Virtual Nursology Theory Week March 17-24, 2021!

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Invitation to discuss terminology
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Details for a Virtual Nursology Week 2021 have just been announced on the Nursology Theory Conference website! This virtual conference will be a combination of the March 2020 program that was interrupted by the COVID-19 pandemic, and a transition to what we can anticipate when we are able to gather at the University of Tennessee in Memphis, which we hope will happen in the spring of 2022!

Since our 2021 conference will be a virtual event, we decided to deviate from the intense 2-day format that works well when we all travel to be together in one place, but creates an unbearable experience of staring at our screens for far too many hours at a time! There will be three general sessions from 10 am to noon (Eastern) on Wednesday March 17th, Monday March 22nd, and Wednesday March 24th. Every day of that week, there will be a schedule of stand-alone 30-minute sessions during which the breakout sessions will be available! Attendees will be able to attend as many of the sessions as you wish – even every single one of them if you so desire!

We are in the process of setting up the details of this plan, and have been in touch with everyone who had an abstract accepted for 2020 so that they can select the time for their breakout session. There will be times available for a few additional breakout sessions, so we will be announcing additional abstract submissions soon.

If you registered for the 2020 conference and asked to have your registration held for the 2021 conference – you are all set, and you will receive confirmation of your registration soon. Registration for those who have not yet registered will be open by November 1st – so watch for details coming soon! Links to all of the conference activities will be available to those who register on an “honor system” basis!

Follow the Nursology Theory Conference website for details on abstract submissions, registration, and breakout sessions! Here are the details for the general sessions to wet your appetite for attending this series of important events!

Wednesday March 17, 10 am to noon (Eastern)
  • Panel discussion honoring the contributions of Rosemary Ellis
  • Keynote address by Patricia Davidson, PHD, MED, RN, FAAN. Professor and Dean, School of Nursing, Johns Hopkins University – topic: Is STEM and Nursing Theory an Oxymoron?
  • Open Discussion
Monday, March 22 – 10 am to noon (Eastern)
  • Student/Early-career Scholars Panel: Emerging Possibilities for the Focus of the Discipline
Wednesday, March 24 – 10 am to noon (Eastern)

The planning team members for 2021 are:

  • Leslie H. Nicoll, PhD, MBA, RN, conference planner extraordinaire! and Nursology.net management team member
  • Deborah Lindell, DNP, MSN, RN, CNE, ANEF, FAAN, Case Western Reserve Frances Payne Bolton School of Nursing faculty and Nursology.net management team. member
  • J. Carolyn Graff, PhD, RN, FAAIDD, University of Tennessee Memphis faculty
  • Wendy Likes, PhD, DNSc, APRN-Bc, FAANP, Dean, College of Nursing University of Tennessee Health Sciences Center
  • Peggy Chinn, RN, PhD, DSc(Hon), FAAN, Web manager for Nursology.net and NursingTheoryConference.com

Being True to Yourself: A Career as a Nurse Educator Guided by Critical Caring Pedagogy

Guest Contributor: Erin Dolen, MS, RN, CNE*

My career in nursing education has spanned the better part of a decade. For the majority of that time, I taught in an associate’s degree nursing program. At first, I was not sure if nursing education was for me. I was always a preceptor on the nursing units during my time in the hospitals, but that does not necessarily equate to being a good educator. After a semester, I was hooked. I found so much joy in showing my students not just how to do nursing, but how to be nurses. Forget “teaching to the test”! I would teach through experience, stories, relationships, respect, and caring.

Over the years, I thought I was developing into an expert nurse educator. I obtained my MSN, I passed my Certified Nurse Educator (CNE) exam, and I achieved quite a following among the student body. Until one day, it all changed. I was accused of being too personal, too attached to my stories and experiences, too outward in my sharing. I couldn’t understand why this faculty member was attacking me for being who I am, for valuing my relationship with my students, for giving them a part of me so they know I am human too. The lateral violence (let’s face it, that is what it was) became too much and I decided to move on to where I currently am, a baccalaureate nursing program.

My world has changed. I am now valued for giving my students everything that I have. For sharing not just my experiences but who I am as a person, a nurse, a mom, a friend. I care about them, and they know this. I want them to succeed beyond all ways they could imagine. I want them to learn from me; not just how to be a nurse but how to be someone who cares, who is empathetic, moral, ethical, a life-long learner, and is committed to the profession of nursing. Through my own education at Teacher’s College, Columbia University in the Online Nursing Education EdD program, now I know why. My whole nursing education career I have been guided by the Critical Caring Pedagogy (CCP).

CCP provides a framework for nursing education that, all at once, encompasses ontology, epistemology, ethics, and praxis (Chinn & Falk-Rafael, 2018). This framework consists of seven critical caring health-promoting processes: preparing oneself to be in relation, developing and maintaining trusting-helping relationships, using a systematic reflective approach to caring, transpersonal teaching-learning, creating and supporting sustainable environments, meeting needs and building capacity of students, and being open and attending to spiritual-mysterious and existential dimensions (Chinn & Falk-Rafael, 2018).

Isn’t this what I have been doing all along? All seven?! I have just come to the realization that my own practice as a nurse educator for the last decade has consisted of being in a caring and guiding relationship with my students, the foundation of CCP. I have been guided by a theory I had no formal knowledge of until now. And yet, I was faulted for it. Told I was giving too much of myself to my students. Told that I was to teach the material, not cultivate relationships. Told I made the two students out of HUNDREDS uncomfortable (yes, you guessed it, these students were academically unsuccessful and reaching for reasons for their appeal to be upheld). I almost gave up teaching. I knew I could not work in an environment that did not support my own values and approach to the teaching-learning relationship. Until I moved into my current position, where my foundation in CCP is respected, appreciated, and celebrated. To where my colleagues also practice with the guidance of CCP, whether they know it or not.

Now I can put into words what I have felt all along. Thank you, Peggy Chinn and Adeline Falk-Rafael, for providing the framework and empirics to support what I felt was the right way to teach deep down in my core. Critical Caring Pedagogy has given my teaching practice meaning and validity. I will carry this knowledge with me wherever I go, and I will never give up teaching.

Source

Chinn, P.L. & Falk-Rafael, A. (2018). Embracing the focus of the discipline of nursing: Critical caring pedagogy. Journal of Nursing Scholarship, 50(6), 687-694. Doi: 10.1111/jnu.12426

*About Guest Contributor Erin Dolen
E Dolen Picture

Erin is an Assistant Professor of Practice at Russell Sage College in Troy, NY. She is a doctoral student in the EdD Nursing Education Program at Teachers College, Columbia University. She has her MSN with a focus in Nursing Education from Excelsior College. Erin has her national certification as a Certified Nurse Educator. Her nursing background is in emergency medicine. She lives in Delmar, NY with her husband and two children.

Letter to the ANA

On September 26, 2020, the Nursology.net management team sent the following letter to the American Nursses Association, urging the organization to take a stand on the U.S. Presidential election candidates. We believe that given the dual pandemic of COVID-19 and racism, nursing’s strong voice of advocacy for the health of the nation must be heard. Here is the letter in its entirety:

September 26, 2020
Dr. Loressa Cole, ANA Enterprise CEO
Dr. Ernest J. Grant, President, ANA President
Dr. Debbie Hatmaker, Chief Nursing Officer, ANA Enterprise
American Nurses Association

Dear Drs. Cole, Grant and Hatmaker:


The Management Team of Nursology.net is writing to urge the American Nurses Association (ANA) to reverse its position against endorsing any candidate for President/Vice President in the 2020 election. We understand that the ANA reversed its previous policy to endorse presidential candidates based on the desire to “engage nurses in the voting process through providing accurate information and data and promoting nursing’s political advocacy role without alienating an entire contingency…acknowledging the reality of political polarization in this country” (ANA 2019 Membership Assembly Consideration of ANA’s Presidential Endorsement Process).

The recent draft of the document, Nursing’s Scope and Standards (2020), specifies nursing’s social contract with the public. The document includes nursing’s commitment to reject racism and promote equity and social justice for all. In addition, the document points to nursing’s accountability and responsibility to promote the health of all populations and to advocate for social and environmental justice, and access to high quality and equitable health care.

The proposed ANA Scope and Standards contradicts the ANA position against endorsing a presidential candidate if a particular candidate is a threat to equity, social justice, equitable healthcare and health for the population. While we respect that the Board made their decision thoughtfully, the current situation calls for a reconsideration based on the positions of the current administration that threaten public health. Scientific American, a journal who has never endorsed a candidate for president, has broken with their policy because of the dangerous anti-science views of the President

Today, the country needs to hear nursing’s voice related to this election from the ANA. We find ourselves in the midst of a perfect storm fueled by the mismanagement of a global pandemic, a health and environmental crisis from rampant fires, storms and floods attributed by scientists to climate change, and the public health crisis of systemic racism.

Many have referred to this election as the most consequential in recent history, certainly in our lifetimes. This is not the time for the nursing profession to sit out and fail to exercise our unified voice and moral authority. As the discipline focused on caring for the health and well-being of the people with an understanding of how the physical, social, political and economic environment influences health and well-being, and as the most trusted profession, the ANA must speak out against the policies of the current administration and endorse Joe Biden and Kamala Harris for President and Vice President. Please reconsider your position based on the actions taken by President Trump after your vote in 2019.

Here are a few reasons why we urge the ANA to reconsider and endorse the presidential ticket that is aligned with nursing values and actions and protects the public health:

  • The current administration’s lack of leadership to enact policies to stem the rising incidence of COVID-19 infections, including the President’s lack of providing timely information to the public that could have prevented thousands of infections and death
  • The current administration’s policies that have threatened accessibility to healthcare for millions of Americans by working to overturn the advances made through the ACA
  • The current administration’s position that denies human contributions to climate change and fails to support policies to abate its dangers.
  • The current administration’s lack of acknowledgement of the racial injustices experienced by people of color, especially Black people, at the hands of law enforcement.
  • The current administration’s policies of family separation at the border resulting in hundreds of children being placed in inhumane and dangerous conditions to their health and well-being.
  • The current administration’s lack of meaningful responsiveness to address the public health crisis of gun violence.

While the recommendations of the ANA’s Presidential Endorsement Process (2019) advocate for individual nurses to participate in election activities at the local, state and national levels and take advantage of educational opportunities to learn about the candidates that will inform their voting, nurses will look to the ANA for leadership, especially now. The ANA is the voice of the profession, and this is not the time for that voice to be silent. Without a unified position, the nursing profession is invisible, and the public trust in nursing’s commitment to protecting public health is compromised. Individual nurses can always vote their choice, but the unified voice of our profession is critical at this time in our history.

Please reverse your position and endorse the candidates that will advance policies that protect the health of the public. We cannot be silent. To be silent is to be complicit.

Thank you for your serious consideration of this request.

Respectfully,

Peggy L. Chinn, RN, PhD, DSc(Hon), FAAN peggychinn@gmail.com

Jessica Dillard-Wright, MA, MSN, CNM, RN jdillardwright@gmail.com

Rosemary William Eustace, PhD, RN, PHNA-BC

Jacqueline Fawcett, RN, PhD, ScD(hon), FAAN, ANEF

Jane Flanagan, PhD, RN, ANP-BC, AHN-BC, FNAP, FNI, FAAN

Dorothy Jones, RN, PhD, FAAN

Deborah Lindell, DNP, MSN, RN, CNE, ANEF, FAAN, Deborah.Lindell@gmail.com

Chloe Olivia Rose Littzen, MSN, RN, AE-C

Leslie H. Nicoll, PhD, RN, FAAN leslie@medesk.com

Adeline Falk-Rafael, PhD, RN, FAAN afalk-rafael@rogers.com

Marlaine C. Smith, RN, PhD, AHN-BC, HWNC-BC, FAAN

Marian Turkel, RN, PhD, NEA-BC, FAAN

Danny Willis, DNS, RN, PMHCNS-BC, FAAN

A Nurse Practitioner’s Perspectives on Theory in Practice

Guest Post
Welcome  to Guest Contributor Christine Platt, NP-C*,

PhD Student at the University of Arizona College of Nursing

This week I asked, why does nursing theory matter to me? Can I see it directly affect my practice? As a nurse practitioner I see, on average, 26 patients each clinic day. Nursing theory helps define who I am as a nurse and what my goals are as a professional. It also can be evident in the way I give care at the bedside or even the way I influence health policies and practices of my community.

To begin, let’s look at what nursing is not. When discussing primary care, it is easy to think about making a diagnosis and then prescribing medication or a procedure to fix the disease. While these aspects may play a role in nurse practitioner practice, they don’t encompass the professional advanced practice of nursing. Without theory, the focus of our practice could easily become too narrow or lack the direction to influence and promote well-being. For example, let’s take the act of treating acne in a clinic. Without a disciplinary perspective, a nurse practitioner (NP) could easily look at the papules and pustules and determine an antibiotic, retinoid, hormonal control (such as spironolactone or oral birth control) will decrease the papules. If the acne is recalcitrant or scarring, the NP may decide isotretinoin is the best course of action. Without theory, we treat diseases instead of the patient and our communities.

Now, let’s contrast the same situation using our unique disciplinary perspective in our practice. Looking holistically, the NP notes that the patient won’t look them in the eyes very often, they seem withdrawn, which could be due to the embarrassment that the acne is causing. As the NP listens and learns more about the patient, they realize that the patient is depressed, has recently had suicidal ideation, and the patient’s current living conditions are stressful with a poor diet. Moreover, the acne flares significantly during weather inversions that increase pollution and aggregate the patient’s asthma. Nursing is not simply writing a prescription for isotretinoin.

Nursing has helped define our profession as a wholistic one that considers the person, environment, and nursing care to improve health (Fawcett, 1984). Nursing is further assessing the patient’s safety, linking them to the right mental health provider, improving diet, while simultaneously developing a relationship of trust. It does involve treating the acne, but it is so much more than the ability to write a prescription or plan of care. It involves understanding the patient’s culture, their beliefs, and the barriers to improved care. As more and more nurses are prepared at the PhD and DNP levels, they have a great opportunity to conduct research and implement change in practice. They continue to evolve the discipline from the original metaparadigm concepts toward the development and use of middle range theories, which are more specific to the problems they are investigating to guide their work. With their specialized knowledge, they influence change at community, state, national, and even global levels. The broad influence of theory translating into practice is evident when browsing over any national nursing conference program. With the case of the acne patient, NPs may take their experiences and develop studies with PhD and DNP nurses who focus on research and quality improvement projects. They can present their findings to legislators on asthma, acne, pollution, and poor nutrition, as a means of decreasing all of these in the community. They develop algorithms for treating acne combined with depression or other diseases.

Next time you come into contact with a patient, reflect on your nursing perspective in addition to all the specialized knowledge you have. Then think about how more specific theories could facilitate your practice, or maybe they are already embedded in your practice, ready to be articulated more explicitly, tested, and further refined. One of my favorite nursing theorist noted, “Nursing is not only a professional practice, it is a scientific practice as well (Reed, 2019).” Theory-based practice is essential and should be included in how we provide and deliver care on a daily basis. However, it is also time to consider how our professional practice can influence and improve our theories. If you have had an experience similar to mine, please share in the comments. I am excited to take part in this process and look forward to hearing how other nurse practitioners translate theory into practice and their practice into theory.

References

Fawcett, J. (1984). The Metaparadigm of Nursing: Present Status and Future Refinements. Image: the Journal of Nursing Scholarship, 16(3), 84-87. https://doi.org/10.1111/j.1547-5069.1984.tb01393.x

Reed, G. P. (2019). Intermodernism: A Philosophical Perspective for Development of Scientific Nursing Theory. Advances in Nursing Science, 42(1), 17-27. https://doi.org/10.1097/ANS.0000000000000249

About Christine Platt

Christine Platt, MSN, PHN, FNP-C began her career in nursing as a registered public health nurse and hospital staff nurse in St. Paul, MN. She became a critical care RN working in both cardiac and neuro intensive care units and received her CCRN certification after moving to Utah in 2006. She took on the role of house supervisor before returning to graduate school at Brigham Young University, where she received her MSN degree to become a family nurse practitioner. Currently, she sees patients in dermatology and also volunteers in the evenings to serve the community’s under- or un-insured population. Her family is a licensed foster family, caring for medically fragile children over the last decade. As a second-year PhD student at the University of Arizona, she has two areas of research, which span her clinical practice of dermatology and her passion for helping children with disabilities in the U.S. foster care system.

Everyone is a “novice” when encountering a new challenge or situation: A perspective from Benner’s theory

Although many experienced nurses consider themselves as experts in their fields of practice, it is important to keep in mind that they, too, become novices when they encounter a new clinical challenge or situation such as the Covid-19 pandemic. Benner’s (1984) theory, From Novice to Expert, is an excellent nursology theory that can guide clinical practice in the context of current health care challenges related to Covid-19. The theory includes five stages–novice, advanced beginner, competence, proficiency, and expertise. As nurses pass through these various levels of proficiency, they develop holistic clinical knowledge influenced by nursology education, experience, and intuition (Benner, 1984).

The purpose of this blog is to summarize an exemplar of a  “novice to expert” nursology educational strategy developed in response to the Covid-pandemic Global Nursing Education exemplar.  The exemplar is about a non-profit 501c3 organization, Dr. Gabone QHSC (Quality Healthcare Solutions and Consulting) Inc., which  served global novice nurses experiencing a surge in Covid-19 cases in their clinical practice. These novice nurses, especially those assigned to “Covid-19” units experienced common challenges reported in the literature such as exposure and anxiety related to the lack of personal protective equipment and fear of the unknown (Chen, Lai, & Tsay, 2020) . As a result, they relied heavily on emerging knowledge from public health experts as well as clinical expertise from frontline workers who had already experienced the impact and management of the disease in their practice settings.  Hence, to better serve the novice nurses, the organization assembled teams of interprofessional Covid-19 frontline healthcare workers from various Covid-19 affected areas to share knowledge about how they utilized their highly skilled analytical problem solving abilities, experience, and education to grasp the emerging situation, events, and behaviors via Zoom meetings.

Six educational sessions were offered as resources to heighten the opportunities for novice nurses around the world, in particular targeting Tanzanian nursologists. The topics covered included:

  • Challenges of Covid-19 in nursing practice across various practice settings
  • Typical nursing care shifts for Covid-19 patients
  • Medication administration and medical protocols
  • Infectious disease management
  • Effective use of PPE to prevent spread of COVID-19
  • Effective coping strategies to promote nurses’ individual and family well-being
  • Creating a culture of safety
  • Challenges faced by prospective health care workers.

As the frontline workers described their expert practice, they widened the novice nursologists’ perspectives and acceptance of actual and potential challenges and situations they might encounter in their practice settings. For example, the meetings provided demonstrations of how nursologists are interconnected and how they face similar challenges such as lack of PPE and fear of becoming infected. In addition, some nursologists shared ways they reused supplies while ensuring safety and efficiency for patient care.

Overall, the feedback from the participants was positive. The online mode of delivery included interactive elements such as chats, polling, and emails to facilitate discussions to move beyond the content elements and also facilitate experiential learning to develop expertise. Future recommendations for effective online global education delivery and programming include consideration of delivery time for synchronous presentations, as well as access to technology and internet service in resource poor countries and communities.

As we move forward, I call upon nursology scholars worldwide to utilize Benner’s (1984) Novice to Expert theory to examine how the lived experiences of frontline nurses during the Covid-19 pandemic facilitate knowledge development among novice nurses in clinical practice. Questions to ponder are: 1) How and what did frontline nursolgists learn during the Covid-19 pandemic? 2) What new nursing knowledge was generated by the frontline nursologists as they became the experts? 3) How can we utilize the new knowledge in nursology education and practice to manage future outbreaks/pandemics?

Please feel free to share your comments to this blog.  

References

Benner, P. (1984). From novice to expert. Addison‐Wesley .  

Chen, S-C., Lai, Y-H., & Tasay, S-L.  (2020). Nursing perspectives on the impacts of COVID-19. Journal of Nursing Research28(3), 5 pages.  http://doi.org./10.1097/NRJ.0000000000000389 

Celebration! 2nd Anniversary of Nursology.net

. . . . it is worth reiterating the point that compared with atheoretical actions, those that are conceptually grounded have a higher probability of achieving their intended consequences. Not just because they are contemplated more intentionally but because the vast majority of . . . . theories/frameworks pay heed to the important messiness of context and the use of power. (1) Patricia Butterfield (2017, p. 9)

Nurses are thirsting for a meaningful practice, one that is based on nursing values and knowledge, one that is relationship centered, enabling the expression of the depth of our mission, and one that brings a much needed, missing dimension to current healthcare. (2) Margaret A. Newman, Marlaine C. Smith, Margaret Dexheimer Pharris and Dorothy Jones (2008, p. E25)

With a strong conviction of the vital importance of nursing’s own theories and frameworks, the Nursology.net management team embarked on the development of a website to provide current and accurate information about discipline-specific knowledge. We started the development of the site in the summer of 2018, with the goal of publicly announcing the site once we had at least 20 theories/models on the site, and at least 1 Exemplar in each of the “Exemplar” sections! We met that goal and officially launched the site on September 18th, 2018! Today, we have

Plus, a new section dedicated to nursing philosophy, a host of resources related to nursology knowledge development, a record of past nursology-related conferences (including proceedings, photos and other materials related to the conferences), information about events that will be happening in the future (despite the pandemic), and an unbroken record of blog posts every Tuesday!

I, Peggy Chinn, have served as the architect of the site and am responsible for the nitty-gritty work of putting it all together, but all of this is only possible because of the work of members of our team of nursology scholars who have identified and composed the content.

Here are reflections from members of our management and blogging teams in response to two questions:

  • How has nursology.net influenced your approach to teaching, research, or practice?
  • What do you anticipate for the future of the discipline, and the role of nursology.net in shaping that future?

How has nursology.net influenced your approach to teaching, research, or practice?

Jacqui Fawcett
The website is exceptionally useful as a resource for the PhD students I have the honor to teach, as well as all other students in our program., and as resource for colleagues who are “thirsting” for information about nursology discipline-specific knowledge. In addition, I cite the blogs in many of my publications—journal articles, book chapters—and presentations at conferences and as a guest lecturer for other nursology programs.

Marlaine Smith
When I’m with any student or faculty group I call attention to the nursology.net site and describe the many resources available.  I’m teaching a course now for PhD students, Evolution of Nursing as a Professional Discipline.  In the first module I introduced students to Nursology and they were invited in the discussion board to respond to a question related to the Nursology site.  I have received so many comments from students and faculty who are amazed at and grateful for the many resources on the site. The Nursology blogs offer short position/perspective pieces that can spark meaningful discussion.

Dr. Eustace

Rosemary Eustice
Nursology.net is a vehicle that highlights the contribution of nursology wisdom to health and health care issues. The website continues to influence my teaching by enabling me to find new teaching and learning strategies that foster students’ acquisition of nursing knowledge to understand nursing phenomena of interest.  One thing that inspires me everyday when I share this website with my students, is to see how much the students appreciate the value of nursing theories and how much they wish for ‘good’ mentors and educators to support the next generation of competent nursologists. On the other note, as a nurse researcher, nursology.net has increased my curiosities on nursing knowledge development and how nursologists can utilize research in clarifying and developing new concepts/ideas using nursing lenses. 

Dorothy Jones
I am impressed with the global response to the nursology.net website. When I have shared this information with faculty and students at a University in Spain where I consult, the reaction has been inspirational. Doctoral students love having “free” access to the nursing theorists and their work in one central space. Faculty describe the site as “a way to connect with the nursing community “globally.” Dr. Emiko Endo from Japan recently translated a nursology blog “Covid 19- What would Margaret Newman Say” into Japanese for her students. She also presented the information to participants attending a virtual Nursing Theory Conference. Dr. Endo reported how moved the audience was by the message. When I shared the web site with a group of International Gordon International Scholars at Boston College, from Italy, Brazil and Africa they were excited to learn about the site and immediately shared it with the other faculty and students.  They noted that they now had immediate access to information about nursing theory never available to them before. The responsiveness of the site to contemporary issues makes nursology.net a living document that promotes nursing knowledge and its potential impact on the health and wellbecoming of all.

Jane Flanagan
I am teaching a new course this year – Philosophical Inquiry for Knowledge Development in Nursing.  I introduced my students to nursology.netas well as the faculty of a companion course – Strategies for Knowledge Development in Nursing. For my course, we will be using the site for the many resources it offers. I have encouraged them to read and respond to the blogs.  I think if I was to have a re-do on my syllabus, I would actually have an assignment include a meaningful contribution to the site. These students are our future nurse leaders and I know like many on this site, we want to hear from them. We have only had one class thus far, but based on the great dialogue, I think they will be joining in on the conversations on nursology.net

Jane Dickinson
I am pointing students to nursology.net in the Nursing Knowledge in Nursing Education course I teach for doctoral students in our Nursing Education program. I also have them write a blog post and an exemplar (if applicable) for submission to nursology.net as course assignments. Nursology.net is an amazing resource where students can learn about nursing theorists and their work. It also provides a wonderful opportunity for them to think and write about their own experiences with nursing knowledge.

Chloe Olivia Rose Littzen
As a PhD candidate, Nursology.net has influenced both my nursing education and the ways in which I know the world. Specifically, Nursology.net was one of the few references I was able to use for specific theory related nursing knowledge content in studying for my comprehensive exams.The organization of theory-related content made it easy for me to find what type of information I needed, and I knew that the information included was substantive in nature. As a nurse, Nursology.net has also informed the ways I know the world by keeping me up-to-date on current issues and events, while simultaneously giving me access to new nursing knowledge content I may have never come across during my own reading. 

Danny Willis
In the PhD course “Nursing Knowledge Development” I have been teaching at the University of Wisconsin-Madison we used the resources on nursology.net to guide our thinking. PhD students  were thirsty to explore the philosophical, conceptual, theoretical, and empirical aspects of the discipline in research, education, practice, and policy. Great examples are showcased on the website, which they enjoyed! As these PhD students prepare for their research and future programs of disciplinary knowledge development as leaders in the discipline, through the website they were better able to understand the value of grounding their work in the discipline, which feels like a Wonderful move in the right direction. Nursology.net is recognized as a go-to resource with the potential for nursologists to contribute to ongoing conversation, like none other! 

Patrick Palmieri
The emerging role of nursology.net in low- and middle-income countries is impactful due to our limited access to nursing knowledge. Unfortunately, knowledge is too expensive for many nurses throughout the world. The limited financial resources in many countries negatively impacts access to nursing literature, including published papers and nursing textbooks. Through nursology.net, student nurses and professors throughout the world have immediate access to contemporary nursing knowledge, including timely theoretical discourse related to current trends and events. Most importantly, nurse scholars such as I, are able to translate the resources, without copyright issues, for immediate application in our courses. This year, we continued to advance a project to translate resources from Nursology.net into Spanish for the history of nursing and theory of nursing courses. Through the efforts of the leaders and many donors at Nursology.net, the barriers to accessing knowledge have been removed. Nursology is linking scholars to students throughout the world!

What do you anticipate for the future of the discipline, and the role of nursology.net in shaping that future?

Jacqui Fawcett
I am both pessimistic and optimistic about the future of nursology—I am very concerned that our disciplinary knowledge will not survive as a continuing way to guide disciplinary advancement—there always is a tension to focus on pragmatic aspects of issues rather than the philosophical, conceptual, and theoretical aspects, and there is much too much emphasis on empirical methods—the primacy of methods for so many people is of great concern to me. In contrast, I am encouraged by the number of people who have been accessing nursology.net and by the continued publication of multiple editions of several books about nursology conceptual models and theories. Nursology.net serves as an ongoing resource for all nursologists, with blogs and other content already shaping what nursologists think about our discipline. We definitely are living our mission to be a repository for all things theory in nursology!

Marlaine Smith
While I can despair at the lack of valuing of nursing theories/models in our research, the lack of content related to nursing theories within the curricula, and the frequent absence of a clear nursing perspective in advanced practice and interprofessional practice, I’m encouraged by signs that there is a renewed appreciation of the importance of generating nursing qua nursing knowledge and practicing from nursing’s disciplinary perspective. Some of those signs… the committed group of scholars who have been attending and contributing to the annual Nursing Theory Conferences…the growing number of AAN members joining the Nursing Theory-Guided Practice Expert Panel…the recognition by CNOs about the value of practicing from a nursing theory-guided model…the lights in the eyes of students who “get it”. Nursology.net will continue to support this emergence. The site has global outreach and can bring the nursing community together around the critical issues of expanding disciplinary knowledge development and application. 

Dr. Eustace

Rosemary Eustace
I am optimistic that the future of the discipline and the role of nursology.net will continue to find a voice in health care, especially in the area of policy making. However, this process will be timely if we continue to value and acknowledge the uniqueness of nursing knowledge in influencing health care outcomes. When I think back at what we have learned so far and are learning each day with the wake of the Covid-19 pandemic, I see a window of opportunity for nursologists to advocate for this unique STEM discipline and use nursing knowledge to make positive changes in health care systems and population outcomes.   

Dorothy Jones
As a discipline we continue to experience many issues, even resistance to articulating nursing science within nursing curricula, research and care delivery.  Emphasis on preparing nurses with essential content that focus on  role development with little grounding in philosophical and theoretical underpinnings of the discipline challenges knowledge development and compromises the visibility of nursing’s impact on care delivery. While the interdisciplinary / intra professional focus on contemporary issues is critical, the unique voice of nursing is essential to informing and reshaping responses to global health concerns. While the threats to advancing nursing science are apparent, there is also indications of a renewed interest in nursing’s identity and expansion of nursing knowledge. Increasing membership in nursing theory groups, attendance at nursing theory conferences and active progress by groups such as the AAN Expert Panel of Nursing Theory Guided Practice to link nursing’s knowledge and policy, offer signs of hope for the future. Nursology.net has been an important catalyst that has supported this renewed dedication to nursing knowledge. The site provides an essential platform for all nurses to share in our history, explore our future, and increase our awareness of new opportunities for nursing’s voice to influence issues of global concern. Thank you nursology.net!

Jane Flanagan
I think we are in a time that has raised our social consciousness and many nurses are questioning our role in power dynamics, sociopolitical movements, structural racism. They are asking are we going to be part of the problem or mobilize and act?  Foundational to our discipline is our ethics aimed at striving for the greater good, health and healing for all people. We can no longer tolerate an inequitable society or health care system that does not meet the needs of those we say we are committed to serve. Nursology.net  is a forum that created the space for us to have the dialogue, work through the sometimes awkward, sometimes obvious and at other times not so obvious issues. It is a safe place that allows all nurses to think, write share and activate. Our future is in not only finding our voice, but in leading the way. Nursology.net is the format and catalyst to accelerating our movement toward a universally experienced wellbecoming.

Jane Dickinson
I see nursing knowledge (and all five ways of knowing!) becoming more prominent in nursing education, research, and practice as we move further into the 21st century. Nursology.net is the preeminent source for nurse educators and leaders in research and practice to share their work, and to inspire newer nurses to take the next step in further developing and refining what we know and what we do.

Chloe Olivia Rose Littzen
I anticipate that nursing theory and philosophy, including our unique disciplinary perspective, will come to the forefront of importance in our nursing practice, research, education, and policy. Additionally, I believe that nursing theory and philosophy will be revealed to play a significant role in the well-being of our nurses and the healthcare environment. I believe Nursology.net will support nurses to be confident and grounded in their own unique disciplinary perspective, promote the use of nursing theory and philosophy in all settings, and provide a forum in which nurses can gather from across the globe to stay up-to-date on relevant issues and events in nursing.

Danny Willis
The future is in our hands and the website will continue to play a major role in orienting nurses and our PhD, DNP, Masters, and Baccalaureate students. Nurse leaders and educators in practice settings would benefit from having this website as a part of their orientation. Therefore, I see it as my responsibility to let every Chief Nursing Officer I meet with know about this resource and offer to speak to anyone in educational leadership roles in practice settings about the website. Faculty leaders must also be aware and able to speak to the substance of the discipline, which the website acts as a vehicle for. Nurse leaders will be called upon to champion ready access to the fundamentals of nursing depicted on the website and to further the ongoing evolution of disciplinary thought and communication. The future of the discipline can be bright as we nurses promote humanization, caring, healing, relationship, love for one another, diversity, belongingness, transitioning through living and dying, meaning in living and dying, and well-becoming. The future can be bright if we nurses promote openness, dialogue, healing transformative power with each other, critique, intellectual curiosity, community, and nursing ethics of our shared humanity and a deep commitment to the greater good for all of humankind and planet Earth in all its complexity and beauty. Onward nursologists! 

Sources for the opening quotes:

  1. Butterfield, P. G. (2017). Thinking Upstream: A 25-Year Retrospective and Conceptual Model Aimed at Reducing Health Inequities. ANS. Advances in Nursing Science, 40(1), 2–11. https://doi.org/10.1097/ANS.0000000000000161
  2. Newman, M. A., Smith, M. C., Dexheimer-Pharris, M., & Jones, D. A. (2008). The focus of the discipline revisited. ANS. Advances in Nursing Science, 31(1), E16–E27. https://doi.org/10.1097/01.ANS.0000311533.65941.f1

Muriel A. Poulin, EdD, RN, FAAN (1925 – 2019)

Guardian of the Discipline
In Memoriam

Contributors: Sarah B. Pasternack, MA, RN
Dorothy A. Jones EdD, APRN, FAAN, FNI

Magnet Study Author and Nursing Advocate, Educator, Leader 

Muriel Poulin was above all – a fierce advocate for nursing. Her disciplinary contributions have transcended her impact on education, practice, administration and policy. Muriel’s work embraced nursing excellence, promoting nursing’s potential in all she did. Above all, Dr. Muriel Poulin modeled what it meant to be a leader in nursing. When she stood up to speak she was articulate, clear and resounding in delivering her sustaining message that nursing made a difference in health care and nursing leaders needed to create the environment for nursing to flourish.

Muriel died on September 6th in 2019 in Sanford Maine. She began her nursing career as a Cadet Nurse, graduating from Massachusetts General Hospital School of Nursing in 1946.  She earned a bachelor’s degree in nursing at Catholic University, a master’s degree in nursing at University of Colorado and a doctorate at Teacher’s College, Columbia University.

Muriel held several nursing positions including the nursing director at the opening of a hospital in Damascus, Syria, during the early 1950s.  She served on the faculty of the University of Kentucky, American University in Lebanon and University of Barcelona. She served as Professor and Chairperson of the Nursing Administration Graduate Program at Boston University School of Nursing from 1972 to the time of her retirement  in 1988. 

As a dedicated leader in promoting the visibility of nursing internationally, Muriel was also unwavering in her promotion of nursing through organizational action. She was a voice for nursing in the American Nurses Association (ANA) throughout her career, holding membership in the organization throughout her career and in her retirement. She was elected Second Vice President of the American Nurses’ Association in 1976 as a Massachusetts member.  

Muriel was a leading force in the early development of the American Academy of Nursing (AAN). She viewed the Academy as the “knowledge arm” of the American Nurses Association, influential, informing and reforming nursing at all levels. She advocated for the early goals of AAN especially the goal that addressed nursing knowledge, development, use and translation to inform education, practice and policy.

During the early 1980s, Muriel was one of four distinguished nurse leaders selected by the American Academy of Nursing to identify and describe clinical practice environment variables that attracted and retained well-qualified nurses.  In 1983 the groundbreaking study, Magnet Hospitals: Attraction and Retention of Professional Nurses was published.  The significant outcome from this study was the establishment of the Magnet Recognition Program by the American Nurses’ Credentialing Center (ANCC) in 1990.  As of August 2020, there are 523 Magnet-designated Hospitals in the US and 10 other countries, with 10 in Massachusetts.  Dr. Patricia Reid Ponte, President of the Board of the ANCC and Clinical Associate Professor of Nursing and Health Administration at Boston College and a former student of Muriel’s, stated “today’s interest in The Magnet Recognition Program internationally can be linked to the efforts of nursing leaders like Dr. Muriel Poulin. This program has had profound positive impact on health care delivery.  Muriel Poulin’s legacy is carried on across the globe through the nurses and advanced practice nurses working in these organizations.” 

Dr. Poulin was honored by ANA Massachusetts as a Massachusetts “Living Legend in Massachusetts Nursing” in 2011 and also as a “Living Legend in Nursing” by American Academy of Nursing in 2012.  In 2016 she was honored by induction into the Nursing Hall of Fame by the American Nurses Association.

Muriel educated and personally mentored many of the current and former nursing executives and leaders in the Boston area and beyond.  Dr. Ponte, stated: “Muriel Poulin was a force of nature – a truly extraordinary nurse, leader, researcher and educator. As a member of my dissertation committee at Boston University School of Nursing in the late 1980s, she pushed me to become a better nurse executive through her mentorship. I will be forever grateful to her. I was able to have lunch with her in the last couple of years when she attended the ANCC Magnet Conference (a real thrill for Muriel) and again at the American Academy of Nursing meeting.”

As a junior faculty (Dr. Dorothy Jones), teaching in the undergraduate nursing program at Boston University, I often wondered if I would ever be able to stand up and advocate for nursing the way Dr. Poulin did in the classroom and at a faculty meeting. One day I got my chance.  I was called to a meeting with Muriel. “I want you to teach my Masters students about health and nursing practice. They need to know this information.” I was pleased and overwhelmed by the opportunity to work with Muriel. We developed a new course that  incorporated holistic nursing concepts  into the Masters in Nursing Administration curriculum. A few years later, she was my AAN Fellowship cosponsor, an honor I will forever remember.

 Dr. Susan LaRocco, Dean and Professor of the School of Nursing, Mount St. Mary College, Newburgh, NY and a graduate of the BU graduate program in Nursing Administration, stated: “Dr. Poulin has been influential throughout my administrative career.  Whenever I had to handle a difficult situation, I could be fearless because she taught me that the patient is the center of all that we do.  When I had to deal with a patient abuse case, I thought that I was going to be fired for pursuing it.  But I knew that I was doing the right thing because a frail elderly patient had been harmed and I could not just look the other way.  After reconnecting with Muriel at a BU History of Nursing Archives event, I had the privilege of meeting her occasionally for lunch.  It was always a lively conversation with this wonderful mentor.”

Dr. Poulin  was an international nursing leader. She worked to prepare nursing organizational leaders, globally, Through her publications, teaching and presentations she influenced a generation of  nurses involved in  leading  hospital and organizational administration today.  Even in her “retirement,” Dr. Poulin exerted her leadership in the profession with service on the Board of Directors of her local Visiting Nurses Association in Maine and with the establishment and management of a very successful second-hand bookstore to benefit a local hospice.  She was a fierce advocate for Nursing and her voice will be missed by many.

Power in Nursing

Power has been a concern to all living beings – humans and animals – since the beginning of time. Nursologists have been sensitive to power issues at least since Florence Nightingale’s time. It is likely, however, that power has different meanings for different people, including those who hold positions associated with power and those who regard themselves as subjected to power and may think they are powerless.

Very specific meanings of power are evident in a nursology theory developed by Elizabeth Barrett and a nursology theory developed by Peggy Chinn. Elizabeth Barrett developed the theory of power as knowing participation in change. This theory focuses on power-as-freedom, which contrasts with power-as-control. Barrett (2010) explained that power-as-freedom comes from and is associated with participating knowingly in life changes.

Peggy Chinn developed the theory of peace and power. This theory focuses on peace-power, which contrasts with power-over. Chinn (2018) explained, “This theory provides a framework for individuals and groups to shape their actions and interactions to promote health and well being for the group and for each individual, using processes based on values of cooperation and inclusion of all points of view in making decisions and in addressing conflicts.

My interpretation of these theories is that both emphasize power as a beneficial attribute that enables the individual or group to thrive and evolve, as opposed to power as a detrimental attribute that often prevents others from thriving and evolving. But what, I wondered, are meanings of power held by other nursologists?

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

Therefore, I invited graduate students at St. Mary’s College School of Nursing in Kurume, Japan, where I am a visiting professor, to share their meanings of power. I asked the students to respond to two questions:

  • How do you define power?
  • How does power affect what you think and do as a nursologist

The students’ responses are given here. I am indebted to Eric Fortin, who is a faculty member at St. Mary’s College School of Nursing, for translating the students’ responses from Japanese to English. (See notes below for more information about St. Mary’s College School of Nursing)

How do you define power?

Yukari Shitaki wrote: Power is generally defined as authority, motive power, energy, and so on. In nursing, I think that there are many things that are demonstrated through relationships among people, such as manpower, empowerment, and power augmentation, which improve technical skills and abilities. In addition, I think that the way people, whether individuals, groups, or society at large, perceive that power changes according to the situation at any particular time. Therefore, for me, power is defined as the force in the fellowship among people that produces synergistic effects and is further demonstrated through the interactions among them.

Kiyoko Tanaka wrote: We as nursologists work to maintain and promote human health, prevent health problems, create an environment that promotes health, and share and resolve issues related to the destruction of the natural environment and the deterioration of the social environment. In contrast, nursology is caring and has the power to realize and maintain a peaceful human society by fulfilling its role

Yoko Hashimoto wrote: In Japan, some nurses work in the government as licensed nurses and are involved in devising national policies. Many other nurses are involved with patients and local residents in hospitals and communities. Nurses see problems and other issues in their daily practice. Therefore, as nurses, we are working to improve the quality of nursing to solve these issues. I believe that nurses consider motivation and the ability to improve the quality of nursing to be power

Risa Fujimoto wrote: I think that nursologists’ power can be defined as action. As nursologists, everything should be done for the patient. It is very important to possess the ability to do something useful for people and to act on and realize what we want to do, including even little things. I also think that studying at graduate school may be the first step that will lead to having the power of a nursologist.

Saki Higashi wrote: The power of a nursologist for me is defined as the ability to constantly grow from the soul and to spread that around to others. I categorize power into three aspects. The first is the core, the second is influences absorbed from one’s surroundings, and the third is action. The core is latent and spiritual and includes one’s thoughts on nursing. The aspect of power that is absorbed from one’s surroundings is the power that can exert influence and that can be taken in from all external stimuli such as patients and other staff through one’s experiences of being a nursologist. Action is the aspect of power that derives from what has been cultivated up to now, including from the first and second aspects, and it works by giving back what has been absorbed from others through one’s practice and by diffusing one’s own power to those around us. Power is not always constant, but fluctuates; and power, although being influenced by others, also gives of itself and continues to grow.

How does power affect what you think and do as a nursologist?

Yukari Shitaki wrote: The reason I wanted to raise the level of my expertise was that I strongly believe in the importance of education. In my work environment as a perinatal nursologist, I encounter situations in which induced abortions are easily requested due to undesired, unexpected, or young pregnancies. One of the reasons for this involves the issue of sex education. I have thought about what I could do to change the consciousness of the women in these cases by inculcating in them the value of life and the desire to protect its dignity. It is difficult to face such a problem through one individual’s power alone, so it is necessary to first acquire the ability to judge the essence of one’s role as a professional and to think about what kind of method is possible to implement an action from an educational perspective. I also think it is possible to augment an individual’s power by utilizing the power of a larger group through fellowship with its members, and thereby be better able to put necessary actions into practice.

Kiyoko Tanaka wrote: As a pediatric nurse, I realize that the family is very important in child development. If families cannot fully understand children with developmental disabilities and cannot understand the characteristics of their own children, it will not be possible to support those children, and it will be difficult to expand their possibilities with adequate developmental support. It will also be difficult to improve their future health in connection with possible secondary disabilities. The risk of ruining a healthy life can also develop. Conversely, with regard to the mental health of parents, especially mothers, of children with developmental disabilities, feelings of difficulty in raising these c)hildren have led to depression and reduced self-esteem. Based on this situation, we, as nursologists have the power of specialized knowledge to offer counseling, guidance, and a positive nursing environment for children with developmental disabilities and their families in cooperation with related organizations such as prefectures, municipalities, hospitals, and schools. We can also provide information about services available for children with developmental disabilities and their families so that they can maintain, promote, recover from, and prevent illness. In addition, we believe that such support will promote the health of caregivers, promote a better understanding of children with developmental disabilities, and lead to their healthy development.

Yoko Hashimoto wrote: Japan has had a background of advanced medical care catering to the needs of an aging society having an increasingly long lifespan, and medical care is moving from the hospital to the home. However, there are few nurses who are practicing in the field of home nursing, so evidence in this field is weak and, therefore, has failed to lead to policies. In the future, it will be necessary to conduct research and establish evidence for issues arising from daily practice to provide high-quality nursing in response to social changes. It is difficult to act alone, so it is necessary to become involved with others and to work together. Through the power of nurses, nursing practice will be better visualized, which will hopefully allow it to occupy a more important position among government circles, thus leading to improved nursing and medical care.

Risa Fujimoto wrote: For nursologists, power is the ability to help people by being useful to them. In my clinical experience, I often wondered whether I could really help others or if there was something more I could do for them. Therefore, I decided to undertake graduate study with the goal of improving my knowledge level and nursologists’ practice skills. As a rehabilitation nurse, I want to become a nursologist with a wide range of knowledge and be involved in primary through tertiary stroke prevention. We can only become useful to people by taking action and practicing what we know. However, to take action, we cannot act entirely alone; we need the knowledge and skills of other nursologists. Personally, if I obtain enough knowledge in graduate school, I am confident that I will have to play a role in creating an opportunity for many nursologists to understand the value of nursology. So, I think that that would be one of my responsibilities as a nursologist. As a practitioner, I will keep in my heart and mind what I believe to be useful for people and will work to obtain knowledge and skills so that I can better perform the actions of a nursologist.

Saki Higashi wrote: Power influences my activities as a nursologist. In the future, by incorporating my experiences and various influences from the external environment and applying them to my nursology activities, I am confident that I will not only grow as a nursologist, but also expand my influence to people, regions, countries, and the world at large.

References

Barrett, E. (2010). Power as knowing participation in change: What’s new and what’s next. Nursing Science Quarterly, 23(1), 47-54. doi:10.1177/0894318409353797 

Chinn, P. L. (2018, August 23). Peace & Power. Retrieved from https://nursology.net/nurse-theorists-and-their-work/peace-power/

Chinn, P. L., & Falk-Rafael, A. R. (2015). Peace and power: A theory of emancipatory group process. Journal of Nursing Scholarship, 47, 62–69.

More about St. Mary”s College School of Nursing on Nursology.net

Who IS the First?

What is Real Nursing and Who Are Real Nurses? Perspectives from Japan

How the Nursing Philosophy of Intermodernism Changed the Way I See the World as a Novice Nurse Scientist

When I started my PhD program, I had no idea how important philosophy would become in my life. Fast forward to now, as a PhD candidate, my nursing philosophy is the cornerstone for how I look at the world and how I perform research as novice nurse scientist. But, this is not to say that prior to my PhD program I didn’t value philosophy! I always had a strong affection for philosophy. When I was in 6th grade, I remember sitting in my government and politics course and being absolutely enthralled with discussions about John Locke (I mean, how cool is the idea of tabula rasa?). In my late teens and early twenties, I began my fascination with eastern philosophies related to yoga and Buddhism. But, even though I had been a nurse since I was 22, I never learned about the philosophy of nursing. It wasn’t until I started my PhD program at age 27 where nursing philosophy even became a part of my nursing knowledge base. Once I wrapped my head around complex areas of philosophical inquiry such as epistemology and ontology, it was like a light bulb went off in a dark room that I had previously been stumbling around in — I finally had a way to make sense of the world as a nurse!

Pamela Reed

            The philosophy that changed it all for me was the philosophy of nursing science and practice called Intermodernism (Reed, 2019). Intermodernism, which was originally titled as neomodernism (1995, 2006a, 2006b), is unique in that it is an expanded view of epistemology where practice and science partner to create new knowledge originally developed by Dr. Pamela Reed (Reed, 2018). Nursing practice, and the nurses within, thus become a source of knowledge, and not just a repository of the knowledge (Reed, 2018) developed in the ivory tower. This is not to say the academe is not important, instead, intermodernism acknowledges the necessity of partnership in knowledge development; the theory-practice gap becomes the theory-practice connection, and ALL nurses are recognized as the theorists they are. Being a theorist is often put on a pedestal, where theory is an intimidating and unrelatable aspect of the academic world. Intermodernism cleverly acknowledges that nurses theorize every day in their practice. And, if you don’t believe that, just ask a nurse to explain how they solved a problem on their last shift, this is theorizing at its finest.

            This is just the tip of the iceberg with intermodernism, and as much as I could ramble on about the ins-and-outs about intermodernism, I invite you to explore some of the literature related to intermodernism on your own. My rationale for this invitation is that it is important in philosophical inquiry to take time for “arm chair work” (as Dr. Reed has very wisely taught me), which is sitting, thinking, reading, and repeating that process – and for me I would add, when you run into a philosophical conundrum or question talk to someone about it!

Comic Art by XKCD

That is why I invite you to explore the new philosophy section on Nursology.net. If you are new to philosophy, don’t get intimidated as we have provided some beginning definitions of at first kind of scary but actually really interesting words such as epistemology and ontology. You will also find lists of substantive literature in both nursing ontology and epistemology. Intermodernism also has it’s very own page here, where I have listed the most relevant articles for your enjoyment. These pages will be continued to be added to, so be sure to check back, and if you think something is missing we would love to hear your suggestions!

References

Reed, P. G. (1995). A treatise on nursing knowledge development for the 21st century: beyond postmodernism. Advances in Nursing Science, 17(3), 70-84. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/7778892

Reed, P. G. (2006a). The practice turn in nursing epistemology. Nursing Science Quarterly, 19(1), 36-38. https://doi.org/10.1177/0894318405283545

Reed, P. G. (2006b). Commentary on neomodernism and evidence-based nursing: implications for the production of nursing knowledge. Nurs Outlook, 54(1), 36-38. https://doi.org/10.1016/j.outlook.2005.01.001

Reed, P. G. (2018). A philosophy of nursing science and practice: Intermodernism. In P. G. Reed & N. B. C. Shearer (Eds.), Nursing knowledge and theory innovation: Advancing the science of practice (2nd ed., pp. 21-46). Springer Publishing Company.

Reed, P. G. (2019). Intermodernism: A philosophical perspective for development of scientific nursing theory. Advances in Nursing Science, 42(1), 17-27. https://doi.org/10.1097/ans.0000000000000249

By and For Numbers: Meaningless Without Theory

We have always lived in interesting and challenging times, filled with reports of numbers indicating what is happening – life expectancy, births, deaths, and most likely millions of other numbers representing important and probably not so important events. Currently, we are living in what many people regard as an especially interesting and challenging time, with numbers about the coronavirus pandemic dominating news reported in the print, radio, television, and internet media. Most recently, numbers about climate change have taken almost center stage as the “hurricane season” occurs. .

I confess to checking the coronavirus pandemic numbers every day, especially for the state of Maine, where I live and now also work during this time of remote teaching and scholarly work. I also keep track of what is happening with hurricanes, which occasionally do make landfall along the coast of Maine and can create many tree downings and power outages, beach erosion, and flooding.

Numbers are perhaps especially important to researchers who conduct quantitative research to test hypotheses. Thinking of numbers within the context of hypothesis testing requires theoretical thinking. Thus, even if implicit, theory is paramount to the interpretation of numbers. Of course, it would be more significant if the numbers were interpreted using explicit theory.

It is, unfortunately, not unusual to read reports of hypothesis testing research conducted by nurses with no mention of any theory that might have guided the research and articulation of the hypothesis. Should we then assume that the researchers are not thinking theoretically? Or, are they unable or unwilling to tell readers what theory was used? As I wrote in a 2019 blog, it is impossible to think atheoretically. Why, then, are so many reports of numbers devoid of any theoretical perspective?

How are we to understand the meaning of numbers about the coronavirus pandemic or climate change without some theoretical perspective? I maintain that it is all nursologists’ responsibility to place all numbers in some theoretical context. For example, nursological conceptual models and theories about primary prevention provide understanding of the extent to which numbers for the coronavirus pandemic are or are not responding to primary prevention interventions (see https://nursology.net/2020/04/21/the-value-of-primary-prevention/). In addition, all nursological conceptual models include attention to the environment, which could easily be extended to encompass the issues surrounding climate change (see my September 24, 2019 post). Furthermore, Nightingale’s theory provides an important nursological perspective for interpreting both pandemic and climate change numbers (see https://nursology.net/2020/05/12/wwfd-what-would-florence-do-in-the-covid-19-pandemic/).

Nightingales’ theoretical perspective of the importance of numbers and the environment is evident in that she “recognized the need to provide an environment conducive to recovery, [and] that data [i.e., numbers] can prompt innovation” (Hundt, 2020, p. 26), and that the effectiveness of theoretically-based innovations is supported by numbers. In particular, for all nursologists “advocating for public policy and conducting research, [theoretically-based numbers] help frame two questions: “How can we improve the health of our communities? Are our interventions making a difference?” (Hundt, 2020, p. 28).

Aula’s (2020) caution about “misplaced trust in numbers” underscores the importance of not only using theory to interpret numbers but also to be wiling to allow the numbers to support rejection of the current version of the theory. Willingness to reject the theory – or at least a hypothesis derived from the theory – is consistent with Popper’s (1965) philosophy of science, which indicates that rejection of the theory leads to a better theory.

“May you live in interesting times” (Wikipedia, 2020) is a widely used saying that may or may not be a positive wish—perhaps it is better to wish to live in uninteresting times that are characterized by tranquility and harmony. I would like to paraphrase a positive interpretation of the saying and offer the wish that all of us may always live in nursological theoretical times and always interpret numbers within the context of nursological theory.

References

Aula, V. (2020, May 15). The public debate around COVID-19 demonstrates our ongoing and misplaced trust in numbers. https://blogs.lse.ac.uk/impactofsocialsciences/2020/05/15/the-public-debate-around-covid-19-demonstrates-our-ongoing-and-misplaced-trust-in-numbers/

Hundt, B, (2020), Reflections on Nightingale in the year of the nurse. American Nurse Journal, 15(5), 26-29.

May you live in interesting times (2020, June 3), In Wikipedia. https://en.wikipedia.org/wiki/May_you_live_in_interesting_times

Popper, K. R. (1965). Conjectures and refutation: The growth of scientific knowledge. Harper Torchbooks.