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.

Grayce M. Sills (1926-2016)

Guardian of the Discipline

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

References

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

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

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

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

About our guest Contributors

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

Christina Nyirati, PhD, RN – 

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

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

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

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

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

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

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

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

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

 

 

 

 

 

 

 

Who IS the First!

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Adeline Falk-Rafael

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

Margaret Dexheimer Pharris

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

Danny Willis

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

Rosemary William Eustace

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

Marian Turkel

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

Marlaine Smith

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

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

Nursology’s Philosophical and Practical Knowledge: Unified and Interdependent

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

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

Alligood writes:

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

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

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

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

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

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

Fawcett writes:

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

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

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

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

References

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

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

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

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

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

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

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

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

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

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

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

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

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

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

What If? Random Thoughts of Sleepers Awake

With apologies to J. S. Bach, composer of Cantata no. 140, Sleepers Awake these are my random thoughts of “What If?” about our discipline while I was a sleeper awake one very early morning.

  • What if Florence Nightingale (circa 1859) founded modern nursology (rather than nursing), titled her book, Nursology: What it is and What it is not, and established the first college/school/department/program of nursology to prepare nursologists?
  • What if we referred to ourselves as nursologists, rather than nurses or advanced practice nurses or nurse practitioners or even “practitioners of nursing” (Orem & Taylor, 1986, p. 39)?
  • What if Dock and Stewart (1938) wrote A Short History of Nursology (instead of A Short History of Nursing)?
  • What if our conceptual models originally were called paradigms, as these abstract and general “horizon[s] of expectation” (Popper, 1965, p. 47) for disciplinary activities are called in other disciplines?
  • What if health was widely regarded as encompassing wellness, illness, and disease, so that wellness would be promoted, and illness and disease would be prevented, rather than health being promoted (who would want to promote illness and disease)?
  • What if NANDA-I was NATA, such that D = Diagnosis were replaced with T = Trophicognosis, which Levine (1966) used as the label for judgments stemming from assessments of each patient’s health (wellness, illness, disease) condition?

Inspired by these possibilities, I asked my Nursology.net management team colleagues to also share their “sleepers awake” inspirations!

Peggy L. Chinn

  • What if all healthcare providers (regardless of discipline) were to base their interactions with patients on nursology fundamental principles and values? If we did this, there would be no computer screens in the room where the interactions take place, or at least they would be way off in the corner and ignored until a basic relationship was established. Every person in the room would be acknowledged, there would be lots of eye contact, and a focus on hearing and listening. That would be for starters!
  • What if there were nursology think tanks happening regularly and often all over the world?
  • What if all undergraduate students had a “Nursology 101” course?
  • What if all current nurses were required to have a continuing education “Nursology 101” course to maintain licensure?
  • What if the accreditation criteria for all nursing programs at all levels addressed the nature of the focus of the discipline in the structure of the curriculum?

Margaret Dexheimer Pharris

  • What if the National Institute for Nursing Research (NINR) only funded proposals based on nursology and contributing to nursology?
    • Jacqueline Fawcett: Following from Dr. Pharris’ question, What if NINR was called the National Institute of Nursology (NIN) or the National Nursology Institute (NNI)?
  • What if there was a nursologist in every community who could know and attend to people across care settings (community, hospital, homeless shelter, long-term care. etc.)? The nursologist–rooted in nursology’s patterns of knowing–would truly know and care for each person and the people who are important to that person, and would collaborate with other nursologists and other healthcare providers within each setting to ensure that the person’s sense of health is honored and nurtured.

Danny Willis

  • What if nursologists always clearly communicated the value added by our knowledge and presence?

Rosemary William Eustace

  • What if all nursologists worldwide are made aware of the impact of nursology on our diverse roles, specialties, training and contributions in meeting overall health outcomes and challenges as part of the 21st century (so-called) nursing campaigns?
  • What if nursologists claim that meaningful healthcare transitions, mutual goal attainments and positive client outcomes would not be possible without the nursologist–client interactions as a vital step to quality health care, such as in keeping with King’s (1992) Theory of Goals Attainment? (See https://nursology.net/nurse-theorists-and-their-work/kings-conceptual-system/)

Marian Turkel

  • What if there was another curriculum revolution and nursologists would have a curriculum focused on nursing as a human science/caring science? For academics this would mean letting go of sacred cows to advance nursing knowledge focused on caring, ethics, health as expanding consciousness, meaning, patterning, presence, and relationships.
  • What if the curriculum for nursologists moved beyond the traditional patterns of knowing (aesthetic, empirical, ethical, and personal (Carper, 1978) to include intuitive, mystical, and spiritual patterns of knowing
    • Jacqueline Fawcett
      Following from Marian Turkel’s second question, readers of this blog may want to read a recently published paper about spirituality as another pattern of knowing (Willis & Leone-Sheehan, 2019). In addition, White (1995) identified sociopolitical knowing as another pattern of knowing. Since that time, Chinn and Kramer (2019) have identified and refined the meaning of emancipatory knowing as still another pattern of knowing. And lest we forget, Munhall (1973) wrote about unknowing as a pattern of knowing, “as a condition of openness” whereas knowing “leads to a form of confidence that has inherent in it a state of closure” (p. 125).

Marlaine Smith

  • What if Nursology 101 was offered for students, or better yet, required for all students enrolled in a university? The course would focus on an introduction to phenomena such as human wholeness, human-environment-health relationships, the nature of health, healing, well-being/becoming, and caring in the human health experience.

In closing, we invite all readers of this blog to contribute their own random thoughts–whether generated as a sleeper awake or during another phase of living–of “What Ifs?”

References

Carper, B. A. (1978). Fundamental patterns of knowing in nursing. Advances in Nursing Science, 1(1), 13–23.

Chinn, P. L., & Kramer, M. K. (2019). Knowledge development in nursing: Theory and process (10th ed.). St. Louis, MO: Elsevier Mosby.

Dock, L. L., & Stewart, I. M. (1938). A short history of nursing: From the earliest times to the present day (4th ed.). New York: G. P. Putnam.

King, I. M. (1992). King’s theory of goal attainment. Nursing Science Quarterly, 5, 19–26.

Levine, M. E. (1966)Trophicognosis: An alternative to nursing diagnosis. In American Nurses’ Association Regional Clinical Conference (Vol. 2, pp. 55–70). New York: American Nurses’ Association.

Munhall, P. L. (1973). ‘Unknowing’: Toward another pattern of knowing in nursing. Nursing Outlook, 41, 125-128.

Orem, D. E., & Taylor, S. G. (1986). Orem’s general theory of nursing. In P. Winstead-Fry (Ed.), Case studies in nursing theory (pp. 37–71). New York: National League for Nursing.

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

White, J. (1995). Patterns of knowing: Review, critique, and update. Advances in Nursing Science, 17(4), 73-86.

Willis, D. G., & Leone-Sheehan, D. M. (2019). Spiritual knowing: Another pattern of knowing in the discipline. Advances in Nursing Science, 42, 58–68. https://doi.org/10.1097/ANS.0000000000000236

 

Ann C. Wolbert Burgess, RN, APRN, FAAN

Guardians of the Discipline
Boston College web page

Dr. Burgess is perhaps best known for her scholarly work about and guiding practice of forensic nursing. She and Lynda Lytle Holmstrom, a sociologist at Boston College, described rape trauma syndrome and founded the first rape crisis counseling program at Boston City Hospital (now Boston University Medical Center). Dr. Burgess played a major role in developing the Federal Bureau of Investigation’s (FBI) Behavioral Science Unit, which focuses on profiling serial killers and other criminals. She also has provided exemplary testimony at trials for sexual assault, murder, and other criminal acts. She is the author or co-author or editor of many, many journal articles, book chapters, and books. In addition, she is the co-developer of the Comprehensive Sexual Assault Assessment Tool (CSAAT), which is based on Roy’s Adaptation Model. Collectively, this work has placed nursing in the forefront of assessment, treatment, and prosecution of many forensic matters.

Dr. Burgess received her baccalaureate and Doctor of Nursing Science degrees from Boston University, and her master’s degree from the University of Maryland. She holds an honorary Doctor of Humane Letters from the University of San Diego.

Dr. Burgess has held faculty appointments at Boston University, Boston College, and the University of Pennsylvania. She developed and taught a graduate program course in forensic nursing, first at the University of Pennsylvania and currently at Boston College.

Dr. Burgess’ major contributions as a Guardian of our Discipline have been widely recognized. She has received many awards, including American Academy of Nursing Living Legend, the inaugural Ann Burgess Forensic Nursing Award by the International Association of Forensic Nurses, the Sigma Theta Tau International Audrey Hepburn Award, the Sigma Theta Tau International Episteme Laureate Award, and the American Nurses Association Hildegard Peplau Award.

Dr. Burgess’ work with the FBI has been portrayed by a character in the television program, Mindhunters. Many years ago, during some of the time that Dr. Burgess was at the University of Pennsylvania School of Nursing, she shared a group faculty house with other nursing faculty colleagues. We often shared dinner and discussed cases about which Ann was providing consultation for the FBI. We would then refer to her as “Annie and the G-Men.” Imagine our surprise when a television program (many years before Mindhunters) soon appeared with a character named Annie, a psychiatric nurse just as Ann is, whose role was consultation with the FBI Behavioral Science Unit!

Portions of this blog were adapted from https://en.wikipedia.org/wiki/Ann_Burgess

Nursologists and Their Comic Character Avatars


Once upon a time, I had a faculty colleague who had a wonderful sense of humor. She

could even inject humor into the statistics and research methods courses she taught. Unfortunately, I did not have anything close to her sense of humor. However, she assured me that it was very difficult to find humor in meta-theory, which is what I taught (and still teach), alas without any humor included.

Imagine my surprise when Peggy Chinn sent me an internet posting  by Jan Friesen and Skander Elleuche, who “developed a method that provides a simple, flexible framework to translate a complex scientific publication into a broadly accessible comic format” (italics in the original).

In an attempt to finally inject some humor into nursology, I started thinking of how comic characters could be transformed into nursologist avatars. I selected comic characters I knew from my childhood and, more recently, from the exhibits in Fawcett’s Art, Antiques, and Toy Museum, a small art gallery, shop, and toy museum that I co-own with my artist husband, John Fawcett. He is the creative one; I keep track of the finances.

My ideas for avatars for nursologists are:

  • Wonder nursologist (aka Wonder woman), whose special wrist cuffs

    deflect all negative concerns about theory

  • Super nursologist (aka Superman), who leaps over complex philosophical, conceptual,  theoretical, and methodological ideas with a single keystroke
  • Star nursologist (aka Star Trek), who goes where other nursologists are not yet ready to go
  • Fantastic nursologist (aka from

    Disney’s Fantasia movie) who converts theoretical knowledge to practice protocols.

  • Mighty nursologist (aka Mighty Mouse), who establishes nurse corporations that contract with clinical agencies to provide nursological qua nursological services to participants in practice (nurse corporations are Grayce Sills’ idea, nursing qua nursing is Jean Watson’s idea)
  • Terminator nursology (aka The Terminator), who eliminates all negative thoughts about conceptual models and theories
  • Spider nursologist (aka Spiderman), who climbs to the heights of nursology

    glory.

  • Yoda nursologist (aka Yoda from Star Wars), whose light saber illuminates all that is nursology.

I invite readers of this blog to contribute their ideas for comic character avatars for nursologists!

The Impossibility of Thinking “Atheoretically”

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.