Are We Ready to Utilize Concept Analyses To Advance Nursology? Could This Be a Way Forward?

Rosemary, we found a recent citation of your research”, is a message I receive from ResearchGate whenever there is a new citation to my work! One message was another citation to one of my early papers (Eustace & Ilagan, 2010), which was the report of a concept analysis of HIV disclosure, published in the Journal of Advanced Nursing. Noteworthy is that this message was a report of the 50th citation to that paper. In the world of knowledge generation, this was particularly exciting news because I realized the impact the paper had for other scholars.  What I didn’t realize was the magnitude of influence the paper had in advancing nursing knowledge. This led me to some random thoughts on who exactly are these authors who cited my work and what was the context of their citations of my paper? A brief review of the citations and literature about the topic indicated that majority were from papers published in non-nursing journals and authored by non-nursing scholars. In addition, I found that some publications from nursing that examined closely related concepts did not cite my work. This surprised me but increased my curiosity about what all of this meant to me as a nursology scholar.

During a recent search of literature, I found an inspiring article by Rodgers et al. (2018) about the limitations of concept analysis. They underscored the importance of “moving knowledge development beyond the level of ‘concept analysis’ to developing a clear linkage to the resolution of problems in the discipline” (p. 451).  I asked myself, how can we do that? Do we have the theoretical and methodological knowledge to do that?  If we do, why are we still “stuck” on concept analysis per se?

These questions prompted me to reflect on my concept analysis of HIV disclosure (Eustace & Ilegan, 2010). I asked myself, what has been done to move beyond the concept analysis of HIV disclosure during the intervening years? A search for the citations using the Semantic Scholar impact search engine (https://www.semanticscholar.org) revealed that one replication of my concept analysis has been published (Kanyamura, Ncube, Mhlanga, & Zvinavashe 2016). Surprisingly, although the impact of the publication indicated was highly influential to others work, especially for background data, the impact of the analysis findings was very limited (see Figure 1). What this meant to me was that there was no indication of linkage of the concept analysis results with knowledge development. Inasmuch as this finding is consistent with Rodgers et al.’s (2018) concern that concept analyses are not being extended to resolve disciplinary problems, how, can we help nurse scholars advance science in this area? Is there a way?

Figure 1: Semantic Scholar Impact Output for the concept of HIV Disclosure by Eustace and Ilagan (2010)

One way forward is to develop clear guiding structures for nursing knowledge development as an essential step in closing the gaps between theory, research, and practice (Marrs & Lowry (2006). To help find a solution, I turned to the well-known approach of Conceptual-Theoretical-Empirical (CTE) structures in nursing that have been advocated for many years by Dr Jacqueline Fawcett (e.g. Fawcett, 1988; Fawcett, 2012). So, where do we start? I propose that nurse scholars consider the following 3 critical steps:

Step 1: Nurse Scholars need to examine where a nursing concept of interest is derived from within our nursing models/theories. For example, the case of the concept of HIV disclosure can be situated within the nursing model of HIV Disclosure developed by Bairan et al. (2007) (i.e. relationship model). It is important for the nurse scholar to indicate the purpose of the concept analysis: is there a need for clarification, development, or refinement or is there little or no literature about the concept? These queries will guide the scholar to the appropriate concept analyses methods. The selection of HIV disclosure, in my case was the lack of a clear definition and a broader perspective of the HIV disclosure process in both the Bairan et al. (2007) model and in other HIV disclosure models (e.g. disease progression (Kalichman, 1995 ); consequences model (Serovich, 2001).

Step 2: Nurse Scholars need to develop a conceptual theoretical empirical (CTE) structure for linking concept analyses to the next step in theory generation. As described by Fawcett and Gigliotti (2001), theory generation studies usually proceed from the “conceptual model directly to the empirical research methods and the data obtained is analyzed creating a new middle range theory” (p. 342). Thus, the CTE structure should direct the nurse scholar to the relevant literature for the concept analysis, which will be summarized and synthesized to identify the antecendents, attributes and consequences of the new descriptive middle-range theory of the concept of interest (see Figure 2 for an example of the CTE structure for the concept analysis of HIV Disclosure). The “C” in the CTE structure represents the HIV Disclosure Conceptual Model by Bairan et al. (2007). The “T” represents the specific concept to be analyzed, which is “HIV disclosure.” The E of the CTE structure indicates the empirical research methods used to generate the antecendents, attributes and consequences of the studied concept, as explained in Walker and Avant’s (2019) approach to concept analysis.

Figure2: Conceptual-Theoretical-Empirical Structure for Linking Concept Analyses to Theory Generation

Figure2

Step 3.  Nurse Scholars need to utilize the findings from the concept analyses to advance nursing knowledge by using the results of the concept analysis to develop/refine theory constructs, develop instruments and then progress to explanatory and predictive theories by linking other concepts of the conceptual model to theory concepts.  So how can scholars use the descriptive middle range theory from the concept analyses to advance existing theory/model development?  Figure 3 provides a CTE structure for a hypothetical study of linking the concept analysis of HIV disclosure to advance the HIV disclosure model by Bairan et al. (2007). The vital step within the CTE structure is the re-evaluation process of the theory of which I have named the “theory refinement” process. In the HIV disclosure example, the original guiding conceptual model by Bairan et al. (2007) needs to be refined utilizing the antecedents, attributes and consequences derived from the concept analysis of the HIV disclosure concept. Scholars should utilize the results of the analysis to assess the adequacy of the constructs of the HIV disclosure model and propose directions for further empirical inquiry to determine the theory’s credibility in clinical practice and advancing the discipline.

Figure 3 – A hypothetical Conceptual-Theoretical-Empirical Structure for the HIV Disclosure Concept Analysis by Eustace et al. (2010)

Here are some epistemological considerations if we choose to move forward with this approach:

  1. How can we best approach T in the CTE structure? In this case, how should nursology theorists guide scholars on how to systematically develop constructs from the descriptive middle range theory to be utilized in refining the concept for the existing theory/model?
  2. What strategic and systematic approaches should we employ to retrieve, summarize, and synthesize the evidence for concept analyses, report findings and, lastly evaluate empirical studies on the concept analyses -theory generation linkage? How can we standardize the documentation process during knowledge dissemination? For example, documenting the specific date ranges when evidence was retrieved, dates when the publication was received, revised, accepted, published online and in the journal.
  3. How should we move forward in designing shared CTE structures that are empirically adequate in nursing situations (Villarruel, Bishop, Simpson, Jemmott, & Fawcett, 2001). For instance, how can we generate a global nursing HIV theory model and also contribute to knowledge development of a global interprofessional HIV Disclosure model?

 

A Call to Action:

ARE YOU READY to end what Draper (2014) calls the “intellectual dead end” (p. 1208) of concept analyses in nursing? If so, join me in articulating and advocating for approaches that facilitate the use concept analyses as the starting point for advancing nursing knowledge. Developing nursology focused CTE structures that link concept analyses to other relevant practice phenomena are timely and very much needed to meet the demands of the complex 21st health care delivery systems. I welcome any comments or suggestions from nursologist around the world on how we can better address this ongoing concern as we think about advancing nursing science for the Future of Nursing 2030.

References

Bairan, A., Taylor, G. A. J., Blake, B. J., Akers, T., Sowell, R., & Mendiola Jr, R. (2007). A model of HIV disclosure: Disclosure and types of social relationships. Journal of the American Academy of Nurse Practitioners, 19, 242-250.

Draper, P. (2014). A critique of concept analysis. Journal of Advanced Nursing70, 1207-1208.

Eustace, R. W., & Ilagan, P. R. (2010). HIV disclosure among HIV positive individuals: A concept analysis. Journal of Advanced Nursing66, 2094-2103.

Fawcett, J. (1988). Conceptual models and theory development. Journal of Obstetric, Gynecologic, & Neonatal Nursing17, 400-403.

Fawcett, J. (2013a). Thoughts about conceptual models and measurement validity. Nursing Science Quarterly26, 189-191.

Fawcett, J. (2013b). Thoughts about multidisciplinary, interdisciplinary, and transdisciplinary research. Nursing Science Quarterly26, 376-379.

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

Kalichman, S. C. (1995). Understanding AIDS: A guide for mental health professionals.  Washington, DC: American Psychological Association.

Kanyamura, D., Ncube, B., Mhlanga, M., & Zvinavashe, M. (2016). HIV Disclosure: Concept AnalysisJournal of Research in Pharmaceutical Science, 3(4), 1-4.

Marrs, J. A., & Lowry, L. W. (2006). Nursing theory and practice: Connecting the dots. Nursing Science Quarterly19, 44-50.

Rodgers, B. L., Jacelon, C. S., & Knafl, K. A. (2018). Concept analysis and the advance of nursing knowledge: State of the science. Journal of Nursing Scholarship50, 451-459.

Serovich J.M. (2001). A test of two HIV disclosure theories. AIDS Education Prevention, 13(4), 355–364

Villarruel, A. M., Bishop, T. L., Simpson, E. M., Jemmott, L. S., & Fawcett, J. (2001). Borrowed theories, shared theories, and the advancement of nursing knowledge. Nursing Science Quarterly14, 158-163.

Walker, L. O., & Avant, K. C. (2019). Strategies for theory construction in nursing. New York, NY: Pearson Education Inc.

Dolores (Dee) Krieger (1921-2019)

Guardian of the Discipline

Dolores (Dee) Krieger, RN, PhD, was a professor emeritus in what was the Division of Nursing at New York University (NYU) in New York City, when she retired.

Dee was born in Paterson, New Jersey, not far from New York City. She earned a diploma in nursing at the Westchester School of Nursing at Grasslands Hospital in Westchester, NY, and baccalaureate, master’s and PhD degrees in nursing at NYU. She was residing near Columbia Falls, Montana, at the time of her death.

Dee taught at NYU for many years, where “she developed innovative curricula. Her graduate course, Frontiers in Nursing, became a model for many other groundbreaking classes in the field of healing” (Therapeutic Touch International Association [TTIA], 2019).

Dee clearly lived the life of a Guardian of the Discipline, especially with her commitment to advancing the innovative non-invasive modality of Therapeutic Touch (TT). Indeed, Dee is best known for her co-founding, with Dora Van Gelder Kunz, of TT, which she taught and gave workshops in at NYU for many years. “In 2010, [Dee] extended the concept of Therapeutic Touch to include the idea of Therapeutic Touch Dialogues which [were designed to explore] in depth the future consciousness of the TT process, research and theory. . . . In 1979, [Dee] established Nurse Healers Professional Associates (NHPA) which eventually became known as Therapeutic Touch International Association” (TTIA, 2019).

Dee “traveled internationally as a teacher and speaker and her many books have been translated into at least nine languages. Thousands of people spread around the world have learned to practice and teach Therapeutic Touch . . . to bring this compassionate work to those in need. Her work is carried on by a cadre of professionals who will extend Therapeutic Touch into the future both theoretically and in everyday healing interactions” (TTIA, 2019). Barrett (2003) pointed out that Dee had taught TT to “48,000 professionals and numerous laypersons.” Barrett (2003) added, “Aside from Florence Nightingale, probably more people recognize the name Dolores Krieger than that of any other nurse throughout history. Her first book on TT is in its 37th printing, and she has written 4 more books on TT.

Dee received many awards for her teaching and TT work, including a Distinguished Alumni Award from NYU (1982) “and the Alice and Elmer Green Award for Excellence from the International Society for the Study of Subtle Energies and Energy Medicine in 1997” (TTIA, 2019). Another award, for holistic healing, was bestowed in 2003 by the Open Center. On that occasion, Barrett (2003) commented  that Dee’s “pioneering work in [TT] has had a profound impact on the practice of healthcare worldwide. Through her lectures, workshops, and writing over the past [2.5] decades, she has helped to bring holistic healing into the mainstream.” The Open Center award is especially noteworthy, as it was “the first award [given] to a nurse and [the Open Center’s] first award in holistic healing” (Barrett, 2003).

However, being an innovator rarely is without challenges from the mainstream. Indeed, as Barrett (2003) indicated, Dee had “withstood political slings and arrows with courageous perseverance. She recently reminded me that she simply responds to misinformation, misinterpretation, and misunderstanding about [TT] with that powerful ally the truth.”

Despite the challenges, Dee’s work has had a substantial impact on healthcare in general and nursology in particular. That impact is evident in the results of a recent search of the Cumulative Index to Nursing and Allied Health Literature (CINAHL), which revealed the vast reach of Dee’s work (see Table).


References

Barrett, E. A. M. (2003, April 6). Introduction of Dolores Krieger on the occasion of receipt of an award for holistic healing from the Open Center. (Personal communication to J. Fawcett, August 3, 2019.)

Therapeutic Touch International Association. (2019). Dr. Dolores “Dee” Krieger: Obituary. Retrieved from http://therapeutictouch.org/

The Environment, Climate Change, and the #Climate Strike: A Nursology Perspective

with contributions by Peggy Chinn
Also see Adeline Falk-Rafael’s “addendum” to this post below

The nursology.net management team agreed to participate in the September 20, 2019 #Climate Strike – Nursology.net went to a  green screen acknowledging the importance of this public action for the entire day on September 20th. By doing so, we joined people “[i]n over 150 countries . . , to support young climate strikers and demand an end to the age of fossil fuels. The climate crisis won’t wait, so neither will we.” (from Global Climate Strike)

Climate can be defined as “characteristic weather conditions of a country or region; the prevalent pattern of weather in a region throughout the year, in respect of variation of temperature, humidity, precipitation, wind, etc., esp. as these affect human, animal, or plant life” (Oxford English Dictionary, 1889/2008)

The lack of sufficient attention to widely documented climate change by so many people, is, of course, the impetus for #Climate Strike. Climate change is defined as “an alteration in the regional or global climate; esp. the change in global climate patterns increasingly apparent from the mid to late 20th cent. onwards and attributed largely to the increased levels of atmospheric carbon dioxide produced by the use of fossil fuels .”(Oxford English Dictionary, 1889/2008).

The nursology.net management team’s concern with climate reflects our heritage of Florence Nightingale’s emphasis on environment and the effects of environment on human beings’ health status. Climate is, of course, a major aspect of environment, although climate is rarely mentioned in nurse theorists’ discussions of environment. An exception is found in the content of Orem’s self-care framework. Orem (2001) referred to two dimensions of what she labeled environmental features–physical, chemical, and biological features; and socioeconomic cultural features. Physical and chemical features include what typically is thought of as at least part of the climate—the atmosphere of the earth, gaseous composition of air, solid and gaseous pollutants, smoke, [and] weather conditions (Orem, 2001). Another exception is found in the content of a new conceptual model—the Conceptual Model of Nursology for Enhancing Equity and Quality—Population Health and Health Policy (Fawcett, in press). Following a suggestion from a PhD nursology student at the University of Massachusetts 2018 Five Campus PhD Forum, climate was explicitly included in this conceptual model in the definition of the physical environment.

Two recent nursing scholars have given primary focus on the environment in their work; their work provides important foundations for nursing action. Patricia Butterfield’s Upstream Model for Population Health (BUMP Health) provides a framework for addressing general issues related to health and the environment at a population level (Butterfield, 2017).  Dorothy Kleffel has been a thought-leader in nursing for more than 2 decades pointing the way toward a nursing focus on the environment and its effect on health (Kleffel, 1996).

A recent search of the Cumulative Index to Nursing and Allied Health Literature (CINAHL Complete), using the search terms, climate AND nursing, yielded 1,875 publications. However, a search using the terms, climate change AND nursing, yielded only 186 publications Two particularly informative publications are scoping reviews of the literature (Hosking & Campbell-Lendrum, 2012; Lilienfeld, Nicholas, Breakey, & Corless, 2018). Another informative publication is a call for action (Travers, Schenk, Rosa, & Nicholas, 2019).

Contemporary interest in environment and climate change has been prompted by two global initiatives–the 2008 World Health Organization (WHO) Member States World Health Assembly resolution (Hosking & Campbell-Lendrum, 2012) and the United Nations (UN) Sustainable Development Goals (Lilienfeld et al., 2018). The WHO resolution supports progress on studies of the effects of climate change on human health, including health vulnerability, health protection and its costs, the impact of migration and adaptation policies, and decision-support and other tools. Other health effects of climate change include an increase in communicable and noncommunicable diseases, weather-related injuries, mental health disorders, and effects of nutritional deficiencies on growth and development (Lilienfeld et al., 2018).

Hosking and Campbell-Lendrum’s (2012) scoping review of literature published between 2008 and June 2010 yielded 40 relevant papers. Of concern is that none of the papers were reports of studies of effective interventions, which clearly was a major gap in our literature of that time. Lilienfeld et al.’s (2018) scoping review placed climate change with the context of nursology. They identified and categorized 48 papers in their search of literature from 1996 to 2018, only a few of which were research reports. The categories are;

  • Background of climate change
  • Health consequences
  • Nursing knowledge and attitudes
  • Reference to UN Millennium Development Goals and/or the UN Sustainable Development Goals
  • Migration and/or adaptation strategies
  • Urgency
  • Plan
  • Climate justice

Once again, a major gap is research, especially the design and testing of interventions.

Travers, Schenk, Rosa, and Nicholas’ (2019) call for action by nurses may be the catalyst needed to advance nursology’s contribution to filling the gap in the literature. They underscored the findings of previous literature reviews revealing the effects of climate change on the environment and, consequently, on human health. Their call for action, which encompasses research, education, advocacy, and practice, exhorts nurse “to step up and see themselves as part of the solution to climate change” (Travers et al., 2019, p. 11).

There is, however, little evidence that nurses have begun to step up, to move beyond “talk about what needs to be done” (Travers et al., 2019, p. 11). As reported in The Washington Post (Tan, 2019), nurses are continuing to talk about climate change. An encouraging development is nurses’ willingness to join climate-oriented organizations as they increase their awareness of and even experiences of recent natural disasters, including hurricanes, wild fires, floods, and tornados (Tan, 2019).

The global action of the #Climate Strike, including worldwide demonstrations led by teenagers on Friday, September 20, 2019, and planned future Friday demonstrations certainly is encouraging. Perhaps these demonstrations will be a catalyst to actions by nursology students, faculty, and practitioners to conduct the research needed to identify effective interventions to mitigate the deleterious effects of climate change on human health. Perhaps, too, these demonstrations will move the UN and federal governments worldwide to fund that research.

Nursology is founded on a holistic conceptual orientation that points the way to recognizing the role of environment on human health, and toward nursing action to respond to this global crisis. It is time for nursologists and nursing as a discipline to step up to the challenge and provide a leading voice for healing the planet, for healing those who are harmed by the climate crisis, and join the many others who are demanding social and political action now to turn this crisis around.

Addendum by Adeline Falk-Rafael: Watson’s early publications of her philosophy and science of caring also explicitly identified the provision for “supportive protective and(or) corrective” environments, including specifically the physical environment as a carative factor. Although her language has changed, I believe the intent has not. That aspect of her theory was one key which led me to develop the mid-range theory of Critical Caring, based on her and Nightingale’s work (although my thinking has also been influenced by Butterfield’s and Kleffel’s work). Note: Adeline  (who is on our management team) was hiking in the Alps when we prepared this post!  Thank you Adeline for adding this important information to this post!)

References

Butterfield, P. G. (2017). Thinking Upstream: A 25-Year Retrospective and Conceptual Model Aimed at Reducing Health Inequities. Advances in Nursing Science, 40, 2–11. http://dx.doi.org/10.1097/ANS.0000000000000161

Fawcett, J. (in press). The conceptual model of nursology for enhancing equity and quality: Population health and health policy. In M. Moss & J. Phillips (Eds.), Health equity and nursing: Achieving equity through population health & public policy. New York, NY: Springer.

Hosking, J. & Campbell-Lendrum, D. (2012). How well does climate change and human health research match the demands of policymakers? A scoping review. Environmental Health Perspectives, 8, 1076-1082.

Kleffel, D. (1996). Environmental Paradigms: Moving Toward an Ecocentric Perspective. Advances in Nursing Science, 18, 1–10. https://doi.org/10.1097/00012272-199606000-00004

Lilienfeld, E., Nicholas, P. K., Breakey, S., & Corless, I. B. (2018). Addressing climate change through a nursing lens within the framework of the United Nations sustainable development goals. Nursing Outlook, 66, 482-494.

Orem, D. E. (2001). Nursing: Concepts of practice (6th ed.). St. Louis, MO: Mosby.

Oxford English Dictionary (1889/2008). Definitions of climate and climate change.

Tan, R. (2019, September 20). Why nurses, America’s most trusted professionals, are demanding “climate justice.” The Washington Post. Retrieved from
https://www.washingtonpost.com/local/why-nurses-americas-most-trusted-profession-are-speaking-out-against-climate-change/2019/09/19/1c5314d8-dae2-11e9-a688-303693fb4b0b_story.html

Travers, J. L., Schenk, E. C., Rosa, W. E., & Nicholas, P. K. (2019). Climate change, climate justice, and a call for action. Nursing Economic$, 37, 9–12.

Happy Anniversary/Happy Birthday to Nursology.net!

We invite all of our visitors to join with us in developing this important resource!  Contact us with your interest and ideas!
This site is developed and managed solely by nursologist volunteers so our costs are minimal, but we welcome contributions to help assure the site’s future!!

Jacqueline Fawcett:

Jacqueline Fawcett

This is a very special blog, as we are celebrating the first anniversary/first birthday of the launch of nursology.net on September 18th. From a chronological developmental perspective, the website is transitioning from infancy to early childhood. However, given the amount of content already posted on this website, the weekly blogs, and the number of nursologists from many, many countries who have accessed the website, I dare to declare that we never were infants and now are mature adults! I am especially grateful to Peggy Chinn, our outstandingly superb webmaster, for her fabulous and steadfast work to create the website, the forms for submission of content and other items, many of the weekly blogs, and everything else that is needed to maintain the vibrancy of nursology.net. I also am very grateful to all members of our management team, whose interest in and enthusiasm for preserving our discipline has fostered so much success in one short year. In addition, I am very grateful to all other nursologists who have contributed content to the website, to those who have written blogs, and to those who have added comments to the blogs. I continue to welcome all nursologists to nursology.net—to view what is on the website, to contribute content, to submit blogs, and otherwise share your thoughts about nursology and all the wonderful work you are doing. The remainder of this blog is contributions from some of the members of our management team; I thank them for sharing their thoughts on the occasion of nursology.net’s first anniversary/birthday.

Peggy Chinn

Peggy Chinn:

When we first conceived of the website that we decided to call “nursology.net,” I certainly never imagined that the site would grow and develop as it has in just the first year! First, even though I have been immersed during my entire career in scholarship around the development of nursing knowledge, I honestly had no idea of the vastness, diversity, and widespread commitment that nurse scholars have demonstrated over the 50=plus years of nursing knowledge development. Those of us who have contributed to the development of the website knew one another professionally, and we all had deep respect for the scholarship that each of us brought to the table. But once we put all of our insights and expertise together in the tangible reality of the website, lo and behold, what we had was much larger than any of us imagined! During the past several months, I have had the opportunity to provide live “deep dives” into the website to demonstrate what is actually here – and with each occasion, everyone who participates leaves amazed at the true vastness of information that is here! As we look forward to the coming year, we will continue to add to the information in each section of the website, but our main focus will be to develop more thoroughly the “Exemplar” sections. After all, each of us involved in the site are nurses first – so our primary concern is using the theoretical ideas, our scholarship, to inform, shape, and re-shape our practices! We believe that nursing perspectives are necessary and valuable – that we offer dimensions that are respected by other disciplines. However, if we do not bring our perspectives as a central concern to each of our practices, something that is extremely valuable will be missing. Nursing perspectives do make a difference in practice, research, education, policy, and quality improvement – and each of the exemplar sections will continue to grow to demonstrate more clearly what that difference is!

Marlaine Smith:

Cheers to nursology.net on its one year anniversary! In only one year, nurses throughout the world have accessed nursology.net, offering us a valuable resource for learning more about the knowledge within the discipline. It is amazing to explore and discover the rich contributions, detailing the development and application of nursing theories of all levels in practice, education, and policy. Thank you to Drs. Peggy Chinn and Jacqueline Fawcett for their leadership in launching and advancing this website and thanks to all the contributors. Here’s to many more productive years of growing nursology!

Danny Willis:

When I pause to celebrate the one year anniversary/birthday of nursology.net, what comes up for me is a sense of hope for the future! Nursology is the substantive perspective that makes the difference in human and environment wellbecomng and alleviation of human suffering. Nursology addresses What Matters Most!” The philosophical, conceptual, theoretical, and empirical contributions that have shaped the discipline and profession are reflected at nursology.net. For nursologists everywhere, nursology.net provides a venue to be engaged in the knowledge endeavor, discerning clear direction should we get distracted. nursology.net is a wonderful resource for the world right here and right now, at our fingertips !! I look forward to continuing to participate in the evolution.

Dorothy Jones:

Nursology.net has become a global phenomenon, offering nurses from around the world immediate access to nursing knowledge and historical developments in nursing theory, education, research, and practice. When I presented the site to doctoral students in Spain, one student noted, “Having access to this site (for free) not only exposes us to information we do not have in our libraries but helps to connect us to our science in a new way. Thank you”. The continued development of nursology, with attention to presentations [in] other languages, will continue to grow the site and expand nurses’ ability to access knowledge and increase disciplinary dialogue around the world.

Dr. Eustace

Rosemary Eustace:

As we celebrate the one year anniversary of nursology.net,, we acknowledge the contributions of many of our founders and nursing scholars to evidence-based nursing (EBN). We call upon our fellow nurses around the world to advocate for the future of nursing that advances nursing science by developing, utilizing, and evaluating EBN to create a culture of health, promote social and financial justice, and increase access and responsiveness to evidence-based health care services.

Margaret Dexheimer Pharris:

Nursology.net has gotten off to a running start! In the past year, nursology.net leaders helped shape and participated in the 50th anniversary nursing theory conference at Case Western Reserve University (see Peggy Chinn’s conference keynote); several nursing journal editors have written about nursology.net in their journals; the American Academy of Nursing’s (AAN) Nursing Theory-Guided Practice Expert Panel has grown to be one of AAN’s largest expert panels; and, there have been over a dozen major nursology related conferences throughout the world. This resurgence of commitment to nursology practice and research rooted in the knowledge of the discipline provides a springboard propelling nursologists to ensure that nursing theory is woven through national nursing education guidelines for all professional levels, that every nurse can clearly articulate the difference that nursology makes because of its theories and philosophical perspectives, and that in the U.S., the National Institute for Nursing Research (NINR) be directed by a nursologist who understands the importance of grounding all NINR funded research in nursing theories and philosophies. These and many other efforts in which nursologists are engaging serve to holistically and equitably enhance the human experience of health. The year 2020 holds great promise for nursology to reach new heights!

Deborah Lindell:

Happy first anniversary to Nursology.net! This site serves a valuable service to all nurses by raising awareness of the essential role nursing knowledge plays in the discipline of nursing. It provides in-depth, understandable information about nursing knowledge in a variety of formats. I especially like the Guardians of the Discipline and the blog which promotes dialogue about current topics in nursing knowledge. I’ve integrated Nursology.net as a required resource in my DNP and MSN theory courses.

Thinking about Ideas in Nursing: 13th Philosophy in the Nurse’s World/23rd International Philosophy of Nursing Society Conference

Welcome to Jessica Dillard-Wright, who has now joined our
Nursology.net blogging team!
Jessica is a founding member of the
Nursing Theory Collective and
currently a PhD Student at Augusta University (Georgia)

I knew I was going to love Moby-Dick when I read the line, “Whenever I find myself growing grim about the mouth; whenever it is a damp, drizzly November in my soul; […] especially whenever my hypos get such an upper hand of me, that it requires a strong moral principle to prevent me from deliberately stepping into the street, and methodically knocking people’s hats off – then, I account it high time to get to sea as soon as I can” (Melville, 1851/1953, p. 17). And I did love it, still do. Sometimes the hypos get the upper hand of me, too, in particular when I am mired in the politics of nursing and education (not to mention the state of affairs we find ourselves in more broadly in the United States). This is especially the case when my ideas feel a couple of standard deviations outside the nursing norm. And then I find my way toward the niches and corners where other nurse dissidents reside and it’s like being at sea. 

The 13th Philosophy in the Nurse’s World/23rd International Philosophy of Nursing Society Conference was held August 18-20, 2019 in Victoria, B.C., a glorious coastal town IPONSlogothat satisfies the seaward impulse and welcomes a conference full of nursing philosophers. Dr. Thomas Foth’s opening plenary on the evening of the 18th softened my perioral grimness, asking us to contemplate the disciplinary apparatuses imposed through humanitarian efforts, focusing specifically on Canadian harm reduction and safe injection efforts for intravenous drug users. Here, Foth made the case that such humanitarian efforts paradoxically perpetuate individualist downstream interventions while failing to address structural inequalities. To this end, humanitarian efforts then shore up the neoliberal state, which in turn reproduces individual inequality and suffering. Foth concluded that the way forward for nursing was political action, oriented toward structural solutions to eliminate the foundations of human suffering. 

The question of politics was picked up in the second plenary session on the morning of the 19th, delivered by Dr. Sally Thorne. Thorne advanced a discussion of Carper’s ways of knowing in which she critiqued the dimension of personal ways of knowing. Thorne cited anti-science views held and advanced by some individual nurses, using anti-vaccination beliefs. Thorne urged nurses to develop a collective set of priorities and to use these priorities as a way to advance nursing writ large in an effort to avoid getting mired in individual nurses’ politics and beliefs. Following Thorne’s plenary, the concurrent sessions began.

In Dr. Kylie Smith’s collaboration with Foth on nursing history as philosophy, my soul found further refuge as Smith unpacked the complex legacy of nursing, the notion of care, and the work required for nurses to contribute to health equity and social justice. This marked another commonality in the concurrent sessions, which explored the hidden and suppressed stories of nursing, including the history of nursing, the colonialist and racist narratives housed within nursing’s assumptions, and the connection of nursing to greater social, cultural, and global challenges like climate injustice, enforced ignorance, and the impact of capitalism.

The critical thread that kicked off the conference was again picked up in a remarkable series of papers in the final concurrent session Dr. Marilou Gagnon first gave a concept analysis of the notion of “whistleblowing” in nursing, unpacking the complexity and muddiness of the concept. This was followed by Dr. Amelie Perron’s talk on the effects of ignorance and knowledge in nursing, advancing the idea of whistleblowing as an act of “epistemic disobedience,” challenging hegemonic order in nursing and healthcare systems. Together, Gagnon and Perron are directing the Nursing Observatory, a project focused on analyzing, acting, amplifying critical perspectives in Canadian nursing. The closing plenary was delivered by Dr. Janet Rankin, an empirical analysis of the “ruling forces” that shape nursing practice as nursing becomes increasingly technologically-dependent.

Of note, in contextualizing ideas in the nurses’ world, most of the papers (including those not commented on specifically here!) connected nursing to “outside” ideas like posthumanism, New Materialism, radical feminism, intersectionality, poststructuralism, neoliberalism, and social justice, situating nurses as political agents, encouraging nurses to engage critically with the ideas and influences that impact their practice, the communities they serve, their profession, and the world around them. A balm for the November drizzle, “the great flood-gates of the wonder world swung open” (p. 21) revealing possibility for nursing praxis, education, philosophy, and policy (Melville, 1851/1953). A call to political action for nursing. If you are interested in reading more, you can find the concurrent session abstracts here.

Currently, the International Philosophy of Nursing Society website is under construction but IPONS would love to have you. Please contact Mark Risjord at mrisjor@emory.edu to join. Look for more information soon on the IPONS conference for 2020, which will be held in Gothenburg, Sweden. 

References

Melville, H. (1953). Moby-dick or the white whale. London, UK: Collins Clear-Type Press.

(Original work published 1851).

 

This was written in conjunction with Jane Hopkins Walsh, who also attended IPONS 2019.

Nursing Journal Editors 2019 Annual Conference: A report

Introduction by Peggy L Chinn, Editor, Advances in Nursing Science

Every year for the past 38 years, nursing journal editors have met to discuss issues in publishing and editing, challenges in the discipline that influence nursing literature, and to educate ourselves to maintain the highest standards of journalism in nursing.  The conference is planned, hosted and conducted by volunteer journal editors who are members of the International Academy of Nursing Editors (INANE).

This year was no exception – we heard from experts about the latest developments that influence how people find and use our literature, the emerging trends in scholarly publishing, including the  latest developments in standards for scholarly writing and ways of attributing cited works, and thought-provoking discussions of the nature of “evidence” and the ways in which our nursing literature provides knowledge, facts and insights that shape nursing practice.  You can see details of the program here.

Nursology.net was very visible at this year’s conference – this is the first year of the INANE conferences since the website was established in September 2018!  We provided ball point pens for all participants, and each speaker received a gift of a Nursology.net tote bag!  We also provided a breakout session and a poster to make sure that everyone at the conference knew the wonderful resource that is now available on the website for our journals and their readers!

Several of us who are on the Nursology.net management team were in attendance – here are some of our reflections:

Jane Flanagan – Editor, International Journal of Nursing Knowledge

As always, I enjoyed this conference because I see my editor friends, we have fun and I learn so much. Editing is sort of a solo act. The journal has your name on it and you want to put out the best product, but its an industry and with that are constant changes. And keeping up – well that is done at odd hours of the night because it is something we all fit in to our busy schedules. This lends itself to lots of moments where you think: “I wonder if anyone has ever dealt with this or that sort of issue”.  Thus the INANE annual conference where we can bring our questions.  It  is a low key event and because of that, we share openly.  We learn so much from each other and it creates a situation where we are part of something bigger than just the journal we edit. I find I always pick up many pearls of wisdom at the annual conference. I presented with Peggy Chinn on nursology at this conference. In a comedy of errors, Jacqui Fawcett was supposed to be with us, but could not get out to Reno due to storms. She had our poster. No worries, we just presented using our computer, which in that space worked.  Then there was the podium presentation and alas, the wrong PowerPoints were loaded and the Internet that was so vital to our presentation refused to cooperate so we winged it. No problem in this audience. They adapted to whatever we did, asked great questions and a wonderful dialogue ensued.  That’s INANE – no pressure, just collegial support.  Lastly, I want to make a plug for the auto museum in Reno – a pleasant surprise and brilliant choice for a reception – lots of laughs and amazing collection of cars – who knew? Already looking forward to Nashville!

Marlaine Smith – Advisory Board, Advances in Nursing Science

This was my first INANE Conference and I had a fabulous time.  It was a gathering of about 160 editors and publishers of nursing journals. I consider these women and men to be the current guardians of our disciplinary literature.  It is such an important responsibility.  They and their editorial boards and reviewers shape the visible and accessible knowledge of our discipline. I found the presentations to be informative, and most importantly very open and collegial.  The sessions were peppered with lots of dialogue.

I was honored to give one of the ending keynotes…title was “In Search of Knowledge for Nursing Praxis Beyond Evidence”.  I reviewed the literature from the 90s to present that critiqued our fascination, if not obsession, with “evidence-based practice”.  While EBP is important, “evidence”, as commonly thought of,  is not the only or most important knowledge to inform nursing practice. We need an epistemology for nursing praxis that is founded on the philosophies and theories of nursology and includes the depth and diversity of all patterns of knowing.  Editors, editorial boards, reviewers, faculty and practice leaders can be influential in several ways: 1) Adopt a balanced perspective on what is worthy of publication – one  that values all patterns of knowing; 2) Include in criteria for reviewers some connection to nursing’s disciplinary focus; for example, “How does this manuscripts contribute to knowledge of the human health experience?” or ”How does this author express a value for nursing’s disciplinary knowledge, that is the philosophical and theoretical perspectives of the discipline? Are relevant nursing theories cited? Reviewers and editors should review references with an eye toward the inclusion of sources from nurse authors and nursing journals; 3) Foster the development of new epistemic forms to inform praxis.  How do we develop literacies for understanding the wholeness of the human health experience? How do we develop, teach and encourage a praxis epistemology that integrates multiple sources of knowledge; and 4) Nursing research and evidence-based practice projects should be grounded in the disciplinary perspective and nursing theory.  As we guide students and review manuscripts, we need to consider what nursing theories are relevant to the studies or projects that are not cited?

Kudos to Leslie Nicoll, Peggy Chinn and the planning committee for pulling off this amazing conference in Reno.

W. Richard Cowling III – Editor, Journal of Holistic Nursing

This was my first INANE conference and there was much to impress, but my two main high points were the Nursology and the COPE sessions. The dialogue in the Nursology session reflected in many ways a great yearning for elaborating the distinctiveness of nursing through advancing knowledge based on nursing theory models. At the same time, I realized that much has been lost in the past few decades with the distraction of nursing toward medically based models of care. Some equate nursing theory and knowledge with particular conceptual and theoretical frameworks rather than the potentials to advance human betterment through the theoretical thinking nurses bring to health care because of there peculiarly essential relationships with persons, families, and communities. The COPE sessions struck me as invaluable from my perspective as a journal editor and writer because of the way the complexities of ethical issues pervade the publishing world. What the COPE leaders and community bring to this is a rich dialogue and exchange the uncovers new ways of understanding ethical issues as they impact writing and scholarship more broadly.

Jacqui Fawcett – Reviewer and advisor for several major nursing journals

My adventure for INANE 2019 encompassed

  • On July 30, A flight from my local airport in Rockland, Maine, to Boston–on time departure and arrival
  • On July 30, A flight from Boston to Denver–on time departure, arrival 4 hours late due to diversion to Cheyenne, Wyoming due to thunderstorms and wind in Denver and need for refueling
  • A cancelled flight from Denver to Reno
  • On July 30, A return “red eye” flight from Denver to Boston–slightly delayed departure due to waiting for other passengers, close to on time arrival in Boston very early in the morning of July 31.

Inasmuch as I would not have been able to get to Reno until (hopefully) some time on July 31 and, therefore, would have missed a session I was scheduled to moderate and at least the poster session and perhaps the paper  I was to present with Peggy Chinn and Jane Flanagan, and the cost of a hotel room in Denver for the night of July 30 was outrageous, I decided to return to Boston on July 30.

Thus, I  regretfully never did get to Reno for INANE 2019.

Fortunately, Peggy and Jane did get to Reno and presented our poster and paper.  Given the convenience of electronic communication (email), I was able to send the final version of our presentation to Peggy and Jane as soon as I arrived in Boston very early on July 31.

Furthermore, Leslie Nicoll was able to find someone else serve as the moderator for the session I was supposed to moderate. I thank Leslie and whoever filled in as the moderator for me.

I look forward to actually attending an INANE meeting in the near future!

Leslie Nicoll – Planning Committee and all-around INANE Gadfly! Editor, CIN (Computers Informatics Nursing) and Nurse Author & Editor

Jacqui–I look forward to seeing you at the INANE Conference next year–everyone, put it on your calendar: INANE 2020, Nashville, TN, August 2-5, 2020.

I have been a journal editor since 1995 and attended my first INANE that summer–in London. I was a happy participant for many years but in 2014, when we hosted the conference in Portland, ME, I became truly committed to the cause (it is a cause as we are all volunteers!) and have worked very hard to “raise the bar” for INANE. Every year people say, “This is the best INANE ever!” and then we try to top it the next year–and have managed to do so for 6 years. It is important that we continually push ourselves in terms of the content that is presented, because as Marlaine noted, the women and men in attendance are the “guardians of the disciplinary literature.” As such, we have a responsibility to ensure that we are adhering to best standards of scholarly publication; dealing appropriately with ethical issues that might arise; communicating  effectively with all stakeholders–not just authors; and being “ahead of the curve” on current trends and innovations that will impact our work and publications.

As a key planner for INANE, I work hard to put together a conference which includes keynote sessions, panel discussions, breakout and poster sessions, plus time for networking. This is all done to meet the key responsibilities noted above. This year’s conference was no exception. Our keynote speakers included two nurses, a physician, and a librarian (with a prior career in nursing) who brought diverse points of view to share with the audience. Breakout sessions and posters tend to be from those more directly involved in INANE and are a wonderful way to learn about emerging research and the day-to-day editorial work of our peers .

I believe it is important to provide stimulation to the right side of brains (which opens the left side for maximum learning!) and we do this at INANE with our opening gala speaker. This year, Carolyn Dufurenna, who describes herself as a “rancher and poet,” joined us to get the show on the road (literally) and for me, she was a highlight. Everyone else was great, too, but Carolyn just added a little extra flair. She loved speaking at INANE and would welcome future invitations to present to nurses. Keep that in mind if you are planning a conference in the Reno or nearby!

Maybe the best thing about INANE is that it is big enough to stimulate lots of discussion, but small enough so that everyone feels like they have a chance to meet everyone else. It is certainly the highlight of my year–I am already looking forward to Nashville! I hope to re-connect with many friends but also have the chance to make new friends. To those reading this who don’t know me–I look forward to meeting you at INANE!

 

 

An Update from the Nursing Theory Collective

Welcome to Chloe Olivia Rose Littzen, who has now joined our
Nursology.net blogging team!
Chloe is a founding member of the
Nursing Theory Collective and
currently a PhD Student at the University of Arizona (Tuscon)

I. Introduction

In June of this year, a blog post was shared on Nursology.net by the Nursing Theory Collective, a group of scholars and students with a mission to advance the discipline of nursing/nursology through equitable and rigorous knowledge development using innovative nursing theory in all settings of practice, education, research, and policy. (Visit that post here). We are using the term nursing/nursology as at this moment in time as we continue to have discourse on the exact word choice we will use to characterize ourselves as a collective. 

To review, the Nursing Theory Collective was formed after the landmark conference, “Nursing Theory: A 50 Year Perspective Past and Future”, on March 21-22, 2019 at Case Western Reserve University. Since May, the group has met monthly to further discuss pivotal issues related to nursing theory and the identity of nursing/nursology, define their mission and vision statement, and to establish action items to drive their vision forward. Currently, the Nursing Theory Collective has 45 members from around the world including Canada, China, Colombia, and the United States, promoting a global perspective of nursing and nursing theory. 

To promote global connectivity, the Nursing Theory Collective created a WhatsApp (https://www.whatsapp.com) group for an easily accessible format that members in other countries can easily connect via their smartphones. In this WhatsApp group, members discuss pertinent issues related to nursing theory and the identity of nursing, sharing articles, actions in progress, or reminders for actions that evolved from previous meetings. Our meetings have been hosted via Zoom Video Conferencing (https://zoom.us) which enables access to participate in most countries, and has allowed us to record all meetings for future reference. A shared Google Drive was also created, enabling all members to have access previous document, to assist in the development of future action items, and to collaborate in real time. 

II. Updates 

To date, the meetings for our collective have revolved around discussions on actions items that can be taken to move the discipline of nursing and nursing theory into the future. In order to accomplish our collective goals, we have been working to define our mission, vision and values, and establishing logical action plans in the forms of scholarly writing and policy letters. In the following paragraphs, you will find a brief synopsis of all the action items that are in progress or completed. 

Mission, Vision, and Values. We have been working diligently on defining our mission, vision, and values as a collective. We recognize that this is a work in progress. We have been inspired by the vast body of prior nursing knowledge and theory work in the United States and abroad, as well as our individual philosophies of nursing. Guiding our mission, vision, and values is a concise definition of nursing theory first advanced by a working group of international nurse theorists, who proposed that nursing theory is simply “a description of what is going on” (Petrovskya, Purvis, & Bjornsdottir, 2019, p.2). Petrovskya, Purvis, and Bjornsdottir’s (2019), elegant definition, adopted from Rolland Munro, invites nurses to engage ideas beyond the theoretical paradigms most familiar to nurses educated in the United States. As this is an ongoing and open process, we invite you into the discussion and to add to our mission, vision, and values.

King Conference. In June 2019, the Nursing Theory Collective submitted an abstract that was accepted to the upcoming King Theory Conference in Washington, D.C. (King International Nursing Group, 2019). The topic of our abstract is, “Driving the Future of Nursing: A Collective Approach to Nursing Theory.” We look forward to being a part of this landmark conference. We plan to arrange a meeting of the Nursing Theory Collective at the King conference, and we welcome all members and non-members to join us for important discussions in driving nursing and nursing theory into the future. We will post details about the time and place for this get together as the date gets closer. One action item of this in-person meeting at the King Conference will be to continue the debate surrounding the adoption of the term nursology to characterize ourselves. 

III. Collaborative Efforts 

As we are a collective, we understand the importance of branching out and collaborating with individuals and groups to enable us to accomplish our mission and vision. To date, collaborative efforts have been placed into two categories: 1) Nursology, and 2) policy items related to nursing education and the future of nursing. Below is a brief synopsis of both of these efforts. 

Nursology. In 2015, Dr. Jacqueline Fawcett presented a case for changing the name of nursing to nursology (Fawcett et al., 2015). A variety of nursing scholars have echoed support for this change, but others have been questioning how this impacts on the discipline as we know it (Parse, 2019). To be mindful of all members views, we held an anonymous survey in June – July 2019 to adopt the term Nursology in our name, mission, vision and values. A total of eighteen votes were received, with 11 (61.1%) in support of adopting Nursology, and 7 (38.9%) in opposition. Members also had the option to write-in anonymously a rationale for their vote, and a variety of comments were received. For example, one member who was in support of the adoption asked “if there was an opposition for the collective to have an open discussion as to why this was.” Concerns that were raised by members in opposition included the marginalization of practicing and non-academic nurses, the validity and legitimacy of the term, and the belief that Nursology should be a term reserved for higher degrees in nursing such as the PhD. Supporters of the adoption argued that the term Nursology, while radical, would improve the strength of the identity of nursing, and has powerful implications for the general public and legislation.

Prior to the results being discussed, Dr. Fawcett kindly agreed to participate in our meeting where we discussed the adoption of the term Nursology, as well as the rationale for members in support or opposition. With this discussion, members had opportunities to further voice their opinion, and ask important questions related to the term and its meaning. For example, one member asked for whom the title nursologist should be reserved. Dr. Fawcett and other members designated the adoption of the term nursologist for all members, who have passed their licensing examination and are a registered nurse. At the end of the meeting, it was proposed as the group was undecided to adopt the term nursology into the mission, vision, and values, but also include nursing. We thank Dr. Fawcett for her involvement, and plan to keep the Nursology group updated as we move forward. Our next discussion on this topic will be in November at the King Conference in Washington, D.C.

Policy Items. In July, two members of the Nursing Theory Collective participated in a Zoom meeting with board members from the American Holistic Nurses Credentialing Corporation (AHNCC, 2019). The purpose of this meeting was to begin a discussion and collaborate on a campaign to express the need for nursing theory to be a core part of the current educational essentials, as they are being revised by the American Association of Colleges of Nursing (AACN) and the National Council of State Boards of Nursing (NCSBN). Action items from this meeting included the development of two letters focused on the educational essentials, as well as the revising of the National Council Licensure Examination for Registered Nurses (NCLEX-RN). To date, the letter to the AACN has been completed and is pending to be emailed out to key members of the essentials committee. After this, we plan to submit this letter for publication to spread the word of this important change that may impact the future of nursing. Our next step will be devising the letter the the NCSBN, we invite anyone who is interested in participating in developing this important letter. We thank the AHNCC for collaborating with us on this important project, and support them in their work as they promote a more holistic space for nurses to practice globally. 

IV. Future Efforts

While we have a significant to-do list as follow up from previous efforts, we continue to strive towards future actions in order to drive our vision for nursing and nursing theory into the future. We intend to remain vigilant about the AACN essentials, the NCSBN revision of the NCLEX, and will continue our activism aimed toward promotion of nursing theory at all levels of education. Our future actions include continuing our monthly meetings to have open discourse on the topic on nursing and nursing theory, we invite all members and non-members alike to participate. Additionally, we plan to write and submit manuscripts focused on demystifying nursing theory for practicing nurses and the educational environment. We welcome any and all ideas on how we can move forward with our goals, and hope that you would consider being a part of this movement. 

V. Conclusion and Invitation – Join us!

The next meeting for the Nursing Theory Collective is August 27th, at 2:00 PM Eastern Standard Time. We encourage all nurses and students, regardless of setting, experience, or educational level, to join us by contacting clittzen@email.arizona.edu to participate. If you are interested in joining the WhatsApp group, please email us to let us know and we will add you promptly. We also have a twitter handle, @NursingTheoryCo, and you are welcome to follow us as we plan future social media events. We plan to continue to update the community here on Nursology.net to keep everyone informed, as well as promote a movement of inclusivity to drive nursing and nursing theory into the future.

With gratitude,
The Nursing Theory Collective

References

American Holistic Nurses Credentialing Corporation. (2019). About AHNCC. Retrieved from https://www.ahncc.org/about-ahncc/

Fawcett, J., Aronowitz, T., AbuFannouneh, A., Al Usta, M., Fraley, H. E., Howlett, M. S. L., . . . Zhang, Y. (2015). Thoughts about the name of our discipline. Nursing Science Quarterly, 28(4), 330-333. doi: 10.1177/0894318415599224

King International Nursing Group. (2019). Events. Retrieved from https://kingnursing.org/content.aspx?page_id=4002&club_id=459369&item_id=976945

The Nursing Theory Collective. (2019, June 18). Moving Towards the Next Fifty Years Together [Blog post]. Retreived from https://nursology.net/2019/06/18/moving-towards-the-next-fifty-years-together/

Parse, R. R. (2019). Nursology: What’s in a name? Nursing Science Quarterly, 32(2). doi: 10.1177/0894318419831619

Petrovskaya, O., Purkis, M. E., & Bjornsdottir, K. (2019). Revisiting “Intelligent Nursing”: Olga Petrovskaya in conversation with Mary Ellen Purkis and Kristin Bjornsdottir. Nursing Philosophy, 20(3), e12259. doi: 10.1111/nup.12259.

How to Teach Nursology: A New Resource on Nursology.net

The nursology.net management team is very pleased to announce a new resource for educators of nursology – Teaching/Learning Strategies. This resource is devoted to explanations of diverse approaches to teaching nursology. The first approach focuses on one way to teach the APPLICATION of nursology conceptual models and theories for practice. This teaching strategy involves teams of students role playing nursologists working within the context of various nursology conceptual models and theories that are applied to a fictional multi-generational, multi-cultural family. (See https://nursology.net/resources/teaching-the-application-of-conceptual-models-and-theories-of-nursology/) Comments about this teaching strategy are welcome.

I am confident that the creativity of all nursologists who each in academic and/or clinical settings will be evident as other approaches to teaching nursology are added to this section of nursology.net. Therefore, the management team invites all educators to use the content guidelines and forms found on the “Teaching/Learning Strategies” page to submit explanations of effective teaching strategies.

I would like to thank Deborah Lindell, a new member of our management team, for her exceptionally fine work developing the content guidelines.

Searching the Literature of Nursology: Strategies for Success

Where is the nursing literature I need? (from https://www.iconsdb.com/green-icons/question-mark-8-icon.html)

Finding relevant literature is, of course, crucial for any scholarly work. I have been searching the literature about nursology discipline-specific conceptual models and theories for many, many years. When I first started these literature searches in the 1970s, I had to use printed indexes, which was exceedingly tedious and time-consuming, although I admit to enjoying the quiet time in university libraries. With the advent of computers and the internet–now many years ago—searching the literature took me out of libraries and into my home study or campus office and onto my computer and saved a great deal of time.

In this blog, I share the computer-based search strategies I have been using for many years. These search strategies have yielded the most targeted searches I have been able to locate for several years. Inasmuch as different vendors may use different keywords, readers are advised to seek help from a librarian if the strategies given here are not effective. Furthermore, readers are advised to read abstracts and articles carefully to determine if the indexing is accurate, as indexing errors do occur from time to tine.

The Cumulative Index to Nursing and Allied Health Literature (CINAHL), which has the most comprehensive indexing of nursing journals of any database, may be accessed via various on-line vendors (e.g., OVID, EBSCO). The headings listed below yield the most relevant citations for specific conceptual models of nursing and nursing theories when searching CINAHL. Note that EBSCO has an Alert option (EPAlerts) that automatically provides citations periodically (e.g., each week, each month) that are sent to the requester’s email address. A university librarian can provide information about how to set up the Alerts using these search terms:

  • Johnson Behavioral System Model
  • King Open Systems Model
  • King Conceptual System
  • Kings Theory of Goal Attainment
  • Levine Conservation Model
  • Neuman Systems Model
  • Orem Self-Care Model
  • Rogers Science of Unitary Human-Beings
  • Roy Adaptation Model
  • Synergy Model AND Nursing
  • Newman Health Model
  • Orlandos Nursing Theory
  • Parses Theory of Human Becoming
  • Peplau Interpersonal Relations Model
  • Watsons Theory of Caring
  • Transitions Theory AND Nursing

Citations for general literature about conceptual models and theories can be obtained using these headings in CINAHL:

  • Nursing Models Theoretical
  • Conceptual Framework
  • Nursing Theory

Before 1988, the most relevant citations for specific conceptual models of nursing and nursing theories in the CINAHL database can be located by using the following subject headings. The same subject headings can be used to locate citations for general materials about nursing models and theories.

  • Models Theoretical
  • Nursing Theory

Medline may be accessed via on line PubMed through various on line vendors (e.g., OVID, EBSCO). The following subject headings yield the most relevant citations for conceptual models of nursing and nursing theories when searching Medline:

  • Nursing Models
  • Nursing Theories

Dissertation Abstracts International (DAI), which also includes Master’s Abstracts, may be accessed via various on line vendors (e.g., EBSCO) and databases, including ProQuest (http://wwwlib.umi.com/dissertations/). The search strategies listed below yield the most relevant citations for conceptual models of nursing and nursing theories when searching DAI:

  • behavioral system (keyword) AND nursing (subject) [Johnson’s Behavioral System Model]
  • King (keyword) AND nursing (subject) [King’s Conceptual System]
  • King’s (keyword) AND nursing (subject) [King’s Conceptual System]
    goal attainment (keyword) AND nursing (subject) [King’s Theory of Goal Attainment]
  • Levine (keyword) AND nursing (subject) [Levine’s Conservation Model]
  • Levine’s (keyword) AND nursing (subject) [Levine’s Conservation Model]
    conservation (keyword) AND nursing (subject) [Levine’s Conservation Model]
  • Neuman (keyword) AND nursing (subject) [Neuman’s Systems Model]
  • Neuman’s (keyword) AND nursing (subject) [Neuman’s Systems Model]
  • Orem’s (keyword) AND nursing (subject) [Orem’s Self-Care Framework and theories]
  • science of unitary human beings (keyword) AND nursing (subject) [Rogers’ Science of Unitary Human Beings]
  • Roy’s (keyword) AND nursing (subject) [Roy’s Adaptation Model]
  • adaptation model (keyword) AND nursing (subject) [Roy’s Adaptation Model]
  • Newman’s (keyword) AND nursing (subject) [Margaret Newman’s Theory of Health as Expanded Consciousness]
  • expanded consciousness (keyword) AND nursing (subject) [Margaret Newman’s Theory of Health as Expanded Consciousness]
  • Orlando’s (keyword) AND nursing (subject) [Orlando’s Theory of the Deliberative Nursing Process]
  • Parse’s (keyword) AND nursing (subject) [Parse’s Theory of Human Becoming]
  • human becoming (keyword) AND nursing (subject) [Parse’s Theory of Human Becoming]
  • Peplau’s (keyword) AND nursing (subject) [Peplau’s Theory of Interpersonal Relations]
  • Watson’s (keyword) AND nursing (subject) [Watson’s Theory of Human Caring]

A discussion of computer and hand searches that remain relevant today is given in Johnson, E. D. (1989). In search of applications of nursing theories: The Nursing Citation Index. Bulletin of the Medical Library Association, 77, 176–184.

Peggy Chinn reminded me to add that any search of the literature must include consideration of the source of citations. For example, all searchers should be alert to the concerns of literature published in predatory journals. See McCann, T. V., & Polacsek, M. (2018). False gold: Safely navigating open access publishing to avoid predatory publishers and journals. Journal of Advanced Nursing, 74, 809– 817. https://doi.org/10.1111/jan.13483  for discussion of predatory journals and guidelines for recognizing these open access publications, which are inappropriate journals for and citations of nursing literature.

Peggy Chinn also reminded me to caution readers about the use of the internet (e.g., Google) as a resource for searches of the nursing literature. She noted, “one of the ways that people get trapped into citing literature from dubious sources is that they use google to search for what they are seeking!” One important way to avoid getting caught in this trap is to use the indexes that I have described in this blog].

Readers of this blog are invited to add comments about their experiences searching the nursology literature and contribute other successful search strategies and search terms.

Report of the 17th Biennial International Neuman Systems Model Symposium

Thank you to guest bloggers Karen Gehrling and Lora L .Wyss for this report!  Scroll down for guest blogger information.

Erin Maughan delivering Keynote Address on Population Health Friday, Malone University

On June 20-21, 2019, approximately 100 nurse scholars gathered in Canton, Ohio for the 17th Biennial International Neuman Systems Model (NSM) Symposium. Colleagues from around the world gathered to share knowledge and expertise in population health and the Neuman Systems Model (NSM).

The keynote speaker, Dr. Erin Maughan, shared significant population health issues and the importance of using models of care as context for interventions. Dr. Jacqueline Fawcett, an expert on conceptual models of nursing, built on the keynote to discuss a NSM perspective of the Conceptual Model of Nursing and Population Health. Podium and poster presentations focused on the application of the NSM for education, research, and practice within the context of various worldwide population health issues.

Dr. Fawcett delivering Plenary Address Malone University

On Thursday evening, at Walsh University, we were inspired by Dr. Betty Neuman, who sent videotaped greetings and encouragement to the participants for moving the use

Global Café discussion led by DeLyndia Green Walsh University

of the NSM forward. Global café discussions provided an opportunity to dialogue about population health issues directly affecting a variety of client systems. On Friday, at Malone University, attendees continued the dialogue and began forging new connections and collaborations between colleagues from across the nation and Europe. Many of the NSM Fellows and grant recipients discussed the application of the NSM as guides for their research, education, or practice work. We will be posting many of the presentations on the Nursology.net 2019 conference page as soon as they become available!

Neuman Systems Model Fellows and Grant recipients: (L-R: Fatma Mataoui, Mickie Schuerger, Dawn Pla, Dwaine Thomas, Obiageli Obah, Marcia Jones-George)

Here are reflections from a few of the Symposium attendees:

Reception Walsh University

Mary Cook, from North Canton, OH, wrote: What a great opportunity to network with nursologists who not only know the Neuman Systems Model (NSM), but truly live (practice) the model. I was amazed at how “easily” some of the conference attendees and presenters on the first day during the Global Café discussions were able to extemporaneously frame shared comments within the NSMl. I was again awed by the presentations, both poster and podium, on the second day in relation to application of the NSM to diverse phenomena. It was overwhelming yet inspiring to witness the respect not only for the model but for the work of Dr. Neuman, Dr. Fawcett, Neuman Systems Trustees, and Fellows. I have had exposure to many of the nursing theories but have not had an opportunity to truly apply one model in my practice. What a great example of how theory can be and is used to guide daily nursing practice.
Mary Cook added: I had the privilege of organizing and overseeing the Silent Auction that is the fundraising portion of each Neuman Systems Model Symposium. There were numerous items donated but the two that commanded the most attention and competitive bidding were framed photos of Dr. Betty Neuman and Dr. Jacqueline Fawcett. Wow! What excitement over the possibility of owning a photo that represented so much to so many! The mentorship provided by these outstanding nursologists is astounding! We must continue mentoring and exploring effective strategies for engaging nursing students (undergraduate and graduate) as well as nurses at all levels of practice in theory application.

DeLyndia Green-Laughlin, from Baton Rouge, LA, wrote: The Neuman Systems Model Symposium was amazing as always, with forward thinking scholars working in collaboration to envision a brighter tomorrow. In this time of globalization, assessing population health through the lens of the NSM could not have been more appropriate. Having been a former school nurse myself, I cared for students and families in a time immediately after Hurricane Katrina. As our keynote speaker, Dr. Erin Maughan compared the Public Health Model with the Neuman Systems Model, I was reminded of the reconstitution the community experienced during the aftermath of the storm. As we had to work through the intra, inter, and extrapersonal stressors toward healing, addressing all five interacting variables was the keys to becoming whole again. In sharing the lived experience with families whose community was destroyed as a result of this environmental stressor, the NSM holds true for its use in the community. I was so excited to hear the many presentations during the symposium. Use of the NSM as a framework to address the opioid crisis that has devastated our nation, the impact caregiving will have on the community in the upcoming years, and our educators structuring their assignments within the model were a part of the breakout sessions. Dr. Neuman, thank you for your contribution to the Profession of Nursing.

Colleagues from The Netherlands attending the Symposium

Wichert Trip, an attendee from Zwolle, The Netherlands: Looking back at the NSM congress a couple of things popped out. Since 3 years I know of the existences of the NSM. I consider myself a freshman. I was overwhelmed by the magnitude of the concept. Not only is it applicable on a single patient, it’s very suitable for communities as well. As a community nurse I saw the NSM from a new perspective. That made my excited and I’m going to integrate the NSM into the minor Connecting Community Professional at Viaa University. I’m looking forward to the next congress!

Foekje Pol-Roorda, an attendee from The Netherlands: “A child with asthma must use his inhaler. But what if the mold grows on the walls at home? Or if the medication is not collected from the pharmacy during the holidays?” This example appealed to me in particular. I often draw students’ attention to the client system, but I also often refrain from making them aware of using inter, intra and extra personal factors to get a good picture of the situation. I myself give a lot of lessons in the minor Palliative care. The congress and the example above made me aware that we can look much more through the NSM and implement it even more in the Minor. And I think that this is an important purpose of a conference: improving education, improving professional practice. Personally, this congress has certainly given me an impulse to make the NSM an integrated part of my daily practice.

Ferdy Pluck, Poster Presenter, from Utrecht, The Netherlands, Malone University

Guest bloggers

Karen Gehrling, RN, PhD

Dr. Gehrling, a Neuman Systems Model Trustee since 1999, is a faculty member at  Walsh University Byers School of Nursing. She has been using the NSM to guide her scholarly work and educational endeavors for many years. In 2016, Dr. Gehrling received the Neuman Award, “established in honor of Dr. Betty Neuman for her distinguished contributions to the nursing profession and given annually to a member of the nursing profession who has made significant contributions to the profession as a nursing educator, leader or clinician. ‘Karen is an outstanding leader in nursing theory development and nursing education,’ said 2015 Neuman Award Recipient Dr. Jacqueline Fawcett, who presented the award to Dr. Gehrling. ‘She is a superb scholar with a record of numerous important papers published in top-ranked peer-review journals and important books, as well as many presentations on timely topics at regional, national and international conferences. Most of all, Karen is an outstanding scholar of the Neuman Systems Model.’ Her areas of interests with the Neuman Systems Model include developing a theory of reconstitution, helping nursing programs and curriculum development utilize the Neuman Model, helping students focus on family communication techniques and health promotion while using Neuman as a framework and the family as client, and most recently while consulting in Colombia South America, learning about the need to translate Neuman’s work into Spanish.” Retrieved from https://www.walsh.edu/nursing-research-day-2016-recap

Lora L .Wyss, PhD,  APRN-CNS

Lora Wyss earned Bachelor’s and Master’s degrees from George Mason University in Fairfax VA, a school nurse certification from Ashland University, and a PhD from the University of Akron. Currently, she teaches nursing full time at Malone University. Beyond her teaching responsibilities, Lora is the President of the Hartville Migrant Ministry Board as well as the nursing director of the medical clinic. Latino migrant farm workers who sought treatment at the center were the subject of her doctoral dissertation and of her outgoing research. Lora has studied the impacts of culture, economic hardship, gender, isolation, and status as barriers to medical treatment.