Uncertainty in Life and in the Time of the Covid-19 Pandemic

Uncertainty is, in many ways, a human condition—each of us most likely feel uncertain about something at least some time in our life. However, the current covid-19 pandemic has brought forth a time of what is great uncertainty for many people worldwide. What, though, is the meaning of uncertainty and the outcome of feeling uncertain?

Merle Mishel’s Theory of Uncertainty in Illness tells us that uncertainty is “the inability to determine the meaning of illness-related events” (Mishel as cited in Clayton Dean, & MIshel, 2018, p. 49). More generally, uncertainty is defined as “The state of not being definitely known or perfectly clear; doubtfulness or vagueness. . . . the quality of being indeterminate as to magnitude or value” (Oxford English Dictionary, 1921/1989).

Mishel’s theory also tells us that uncertainty may be regarded as a danger or an opportunity. What are dangers associated with uncertainty during the covid-19 pandemic? Mental health problems, such as anxiety and depression, have been cited as a danger—Chinn wrote of the “Hidden Risks of Physical Distancing and Social Isolation” during the current pandemic. Foli wrote about the psychological trauma experienced by nurses caring for people with covid-19.

What are opportunities associated with uncertainty during the covid-19 pandemic? Media attention to the inequities of health care based on race is an opportunity to highlight what nursologists have known at least since the time of Florence Nightingale. The nursology.net management team has crafted a statement in support of the elimination of health care inequities that is visible in the sidebar of this website. The statement reads in part, “We are dedicated to building praxis in nursing that reflects the tradition of nursing’s dedication to social justice, that addresses injustice, and that welcomes dialogue and action focused on creating needed change within nursing and healthcare.” All nursologists have an opportunity, on which we must now capitalize, to be at the forefront of developing and applying knowledge to overcome finally widely recognized racial-based health care inequities. We must grasp the opportunity given to nursologists by the media and wider society to be recognized as competent and compassionate carers of people critically ill with covid-19. By doing so, we will actualize #neverforget, which Balakrishnan (2020) used to refer to climate change but is perfect for nursology especially at this time.

 Michsel’s Revised Theory of Uncertainty in Illness  tells us that the outcome of feeling uncertain is a new life perspective. What is a preferred new live perspective? Are nursologists and all citizens of our planet willing to a new value system to guide the way we live and interact with others?

Although Mishel’s theories are about uncertainty in illness, many other facets of life involve uncertainty. For example: Will my car start today? Will public transportation be on time? Will the meal I ordered or cooked myself be delicious? Will my family member or friend like the gift I purchased for her or him? Will my partner always love me? Extended to knowledge development, we know that  inferential statistics used to test theoretical hypotheses do not produce results that are “facts” or “laws,” but instead are numbers that represent a certain level of probability – we are, for example,  95% (p = 0.05) or 99% (p = 0.01) certain about some result but %5 or 1% uncertain about the result. Thus, much of what we know empirically is under conditions of uncertainly.

Clearly, if we are to live comfortably with uncertainty, we need to be comfortable with learning that which is not yet certain (if it can ever be certain!). Within the context of theory development, we can learn from rejection of our hypotheses. Indeed, Popper (1963) maintained that rejection of hypotheses is desirable as the next hypothesis will be better–we will have a better theory.  Glanz (2002) added, “There is as much to learn from failure as there is to learn from success” (p. 546).  Knowing “what is not” advances theory development by eliminating a false line of reasoning before much time and effort are invested. Thus, wanting to be certain may be a trap that leads to arrogance or a barrier to accepting at least a certain extent of uncertainty. Paraphrasing Barry (1997), who wrote about truth in science, we can indicate that one can reach certainty “no more than one can reach infinity” (p. 90).   

References

Barry, J. M. (1997). Rising tide: The great Mississippi flood of 1927 and how it changed America. New York, NY: Touchstone/Simon and Schuster.

Balakrishnan, K. (2020, May 28). Aggressive containment, extensive contact tracing. Panel presentation as part of the Coronovirus Seminar: Global perspectives. Boston University School of Public Health webinar/ Retrieved from https://www.bu.edu/sph/news-events/signature-programs/deans-seminars/coronavirus-seminar-series/covid-19-global-perspectives/?utm_medium=email&utm_campaign=DLE%20-%20DSS%20-%20COVID%20-%20Global%20-%2023&utm_content=DLE%20-%20DSS%20-%20COVID%20-%20Global%20-%2023+CID_d2cf1e251bb8e6c937a202dfa97b651b&utm_source=Email%20marketing%20software&utm_term=Join%20us%20online

Clayton, M. F., Dean, M,, & MIshel, M (2018), Theories of uncertainty. In M. J. Smith & P. R. Liehr (Eds.). Middle range theory for nursing (4th ed., pp. 49-81). New York, NY: Springer.

Glanz, K. (2002). Perspectives on using theory. In K. Glanz, B. K. Rimer, & F. M. Lewis (Eds.), Health behavior and health education: Theory, research, and practice (3rd ed., pp. 545-558). San Francisco: Jossey-Bass.

Oxford English Dictionary. (1921/1989). Definition of uncertainty. Retrieved from https://www-oed-com.ezproxy.lib.umb.edu/view/Entry/210212?redirectedFrom=uncertainty#eid

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

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