Some nursologists have claimed that they are “atheoretical.” When asked what they mean, they tend to say that they do not subscribe to or use a particular conceptual model or theory when conducting research or practicing. However, it is, according the physicist turned philosopher of science, Sir Karl R. Popper (1965), it is “absurd” to think that each of us does not have a “horizon of expectations” for whatever we are observing or doing (p. 47). Continuing, Popper (1965) claimed that everyone always has expectations, even if not in conscious awareness.
Following from Popper, I submit that it is impossible to think “atheoretically.” Instead, I submit that every nursologist has a “horizon of expectations” in the form of a conceptual frame of reference that guides what she or he is observing or doing as research is conducted, curricula are constructed, interactions are occurring with people who seek nursologist services, and nursologist services are administered. That conceptual frame of reference is what I refer to as a conceptual model or a grand theory.
I suspect that every nursologist agrees that she or he “talk[s] nursing” (Chalmers, as cited in Chalmers, Kershaw, Melia, & Kendrich,, 1990, p. 34), thinks nursing (Nightingale, 1993; Perry, 1985), and engages in thinking nursing (Allison & Renpenning, 1999) rather than mindlessly doing tasks and carrying out physicians’ orders (Le Storti et al., 1999). But what do those nursologists regard as nursing? What is meant by talking or thinking nursing? I also suspect that every nursologist agrees that she or he engages in critical thinking and clinical reasoning. If so, what is the frame of reference for the thinking or reasoning? Something has to capture one’s attention (Myra Levine (1991), developer of the Conservation Model, called what captures one’s attention provocative facts, which are noticed within the context of conservation of energy, structural integrity, personal integrity, and social integrity.
Thus, the challenge for each nursologist who regards self as thinking “atheoretically” is to identify what her or his frame of reference (horizon of expectations) is. What is that person’s view of who are the human beings or documents that are appropriate for whatever activity is being done (i.e., research, practice, education, administration)? What is the person’s view of the relevant environment? What is the person’s view of what constitutes wellness, illness, and disease? What is the person’s view of what nursologists’ do in practice – what is worthy of assessment, how are priorities set when planning, what interventions are appropriate, and most of all, what outcomes are expected?
It is possible that my claim that being “atheoretical” is impossible. Therefore, in closing, I urge those of you who claim you are “atheoretical” to respond to this blog and let everyone know what you mean by being “atheoretical” in all of your nursologist activities.
References
Allison, S. E., & Renpenning, K. (1999). Nursing administration in the 21st century. Thousand Oaks, CA: Sage.
Chalmers, H., Kershaw, B., Melia, K., & Kendrich, M. (1990). Nursing models: Enhancing or inhibiting practice? Nursing Standard, 5(11), 34–40.
Le Storti, L. J., Cullen, P. A., Hanzlik, E. M., Michiels, J. M., Piano, L. A., Ryan, P. L., & Johnson, W. (1999). Creative thinking in nursing education: Preparing for tomorrow’s challenges. Nursing Outlook, 47, 62–66.
Levine, M. E. (1991). The conservation principles: A model for health. In K. M. Schaefer & J. B. Pond (Eds.), Levine’s conservation model: A framework for nursing practice (pp. 1–11). Philadelphia, PA: F.A. Davis.
Nightingale, K. (1993). Editorial. British Journal of Theatre Nursing, 3(5), 2.
Perry, J. (1985). Has the discipline of nursing developed to the stage where nurses do “think nursing?” Journal of Advanced Nursing, 10, 31–37.
Popper, K. R. (1965). Conjectures and refutations: The growth of scientific knowledge. New York, NY: Harper and Row.
I absolutely agree with. If one is doing nursing atheoretically, it suggests that nursing is what nurses do. Not what they think about. It’s difficult to propose expected outcomes or to have a basis for evaluation of an action. It has been my experience that most persons who assert they’re atheoretical are working from medical or psychological models- or intellectually unmotivated.
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Sorry, it has taken me so long to find this article. I, personally, have never claimed to be atheoretical. In my practice with individual clients, however, I drew primarily upon the work of Imogene King. In my developing of self-sustaining clinics addressing community needs, I adapted Saul Alinsky’s community development theory to community nursing and health services delivery systems in Bolivia and in Missouri.
Some people have claimed, however, that I espouse atheoretical nursing. In work as a nursing language/classification developer, I have said, however, that nursing diagnosis classification needs to be theory-agnostic (and earlier in my career I have said that a classification needs to be atheoretical meaning, in my mind, the same).
But what does a theory-agnostic classification mean? It means a valid classification makes no assumptions about the distribution of the diagnoses within the classification based on the theory from which the diagnosis is derived. The only criteria for acceptance are research criteria. Thus, any one diagnosis may be the product of one or more theories.
Furthermore, while each theory may have its own taxonomic framework and theoretically-derived diagnoses, a taxonomy of nursing diagnoses based on the work of nurses worldwide must be able to incorporate diagnoses from multiple theories.
As an aside, I find the patterns of knowing nursology a most interesting taxonomic framework in and of itself. I hope the dissertation itself is published in English or Spanish. Or, do please let me know if an English or Spanish article is published based on Dr. Ramos’ dissertation. Thanks!
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