s comment “that medicine and nursing should never be mixed up, since it spoils both” (p. 61).

I am certain that both Florence Nightingale and Martha E. Rogers would agree that the proper name for our discipline is nursology and that the members of the discipline are appropriately referred to as nursologists. I also am certain that both would applaud the development of nursology.net as a repository for all things theoretical in nursology!

References

Rogers, M. E. (1978, December). Nursing science: A science of unitary man. Paper presented at Second Annual Nurse Educator Conference, New York. [Audiotape.]

Rogers, M. E. (1992). Nightingale’s notes on nursing: Prelude to the 21st century. In F.N. Nightingale, Notes on nursing: What it is, and what it is not (Commemorative edition, pp. 58–62). Philadelphia: Lippincott.

Marlaine Smith – Standing on the Shoulders of the Giants of Nursology

Marlaine Smith

As we approach the birthdays of Florence Nightingale and Martha Rogers on May 12th I’m reminded that we are standing on the shoulders of the giants of nursology.  What is my responsibility as I stand on these shoulders? First, is to acknowledge and cite the work of the giants who have come before us. At times I hear newer ones to our discipline speak of a great new idea or concept that I know was actually something that was advanced by previous scholars and is in the literature.  This certainly is not the fault of the newer members coming into our professional discipline. It is our responsibility of faculty and mentors to expose students of nursology to the wisdom of our heritage. As Peggy Chinn admonished us in her blog, let’s  get rid of the instructions to students that they should only review the past five years of the literature.  Our students need to be introduced in the most engaging way to the seminal writings of our foremothers and forefathers.  Would any undergraduate psychology student not be introduced to  Freud, Piaget, Erikson? Absolutely not! Our challenge is to create opportunities for the past work of our scholarly giants to come from the shadows into the light.  In my BSN program I was briefly introduced to Florence Nightingale…just by name…Do you know what I remember? …only that I heard that Florence Nightingale died of syphilis.  While this is not true, that myth was propagated widely and it diminished us. When I began my Masters program I had to read Notes on Nursing as part of my theory course.  I was filled with amazement and pride that this courageous, brilliant woman discovered the human-health-environment-caring connections that ground nursology today.  Let’s give this gift to our students by studying the giants of the past. By standing on the shoulders of the giants of nursology we can reach lofty heights. The most beautiful buildings need strong foundations.  They cannot exist without them. In order to build our professional discipline to new heights we must build on our disciplinary, theoretical foundations. In this way, we are truly building NURSOLOGY. This doesn’t mean staying within the limits of the past.  We are free to innovate, create, change, renovate, regenerate as we reach for the possibilities of what nursology can bring to the world.

 

Nursology’s Philosophical and Practical Knowledge: Unified and Interdependent

Guest Contributor: Martha Raile Alligood, RN, PhD, ANEF

A few months ago, Martha Alligood sent me (Jacquelyn Fawcett) this intriguing article: Rovelli, C. (2018). Physics needs philosophy, philosophy needs physics, Foundations of Physics, 48, 481-491. We decided to write a paper, which has evolved into this blog, about the relationship between philosophy and science in nursology. The specific purpose of this blog is to underscore the importance of the relationship between practical knowing and foundational (philosophical) knowing for advancement of nursology.

Alligood writes:

Rovelli (2018) wrote about the interrelationship of philosophy and science (physics). His discussion of practical and foundational knowing led me to think about nursology and the contemporary disciplinary shift to a practical focus from one that was dominated by general foundational philosophical questions. For example, nursological literature has evolved from a strong foundational philosophical knowledge development focus on nursology’s discipline-specific concepts, models, and theories to an equally strong practical focus on quality of practice and nursing education expansion in relation to practice, specifically, the development of the Doctor of Nursing Practice (DNP) degree programs.

Time has shown the value of such shifts in focus for a discipline. Advancement of a discipline calls for recognition and valuing of the complementary relationship between practical knowing and foundational knowing, as both are essential to the development of a professional discipline, such as nursology.

Practical knowledge is–or should be–based on the results of scientific research. However, if science is essential to move the discipline ahead, then philosophy ensures that we move in the right direction. But, “a broader understanding of the interdependence of practical and philosophical matters in professional nursing is needed” (Bruce, Rietze, & Lim, 2014, p. 65). Drawing from Einstein’s discussions of the influence of philosophies and philosophers on his work, Rovelli (2018) noted, “Scientists do not do anything unless they first get permission from philosophy” (p. 484).

Rovelli’s (2018) claim of an interdependent relationship between physics and philosophy for his discipline also is relevant for nursology. That is, contemporary growth and development of nursology requires an explicit interdependent relationship between foundational knowing and practical knowing. Indeed, the re-emergence of nursology as the name for our discipline after its initial introduction in the 1970s (Fawcett, 2018) is evidence of a contemporary need for terminology at a level of abstraction to incorporate all of the discipline’s knowing–both philosophically foundational and scientifically practical.

Within nursing history there are examples of practical knowing leading to foundational knowing, such as research about the impact of patient positioning that has led to foundational knowledge, but it seems that foundational knowing has the capacity to affect practical knowing in a more powerful manner. An excellent example is the clarification of the disciplinary boundaries of nursological knowledge pertaining to human beings, environment, health, and nursing goals and processes (Fawcett, 1984; Fawcett & DeSanto-Madeya, 2013). This metaparadigmatic clarification led to expansion of nursological knowledge, practice, research, education, administration, and perhaps most importantly, a clearer understanding of the theoretical knowledge that existed at that time.  Explaining the relationship of the various models or theoretical works provided clarity and understanding to move nursological knowledge development to a new level.

Ironically, recognizing the structure within which the various conceptual and theoretical frameworks fit may be seen as both practical and philosophical. Some of the very early National League for Nursing (NLN) faculty-curriculum development work that contributed to that understanding was very practical (O’Leary, 1975; Torres & Yura, 1975). Knowledge and understanding leads to future knowledge and understanding. Thus, foundational knowing and practical knowing collectively is nursological knowing that builds on all previous knowing. That is, there is no dichotomy between philosophical and practical knowing; instead, their complementary unified interrelationship may feature one or the other at periods of growth and change in nursology. Clearly, we want to ”counter those who would discard the discipline’s theoretical traditions as irrelevant or counterproductive, we need to [position] this new generation of critical scholarship to champion the intellectually exciting and complex philosophical challenge within which nursing has been engaged throughout its ideational history” (Thorne, 2014, p. 86).

Fawcett writes:

We know from Kuhn’s (1971) classic treatise on scientific revolutions that disciplinary perspectives change over time, typically as the result of scientists’ inability to continue to find support for a previous version of the disciplinary perspective. Sometimes, the revolution is in methodological shifts and sometimes it is in philosophical paradigm shifts. An example of a methodological shift is our contemporary acceptance of mixed methods research instead of the assertion—lasting into the early 2000s–that qualitative and quantitative methods are philosophically separate and, therefore, cannot ever be combined. An example of a philosophical paradigm shift is the growing recognition and acceptance of conceptual models and theories that reflect the simultaneity world view instead of those conceptual models and theories that reflect the totality world view (Parse, 1987).

The growing interest in nursology as the name for our discipline may be the beginning of major methodological and paradigm shifts from the contemporary emphasis on practical knowledge to a fuller understanding of the vital interrelationship of foundational and practical knowledge. These shifts are evident in that acceptance of nursology as the proper name for our discipline indicate that the foundational knowledge of our discipline guides the way we view our science and our practice—always within the context of an explicit nursological conceptual model and/or theory—rather than leaving the knowledge aspect of our science and our practice to the claim of being “atheoretical” (Fawcett, 2019). As Popper (1965) pointed out, everyone has a “horizon of expectations” (p. 47), such as a conceptual model or theory that guides research and practice, and as McCrae’s (2012) noted, “the legitimacy of any profession is built on its ability to generate and apply theory” (p. 222).

Finally, as Donaldson and Crowley (1978) so wisely told us,

A key point . . . is that the discipline should be governing clinical practice rather than being defined by it. Of necessity, clinical practice focuses on the individual in the here and now who has a problem requiring relevant and appropriate action. The discipline, in contrast, embodies a knowledge base relevant to all realms of professional practice and which links the past, present and future. Its scope goes far beyond that required for current clinical practice. If the discipline were so narrowly defined, professional nursing could be limited to functioning in the realm of disaster relief rather than serving as a force in the promotion of world health. (p. 118)

References

Bruce, A., Rietze, L., & Lim, A. (2014). Understanding philosophy in a nurse’s world: What, where, and why? Nursing and Health, 2(3), 65-71.

Donaldson, S. K., & Crowley, D. M. (1978). The discipline of nursing. Nursing Outlook, 26, 113–120.

Fawcett, J. (1984). The metaparadigm of nursing: Present status and future refinements. Image: The Journal of Nursing Scholarship, 16, 84 87.

Fawcett, J. (2018, September 24). Our name: Why nursology? Why .net? Retrieved from https://nursology.net/2018/09/24/our-name-why-nursology-why-net/

Fawcett, J. (2019, January 22). The impossibility of thinking “atheoretically.” Retrieved from https://nursology.net/2019/01/22/the-impossibility-of-thinking-atheoretically/

Fawcett, J., & DeSanto-Madeya, S. (2013). Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories (3rd ed.). Philadelphia, PA: F. A. Davis.

Kuhn, T. (1971). The structure of scientific revolutions. Chicago: University of Chicago Press.

McCrae, N. (2012). Whither nursing models? The value of nursing theory in the context of evidence-based practice and multidisciplinary healthcare. Journal of Advanced Nursing, 68, 222–229. doi: 10.1111/j.1365-2648.2011.05821.x

O’Leary, H. J. (1975). Changes in community nursing service that affect baccalaureate nursing programs. In Faculty-curriculum development, Part V. The changing role of the professional nurse: Implications for nursing education. New York, NY: National League for Nursing, Pub. No. 15-1574.

Parse, R. R. (1987). Nursing science: Major paradigms, theories, and critiques. Philadelphia, PA: Saunders.

Popper, K. R. (1965). Conjectures and refutations: The growth of scientific knowledge. New York, NY: Harper and Row.

Rovelli, C. (2018). Physics needs philosophy, philosophy needs physics, Foundations of Physics, 48, 481-491.

Thorne, S. (2014). Nursing as social justice: A case for emancipatory disciplinary theorizing. In P. N, Kagan, M. C. Smith, & P. L. Chinn (Eds.), Philosophies and practices of emancipatory nursing (pp.79-90). New York, NY: Routledge.

Torres, G., & Yura, H. (1975). The conceptual framework as part of the curriculum process. In Faculty-curriculum development Part III: Conceptual framework-Its meaning and function. New York, NY: National League for Nursing, Pub. No. 15-1558.