Hidden Risks of Physical Distancing and Social Isolation

The single most important and essential step being taken worldwide to contain the spread of the COVID19 crisis is what is widely known as “social distancing.” But in fact this is physical distancing that heightens the risk of social isolation, conflict and stress. This necessary physical distancing is only tolerable for the most introverted of introverts, leaving the rest of the population in a state of periodic unrest at best, and deep distress at worst.  We are then faced with not only the possibility of disease/illness caused by the novel corona virus – we are faced with the dis-ease of daily living.  When the environment to which someone is compelled to retreat is a relatively safe haven that provides nurturing and encourages creative solutions to the inevitable frustrations and stress, the outcome will probably be okay at least – perhaps even resulting in some new and healthier patterns of daily living!  But the reality is that for far too many, the environment of “home” is a place of emotional tension, sometimes even emotional and/or physical danger.  For those who are “essential” workers – like many nurses – the workplace where they are now compelled to spend a considerable amount of time is one where their own physical well-being is at risk, and the culture may be also less than nurturing or pleasant – even abusive.  Even the best of circumstances can easily erupt into harmful conflict and emotional tension at a moment’s notice, ignited by the stress and tension of the uncertainties and dangers that we all face in this pandemic.

Now more than ever the world needs nursing – the practice of caring for others informed by the knowledge and the wisdom passed along in the theories and philosophies of nursology.  To me the unifying unique characteristic that is so vital as we face the COVID19 pandemic is the holistic nature of nursing theory and practice.  There are many insights that any of us can tap into in any of our theories – now documented on this website and accessible through the site’s galleries.

My theory and practice of “Peace and Power” is among those that directly address the challenges of social and emotional conflict and distress – distress that also compromises physical well-being.  The theory was developed as an approach to group process that shifts away from the power-over (often damaging) approaches that dominate group interactions, and toward an approach that nurtures all, that respects each person’s humanity, and that deals with conflict in ways that nurture growth and healing – not harm and hurt.  The “group” can  be as small as two people!  Shifting to this approach is not easy and it is especially hard to start learning in a context already stressed by the current pandemic – but it can be done!  The specific theoretical concept and practice is “conflict transformation.”  This abstract concept is possible to translate directly into practice – into the realities of every-day life – starting with awareness of the potential for unrest during this challenging time, and the commitment to  start practicing even with the smallest tension!   Here are a few practical ideas for using this approach where you live and work now.

When you are directly involved in a stressful interaction:
  • If you can, acknowledge the situation as soon as you even suspect that this might escalate.  Do not try to “fix” the conflict, simply acknowledge that it is happening, and ask for others to take time to reflect and find a new direction.  If it is now already escalated, step in to share (briefly) your sense of what is happening, and to ask everyone to take time to breathe and reflect on what is happening. This may be a few minutes, or a few hours – maybe a couple of days.
  • During this time, take deep breaths every few minutes to calm and center your spirit.  Focus on your own body/mind/spirit feelings and your own hopes for how this situation will unfold. Recognize and take into account the stress of the situation around you – in this case the pandemic and the real-life stress everyone is experiencing.
  • Shift to a place of inner calm, where you move away from blame and toward understanding of the situation as a whole.
  • Clarify the underlying values that you believe everyone in the situation shares.
  • Prepare your own “critical reflection” that you will share with the others involved.  This reflection consists of these elements:
    • I feel … focus on your own feelings without blaming others
    • When (or about) … describe factually what happened when your feelings came to the surface.
    • I want, I offer .. describe what you envision happening next to move away from or resolve (transform) the conflict, even if it seems impossible to happen.
    • Because … name the value, goals or ideals that you share with the others who are involved.
  • Take a deep breath, and return to the situation ready share your reflection and invite the others to also move away from conflict toward peaceful and health-promoting interactions. Listen carefully to what everyone shares, and join with them in finding a path forward.  The path might still be rocky along the way, but you will now have a foundation from which you can build.  Keep the process of transforming conflict alive and well as you navigate troubled waters.
When you observe a stressful, potentially harmful interaction:
  • Acknowledge what you are observing, even if it is not immediately clear that something harmful is happening.
  • Offer to serve as a mediator or facilitator, bringing awareness of the situation to light, and encouraging a move away from harm and toward understanding
  • If others are open, share the “Peace and Power” process of conflict transformation as an approach to deal with the situation.

A Dozen and One Ways to Love Our Discipline!

Later this week February 14th, is Valentine’s Day – the internationally recognized holiday that variously inspires young children to try their hand at making an original card expressing at least admiration for other children, and compels adults to exchange gifts symbolizing their adoration of one another.  Putting aside the commercialization of a day with deep roots in Roman religious festival traditions, I would like to consider ways in which we as nursologists can express, in our actions and deeds, our fundamental respect – and yes, our love, for the discipline to which we have committed our professional lives, and for many, our personal lives as well.

So in the spirit of the best traditions of Valentine’s day – here are a dozen and one ways to love our discipline!

  1. Express appreciation every day to a nurse who has made, or makes a difference in your life.
  2. Form a small support or interest group with a few nurse colleagues to work on a persistent challenge you are facing; include early-career nurses who are so vulnerable to these challenges.
  3. Recognize ways in which racism and other forms of discrimination are expressed in everyday ways in your work environment, acknowledge your part, and explore ways to resist and transform these situations.
  4. Practice the fine art of “active listening” whenever you encounter a nurse colleague whose point of view differs from your own, explore common ground and build bridges of understanding.
  5. Reach out to a nurse who is hurting, discouraged, or fearful for any reason;  listen to their story, and pledge to continue to listen.
  6. Settle on your own clear and succinct explanation of what nursing is all about; express this to at least two other people every day, and notice their responses to refine your message.
  7. Read one article every month, or two books a year, to learn about nursing history and the nurses who made significant contributions to our discipline.
  8. Practice one or more self-nurturing activity every day, such as physical activity (walking, yoga, tai chi), meditation, play and laughter, saying “no” as a complete sentence!
  9. Resolve to speak the truth of nursology to power at every possible opportunity.
  10. Use every avenue possible to communicate with the public – with your local community leaders, the media, and politicians.
  11. Love and care for the earth and its animal creatures as you would your most cherished patient; take at least 3 opportunities each day to teach others to love and care for the earth and for animals.
  12. Join at least one nursing organization and work to create needed changes in our discipline and in healthcare.  AND
  13. Follow Nursology.net, share the site far and wide, and participate in sharing ideas to shape the future of nursing/nursology.
Thank you to the following nursologists who have contributed to this list!
Chloe Olivia Rose Littzen
Jane Hopkins Walsh
Jess Dillard-Wright
Brandon Blaine Brown
Savina Schoenofer
Marlaine Smith
Vanessa Shields-Haas
Christina Nyirati

Decolonizing Nursing

Series: Notable Works
See Recording of March 9th Platica, hosted by Caroline Ortiz

As the year 2020 starts to unfold, along with escalating tensions world-wide related to power imbalances, inequities, and injustices, I am drawn to consider how our own endeavors related to the development of nursing knowledge intersect with these very large tensions that so directly shape the health of people worldwide.  I will not even attempt to present you with a “laundry list” of ways in which we could begin to tackle these issues as nursologists – the list alone would greatly exceed the boundaries of a reasonable blog post. Instead, I have decided to focus on one critical topic that repeatedly rises to the surface in many nursing discourses – the topic of racism.  Despite the fact that race and racism so repeatedly rise to the surface with a clear intent to address this issue, there is typically little or no substantive discussion that begins to reach deep down into explanations or understanding of what is really going on. Our efforts to  address the issues are sincere and well-intended but more often than not, end up being superficial “remedies” – often remedies that themselves have clear and undeniable racist dimensions. Seldom, if ever, is there a recognition or discussion of the ways in which nursing perspectives sustain the structures of racism. 

The nursing literature, over the past decade, has provided our discipline with a number of notable sources addressing race and racism, most prominently from an emancipatory, critical theory perspective (see Kagan et al., 2014).  But one notable work in particular is well worth our focus – titled “Toward decolonizing nursing: the colonization of nursing and strategies for increasing the counter-narrative” authored by Canadian and South African  authors Elizabeth McGibbon, Fhumulani M Mulaudzi, Paula Didham, Sylvia Bartond and Ann Sochane (McGibbon et al., 2014)

 The authors draw on Canadian experience, where culturally, there is very active, visible and dedicated progress toward truth and reconciliation addressing the injustices imposed by European settlers on native Indigenous peoples (see for example the excellent webinar on “Racism and Privilege in the Everyday”).  The United States in general is far behind Canada, South Africa and other colonized nations in openly and systematically embedding awareness of these injustices in public discourse. Unlike other colonized countries, the US has not yet established practices and programs that attempt to address the significant injustices that have seriously harmed those who have been historically disadvantaged, as well as the effects of these colonizing systems and practices on those who have inherited white settler privilege.  The truth is that each situation in which there is disadvantage for some and advantage for others has specific and unique characteristics, but the common threads that run through all such situations, particularly where race and skin color are concerned are significant. McGibbon and her colleagues have provided a cogent explanation that specifically addresses the realm of nursing theory, and ways in which colonization inhabits much of our nursing theorizing. This is not to say that certain nursing theories should be banned from our lexicon because of their colonized and colonizing characteristics.  Rather, examining nursing perspectives from this standpoint is a key that can begin to shift nursing into spaces, actions and ways of theorizing that hold potential to resist the harmful dynamics of colonization, specifically the dynamics of racism.

As Dr. McGibbon reiterated to me in a recent personal communication:

Colonization is a term that refers to the Eurocentric project of empire building that was motivated by the intent to “civilize” the rest of the world.

“Decolonization” is the process of exposing, resisting and transforming the continuing presence and influence of colonial practices and thought.

The project of colonization historically involved indiscriminate destruction of the ways of life, the cultural values, ways of being, spiritual traditions – the whole experience of people who were not European (read not white skinned) – in other words, people of dark skin.  In their article, McGibbon and colleagues provided a detailed and clear explanation of the nature of colonization, as well as the contributions of postcolonial scholars, particularly those of indigenous backgrounds, who have taken bold steps to reveal the devastation and painful struggle, as well as the courage and skills of survival for those who have been, and still are harmed by colonial practices and thought. 

Most significantly, McGibbon and colleagues provided several still-relevant clues where we can focus our attention in the quest to decolonize nursing.  The first challenge is raising awareness of ways in which colonization, and its racist underpinnings persist in nursing thought. They stated: 

Nursing has developed within all of the . . .  contexts of colonization, including the intersections of racism and sexism that inform the colonial project. Embedded beliefs and assumptions provide a foundation for the colonizing of intellectual development in nursing. Similarly, racism and white privilege play a central role in the continued colonization of the profession.” (p. 183)

First, they addressed the persistent belief that we have now moved beyond the “old” days when the white settlers arrived to inhabit, uninvited, the lands of indigenous people.  The same belief persists in the United States where we sustain the notion that we are beyond the slavery of African people that ended decades ago. Since those “days” are in the long-ago past, we tend to sustain the notion that we are now all equal – that we all inhabit the “same” world and that the cultural [read dominant white culture] norms are true for all.  We recognize that there are disparities, and acknowledge some of the disadvantages experienced by people of color, but fail to recognize, or acknowledge that white privilege remains as powerful a dynamic as it ever was. The languages of “diversity” and “multiculturalism” actually sustain this dynamic; when examined closely these perspectives in nursing treat cultures of color as “other” – as interesting curiosities.  Culture is seen as characteristics of any practices that are not white.  Notice that there are rare, if any discussions of white dietary practices, rituals, family relationships, religious practices. “White” experience is typically seen as diverse and individualized, as the “norm” against which other practices are judged or compared, whereas the experience of the “other,” of “people of color” are seen as essentialized markers of difference, with the “white” norms as the point of reference.

Another characteristic that reflects the effects of Euro-centric thought, and that persists as a pervasive characteristic in nursing thought, is the emphasis on empirics, and the presumption of “objectivity” in part because it is removed from the vicissitudes, the contamination, of everyday experience.  The gold standard of “evidence” presumes a certain “objectivity” that is apolitical and assumed to be universal to all human experience. The result is discourse that is largely grounded in white privilege, and its concurrent erasure of the experience of those with dark skin. When “race” is taken as a demographic variable, it tends to be treated, as in real life, as “different” and something other than what is presumed to be the “norm.” As McGibbon and colleagues pointed out, even when race and racism are brought into a conversation, the dominant impulse in relation to the nursing theoretical frameworks is to hide such dynamics in the larger metaparadigm concept of “environment.” 

Nursing’s search to become a credible science reflects this same dynamic of white privilege and unquestioned valuing of positivist values.  The focus of much of nursing’s theorizing is on the individual as a person with uninhibited free will, one who can care for oneself (with ample resources assumed to be available), with only a passing nod in the direction of the family and community (critical and central concerns for those who are not privileged).  The positivist assumption of the whole as the sum of the parts is reflected in just about all undergraduate nursing curricula, in the focus of our textbooks, and organization of hospitals, medical (and nursing) specialties – divided into children (under the medicalized label of pediatrics), various adult conditions (many of which have been transposed into major profit centers), mental health (again medicalized as “psychiatric”) etc.  To the extent that “family and community” is addressed, these vital, central dimensions of human experience are treated as separate and different from the individualized organizing concepts.

These dimensions of awareness are critical, but importantly, McGibbon and her colleagues devoted a significant focus on what this means for our current situation, and the future development of nursing knowledge.  They outline examples of everyday racism and the ways in which nurses of white privilege sustain racist practices, even when we wish not to do so and believe we do not. But as they correctly noted:

These experiences of ongoing racism form the fabric of everyday life for racialized nurses and are largely invisible for the perpetrators, be they in the individual, face-to-face realm, or at the level of governance and policy-making. (page 185)

They pointed to three significant steps that all nurses, and particularly white nurses and white nurse scholars, can take to begin to participate in the effort to decolonize nursing. These are  

  • Understanding racism and white privilege, and creating counternarratives that dismantle colonized thinking, in particular biomedical hegemony and other colonizing ideologies;
  • Committing to action based on social justice and human rights; and 
  • Sustaining attention to the structural determinants of health.

I would add one additional “goal” that deserves our particular attention as nursologist – the potential to completely re-vamp the organizing concepts and constructs of our discipline based on the insights from the three decolonizing projects that McGibbon and her colleagues outline.

The persistent question that always surfaces in these kinds of discussions (particularly among white people) is “What can I, as only one individual, do?”* In my view, the most important and fundamental step is to learn about and take to heart the ways in which our own actions and perspectives sustain racism in our everyday practices. For those of us who inherited white privilege, we have a particular responsibility to dedicate ourselves to our own self-awareness and commitment to change.  I have provided below a list of various resources that I have found invaluable in my own journey. Once we begin to explore our own experience, and understand the dynamics of colonization, we will begin to see a huge shift that will have great power in the direction of decolonizing nursing. 

Sources cited:

Kagan, P. N., Smith, M. C., & Chinn, P. L. (Eds.). (2014). Philosophies and Practices of Emancipatory Nursing: Social Justice as Praxis. Routledge.

McGibbon, E., Mulaudzi, F. M., Didham, P., Barton, S., & Sochan, A. (2014). Toward decolonizing nursing: the colonization of nursing and strategies for increasing the counter-narrative. Nursing Inquiry, 21(3), 179–191. https://doi.org/10.1111/nin.12042

Resources for self-awareness

Recommended reading, especially for white people, but also for people of color to gain understanding of the ways in which white privilege is sustained.

DiAngelo, R. (2018). White fragility: Why it’s so hard for white people to talk about racism. Beacon Press.

Two part blog posted on The Scholarly Kitchen relating the everyday experiences of people of color in the white-dominated publishing industry, 

On Being Excluded: Testimonies by People of Color in Scholarly Publishing (Part 1).

On Being Excluded: Testimonies by People of Color in Scholarly Publishing, Part II

 “Everyday Feminism” webinars (available for a modest fee)

Beyond Diversity: How to Build a Truly Anti-Racist Organization

So… You Have White Guilt. What Now?

Please also see the webinar series recommended to me by Dr. McGibbon – produced by the Indigenous Cultural Safety Collaborative Learning Series (ICS)

* Addendum 2020-02-01: I have been asked to also address ways nurses of color can address issues of racism.  First, I fundamentally believe that it is unacceptable to expect that our colleagues of color have any responsibility here.  Addressing this issue from the standpoint of someone who is racialized is exhausting, frustrating and disheartening – the effort and energy required to deal with the effects of everyday racism is more than many can bear.  And, as a white person, it is presumptuous of me to assume that my suggestions will have merit.  Understanding this, here are a few ideas that I have picked up from listening to women of color who are engaged in this work:

  • When you see an opportunity to speak your truth, find allies who will hear your words and feel your experience.
  • Develop spaces where you are nurtured, where you are truly “at home” – where you can relax, be yourself, and speak your truth.  This is likely to be a context in which there are no white people (yet) – but having this space will nurture your confidence to search for other allies.
  • Find others who are actively involved in anti-racism work in your community. These colleagues will help you develop a clear and unwavering dedication, and the strength, to face the challenges of everyday experience.

2nd Annual Nursing Theory Conference March 20-21, 2020!

The year of 2019 brought a surge of interest in the development of nursing knowledge – theories, models and philosophies that define our discipline and provide direction for the vital service nurses provide worldwide!  Two major 2019 conferences – Case Western Reserve in March, and the KING collaborative conference last week in DC – inspired the establishment of a structure for an annual nursing theory conference!  The 2020 conference will again be at Case Western Reserve University, March 20-21! And plans are already underway for spring conferences in 2021 and for 2022 – the locations and dates for these conferences will be announced very soon.

As noted on the conference website,

The purpose of the Annual Nursing Theory Conference is to provide a global forum where all nurses can gather to nurture and critique nursing theory thereby expanding nursing’s unique disciplinary knowledge for practice, research, education, and policy. Recognizing that the ultimate purpose of nursing is the improvement of the health and wellbeing of all people, situated in the wholeness of their system context, we commit to supporting a place for active and equitable theoretical discourse. We value, support, and encourage the diversity of theoretical perspectives in nursing to enhance our unique knowledge base. Grounding us firmly in these tenets, we acknowledge the powerful link between philosophy, theory, research, and social change.

The theme for the 2020 conference is “Evolution from the Scientist Nurse to Nursologist: Values and Vicissitudes.”  This theme was inspired by  the ideas published  in Nursing Research in 1970  by Rosemary Ellis titled “Values and Vicissitudes of the Scientist Nurse.”  The program will open by reflecting on how Ellis’s early ideas contributed to where we are today, and the choices we now face as we shape a vision for the future development of nursing knowledge.  The major portion of the program will feature breakout sessions based on participant abstracts, where nursology scholars can present their current work in a context of rich discussion that challenges and inspires our movement forward!  Toward the conclusion of the conference, there will be time for theory-specific groups to gather and discuss matters related to their particular work, giving conference participants an opportunity to connect with others who are working from a specific theoretical framework.

The 2020 conference will firmly establish an ongoing context for nurturing the ideas and frameworks that shape our discipline – building on the values of the past and shaping the vicissitudes of the future! Explore the conference website today, and plan to be there!

Registration now open!
  • Early Bird registration ends February 15, 2020
  • Regular registration ends March 15, 2020
  • There is no on-site registration!
Abstract Submissions now being accepted!
  • Abstract due date: December 15, 2019
  • Notification date: January 15, 2020

Rhetaugh Etheldra Graves Dumas (1926 – 2007)*

Guardian of the Discipline

Rhetaugh Etheldra Graves Dumas was an esteemed nursing “leader with vision, insight, and wise counsel who had a major impact in the advancement of nursing, health care, and academic programs.“ She was inspired to become a nurse because of her mother, who wanted to be a nurse but could not because schools of nursing did not admit African American women at that time. Dr. Dumas earned her BSN degree from Dillard University in New Orleans in 1951, Her nursing career began as a school nurse in the segregated schools of Natchez, Mississippi. With a strong determination to improve the welfare of others, she went on to earn her master’s degree in psychiatric nursing from Yale University in 1961. In1975, when nursing doctorates were rare, she earned her doctoral degree in social psychology from the Union for Experimenting Colleges and Universities (now known as Union Institute & University).

Throughout her career, she was a strong advocate for Black  women and Black nurses, urging baccalaureate nursing education for all.  Dr. Dumas was the “first” in many dimensions related to the development of nursing as a discipline.  She was the first nurse to conduct clinical experiments that evaluated nursing practices. She was the first African-American to be named as a Dean of Nursing, University of Michigan (1981). She was subsequently appointed as Vice-Provost of the University, serving until her retirement.

Most notably,, she was the first woman and first nurse to serve as deputy director of the National Institute of Mental Health, from 1979-1981. As President of the American Academy of Nursing (1987-89), she led the establishment of Expert Panels to develop strong policy statements based on nursing expertise.  She began her presidency with the motto of “many voices, one vision,” calling on expansion of the Academy as a major force in shaping the future of healthcare.  Her vision for the Expert Panels was a way she saw to substantially engage nurse scholars in bringing nursing perspectives and expertise to the policy-making table.  Today over 20 Expert Panels of the Academy provide vital leadership driving research and policy that is  grounded in the values of the discipline of nursing.

I had the distinct privilege of working with Dr. Dumas as a member of the Board of Directors of the Academy when she was President.  Her clarity, strength of vision, and unrelenting commitment to nursing as a discipline remains as a major influence that inspired me, as a young scholar, to never waiver from a commitment to the very best that nursing offers in the service of others.

See more information about Dr. Dumas here and here

* Portions of this post originally appeared on the NurseManifest blog

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!

 

 

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.

 

Roy Adaptation Association – International (RAA-I): 2019 Annual Conference Report

Debra Hanna, inducted as first President of RAA-I, June 8, 2019

We welcome this report contributed by Debra R. Hanna, President, RAA-I.  For additional information about the conference, and to download selected presentations, see the Nursology.net past conference page here.

Members of the Roy Adaptation Association—International gathered in Los Angeles, California on June 7 and 8, 2019 for their annual conference. This year’s conference theme was “Adaptation Towards Transformation for the Future.”
The conference opened with a lively, intriguing presentation by Dr. Scott Ziehm from University of San Francisco, California. His presentation “The State of Nursing Science through the DNP and PhD lens: Historical Perspectives and Future Directions” aptly set the stage for two workshops that followed. Dr. Ellen Buckner from Samford University, Alabama, conducted a dynamic workshop on Knowledge for DNP education. Dr. Debra Hanna from Molloy College in New York, and Drs. Alejandra Alvarado and Maria Elisa Moreno-Fergusson from Universidad de la Sabana in Chia, Colombia conducted a second workshop on Knowledge for PhD Education. The workshops were followed by the Awards ceremony for presenters of Award-winning papers. That afternoon, attendees enjoyed a relaxing reception during the poster session.

The second conference day opened with a networking breakfast, where Executive Board member Dr. Pamela Senasac guided attendees in an enjoyable ice-breaker exercise. A spirit of welcoming hospitality has always characterized our annual RAA-I conferences, so the ice-breaker exercise was in keeping with our long-established organizational persona. RAA-I Executive Board members hope to always preserve the spirit of genuine welcome to every colleague that wishes to join us.
Sr. Callista Roy gave an inspiring keynote speech: “Adaptation Towards Transformation for the Future.” After a short coffee break, the conference resumed with presentations of award-winning papers.

The Susan Pollack Award went to Melissa Lord, DNP, Jennifer Hunt, DNP and Ellen Buckner, PhD for their study: Promoting Adaptation in Female Inmates to Reduce Risk of Opioid Overdose Post-Release through [project] HOPE. The Lizzie Whetsell Award went to Britton Buckner and Ellen Buckner, PhD, for their work using the Roy Adaptation Model to facilitate child adaptation in refugee-camps. The Carol Baer Award went to Luis Carlos Rodriguez Chanis and Yolanda Gonzalez, PhD of Panama, for their study of people living with chronic heart failure. The General and Mrs. Huberto Valesco Award went to Drs. Alejandra Alvarado Garcia and Blanca Venegas for their research to develop coping strategies within a group of chronically ill elderly adults. The last award was recently established as a memorial for one of our late RAA-I colleagues from Colombia. The Maria Elena Lopez award went to Beverly Kass, DNP, of New Jersey for her study that addressed caregiver coping with role strain.
During the annual Business Meeting the Leadership Mentoring program was described. Nine new mentees were matched with eight mentors in a short ceremony. Three newly elected officers of RAA-I were inducted: Dr. Debra Hanna, President, 2019-2012; Dr. Clare Butt, Treasurer, 2019-2021; Dr. Ellen Buckner, Secretary, 2019-2022. Sr. Callista Roy reported that Dr. Sumiko Tsuhako, our well-loved Executive Board member and First President of RAA-Japan has decided to step down from these roles after more than 13 years. Several colleagues from Japan were present at this year’s conference with very good news about the formation at St. Mary’s College in Fukuoka, Japan of a wonderful new nursing research center. From the photos they shared with attendees, we saw that the Roy Academia Nursology Research Center is located in Roy Academia Hall at St. Mary’s College. Transformation for the future of RAA-I was evident in several ways this year.

Our next annual conference for RAA-I will be held in Los Angeles, California on June 19, 20, 2020. The theme for the 2020 conference is: Roy Adaptation Model: Contributions to Authentic Nursing Knowledge. The Call for Abstracts will be released soon.

Mount St. Mary’s University Los Angeles, California.
Photo retrieved from https://www.msmu.edu/about-the-mount/nursing-theory/roy-adaptation-association/conference/

A Theory of Parental Post-Adoption Depression: What’s New is New Again

Welcome to guest blogger Karen J. Foli, PhD, RN, FAAN,
Associate Professor,
Director, PhD in Nursing Program
Purdue University School of Nursing
Here she discusses the challenges of interacting with public media
about her theory of parental post-adoption depression (PAD)

Recently, I was contacted by journalists from Denmark and the New York Times. In both cases, they wanted to interview me about my middle range theory of parental terpost-adoption depression (PAD). I was honored to be asked about my work, but what struck me was a feeling of déjà vu. When my book, The Post-Adoption Blues: Overcoming the Unforeseen Challenges of Adoption (2004 and co-authored by John Thompson) was published and then followed by several empirically driven papers published in peer-reviewed journals (see references below), the press was out en masse.

It’s tricky talking to the press. I’ve made my share of mistakes and learned with every interview I’ve given. But back to the content of these interviews – parental post-adoption depression. The first questions I can count on are: “How does this compare with postpartum depression? What about hormonal changes? How common is PAD?” First, I try to explain that we now see postpartum depression as encompassing the perinatal time period. I describe how we really don’t know about hormonal changes with adoptive parents, but there are differences in the experiences of these two parent groups. In terms of prevalence, we’re not sure – my best estimate is 10% to 20% of adoptive parents may experience depressive symptoms.

Adoptive parents reach into society for a license to parent a child born to others. They go through a rigorous, invasive process during which they are waiting, and ultimately matched with an infant or child. Often, parents “sell” themselves as “super parents,” beings that set themselves up with high, often unrealistic expectations. Herein lies the heart of my theory: unmet expectations of themselves as parent, of their child, of family and friends, and of society and others, are associated with depressive symptoms. Based on my research, expectations of themselves are the hardest to meet.

The question becomes: how do nurses and nursology fit into this? Based on my research and writing (see also Nursing Care of Adopted and Kinship Families: A Clinical Guide for Advanced Practice Nurses), the answer is more than you would suppose. Social work is the historical and current default profession that we defer to when children are relinquished and for home studies that evaluate the fitness of adoptive parents. Yet we understand that adoptive children visit healthcare providers more frequently than birth children. Herein lies our opportunity as care providers to support families.

Many adoptive parents experience significant shame when they struggle with PAD. Sometimes, when they share their feelings, they will be met with: “But isn’t this what you’ve wanted?” Nurses in myriad specialty areas can make a positive impact. Pediatric nurses can assess the dynamics between the child and parent and look for cues of impaired or delayed bonding. Nurses providing care to older adults can also assess for PAD – relative placements in foster care and in informal arrangements are surging (also known as kinship caregivers). Primary care providers have multiple opportunities to look for signs of parental depressive symptoms post-adoption and ask about expectations that were or were not met.

To end, when parents experience depression, we know the kids suffer too. Nurses can be savvy caregivers to this special and vulnerable group of parents and their children. While this blog is too brief to relay all that we know about PAD, it’s a welcomed beginning.

References

Foli, K. J., Lim, E., & South, S. C. (2017). Longitudinal analyses of adoptive parents’ expectations and depressive symptoms. Research in Nursing and Health, 40(6), 564-574. doi: 10.1002/nur.21838

Foli, K. J., Hebdon, M., Lim, E., & South, S. C. (2017). Transitions of adoptive parents: A longitudinal mixed methods analysis. Archives of Psychiatric Nursing31(5), 483-492. doi: https://doi.org/10.1016/j.apnu.2017.06.007

Foli, K. J., South, S. C., Lim, E., & Jarnecke, A. (2016). Post-adoption depression: Parental classes of depressive symptoms across time. Journal of Affective Disorders200, 293-302. doi: 10.1016/j.jad.2016.01.049

Foli, K. J., South, S. C., Lim, E., & Hebdon, M. (2016). Longitudinal course of risk for parental post-adoption depression using the Postpartum Depression Predictors Inventory-Revised.  Journal of Obstetric, Gynecologic, and Neonatal Nursing, 45(2), 210-226doi:10.1016/j.jogn.2015.12.011

Foli, K. J., Lim, E., South, S. C., & Sands, L. P. (2014). “Great expectations” of adoptive parents: Theory extension through structural equation modeling. Nursing Research, 63(1), 14-25. doi: 10.1097/NNR.0000000000000006

Foli, K.J., South, S.C., & Lim, E. (2014). Maternal postadoption depression: Theory refinement through qualitative content analysis. Journal of Research in Nursing, 19(4), 303-327. doi: 10.1177/1744987112452183

South, S. C., Foli, K. J., & Lim, E. (2013). Predictors of relationship satisfaction in adoptive mothers. The Journal of Social and Personal Relationships30(5), 545-563. doi: 10.1177/0265407512462681

Foli, K. J., Schweitzer, R., & Wells, C. (2013).  The personal and professional: Nurses’ lived experiences of adoption. The American Journal of
Maternal/Child Nursing, 38
(2), 79-86. doi: 10.1097/NMC.0b013e3182763446

Foli, K. J. South, S. C., Lim, E., & Hebdon, M. (2013). Depression in adoptive fathers: An exploratory mixed methods study. Psychology of Men & Masculinity, 14(4), 411-422. doi: 10.1037/a0030482

Foli, K. J., South, S. C., Lim, E., & Hebdon, M. (2012). Maternal postadoption depression, unmet expectations, and personality traits. Journal of the American
Psychiatric Nurses Association
18(5), 267-277. doi: 10.1177/1078390312457993

Foli, K. J. (2012). Nursing care of the adoption triad. Perspectives in Psychiatric Care, 48(4), 208-217. doi: 10.1111/j.1744-6163.2012.00327.x

Foli, K. J., South, S. C., & Lim, E. (2012). Rates and predictors of depression in adoptive mothers: Moving toward theory. Advances in Nursing Science35(1),
51-63. doi:10.1097/ANS.0b013e318244553e

Foli, K. J., & Gibson, G. C. (2011).  Training ‘adoption smart’ professionals.  Journal of Psychiatric and Mental Health Nursing, 18(5), 463-467. doi:  10.1111/j.1365-2850.2011.01715.x

Foli, K. J. & Gibson, G. C. (2011).  Sad adoptive dads:  Paternal depression in the post-adoption period,International Journal of Men’s Health10(2), 153-162. doi: 10.3149/jmh.1002.153

Foli, K.J. (2010). Depression in adoptive parents: A model of understanding through grounded theory. Western Journal of Nursing Research, 32, 379-400. doi: 10.1177/0193945909351299

Foli, K. J. (2009). Postadoption depression: What nurses should know. American Journal of Nursing, 109, 11. doi: 10.1097/01.NAJ.0000357144.17002.d3

What makes a theory or model “nursing”?

To our readers: the Nursology.net blog exists to prompt thoughtful discussion of critical issues related to the development of nursing knowledge.  We welcome your thoughts, challenges, alternative points of view, and critical questions!  Do not hesitate to comment on this or any other post at any time!  You are our “peer reviewers” and your perspectives contribute to all in our nursology.net community!

I am often asked (as are many of my colleagues):  What makes a theory or model a nursing theory or model?  This question is close to the challenge that I addressed in my keynote address in March at the Case Western Reserve Frances Payne Bolton School of Nursing Theory conference.  This question deserves serious reflection and discussion, because how each of us responds to this question is at the heart of what we envision for our discipline moving forward. In my keynote, I noted that various definitions of nursing as a discipline point to two essential matters: 1) knowledge of the human health experience, and 2) knowledge of nursing healing [well-becoming] actions.  Here I explore the issue of nursing theories and models, and propose that like the definitions, nursing theories and models are characterized by a focus on these same two essential characteristics.

One reason that questions concerning the nature of nursing theory keep surfacing is the fact that so many nurses who embarked on activities related to the development of nursology (nursing science) were educated to be scholars (researchers, theory developers) in fields outside of, but related to nursing.  There are contemporary nurses who opt to pursue their preparation for scholarship in other disciplines, influenced by the appeal of certain lines of inquiry that are already well developed in another discipline, and recognizing the significant connection between nursing’s interests and the interests of other lines of thought.  When I say “related” what I mean is that the gaze of these other disciplines is certainly pertinent to what concerns nursing, but the central concern of nursology is not actually “at the center.”  When a nurse scholar’s central focus is on the periphery, it is likely to be better placed within the scope of another discipline.

Sally Thorne (2014) has addressed this tension often in her work, most specifically in her chapter that appears in the text “Philosophies and Practices of Emancipatory Nursing.” In this chapter titled “A Case for Emancipatory Disciplinary Theorizing” (pages 79-90), Dr. Thorne pointed to the habits of “false dichotomizing” and the allure of borrowing theories from other disciplines, both of which lead to valorizing constructions from other disciplines, while neglecting the distinct focus of nursing. False dichotomizing, in the the case of social justice concerns, is the tendency to pigeon-hole a theory as either being focused on “the individual” or on “the community” (social justice), failing to recognize that from the earliest days of theorizing in nursing, scholars have explicitly embraced both the individual and the community and the  social injustices that require nursing action.  Likewise, immersion in and borrowing from the theoretical traditions of other disciplines can lead to neglect of the complex social mandate that is central to the discipline of nursing.  Unlike other disciplines, many of which focus on building knowledge as an end in itself, nursing’s mandate to act shifts the disciplinary focus so that knowledge related to a phenomena must include a focus, or point the way to “right” or “good” nursing action.  I have addressed the challenge in nursing of developing theory with this extremely complex perspective as one of the reasons for turning to theory in other disciplines, where the focus is more limited, and this complexity is typically unacknowledged and undeveloped or underdeveloped.  (see “Thoughts About Advancement of the Discipline: Dark Clouds and Bright Lights”)

From my perspective, regardless of the theorist’s background, or the origin of methodological approaches, what defines a theoretical construction as nursing arises from a clear orientation to the values and priorities of the discipline – the direction in which nursologists focus their “gaze.”  The focus of nursing must include the two elements that centrally define our discipline: knowledge of the human health experience, and knowledge of nursing actions leading to health and well-becoming.

Every discipline has the right and the responsibility to define and to conceptualize its own knowledge, domain, practice – the field which it covers. Of course people from other disciplines, and the public, have a responsibility to challenge the discipline in any way that is needed – a process that contributes to the ongoing development of the discipline. This process was prominent during the early phases of feminist thought in which feminist scholars from all disciplines developed a “gaze” focused on the rights and well-being of women, challenged the parameters, assumptions and practices of their own, and other disciplines as well. This led to vast changes for the better in all of the sciences and the humanities.

Where nursing is concerned, or more specifically nursology, disciplinary knowledge must derive from those who have been immersed in the history, philosophy, theory, and the practices of the discipline – something that is required for any discipline. Even though, for example, I do know a lot about the field of educational psychology where I earned my PhD degree and where I completed many courses in psychology and educational psychology, I do not have the background and experience to even begin to claim that I could contribute to the knowledge base of that discipline. I have used theories and insights from other disciplines in my own work contributing to the discipline of nursing, but that is quite a different kind of scholarship than would be required to contribute to the discipline of psychology (or sociology, or anthropology, etc.). My own theorizing in nursing reflects my educational psychology background, particularly the work of Brazilian educator Paulo Friere.  While the very relevant focus of Friere’s work is on human liberation from oppressive conditions, in my work the focus shifts to the health experience involved in group interactions,  conditions which influence, perhaps even threaten human health and well-being.  Health-promoting group interactions in my work draw on the methods of Friere’s  liberation theory,  but are specifically directed toward creating group actions and interactions that are life-affirming, nurturing, and support human well-becoming.

I do not think it is helpful to dwell on the simple fact of whether or not a person contributing to the knowledge of the discipline is a nurse — not all nurses are prepared to contribute to the knowledge base of the discipline, nor should they be expected to. And there are certainly nurses whose “gaze” is directed primarily on phenomena that are rooted in other disciplines.  The key to me is where a theory or model focuses the gaze – what phenomena are central, and are those central ideas consistent with the defining focus of the discipline.  I find it difficult to imagine how someone could contribute to nursing knowledge without a nursing background, or without experience in nursing healing/ well-becoming actions, as well as a background in the history and foundational knowledge of the discipline.  Beyond this essential background from which the theoretical ideas emerge, nursing theories and models are defined by the substantive focus on the phenomena of the experience of human health and well-being, and the dynamics that contribute to nursing healing and well-becoming practices.   As we have demonstrated in gathering together for this website information about the theories and models we do have, there are many more than many nurses have as yet imagined!  But the task of clearing our mental images to more fully appreciate the possibilities in the development of the knowledge of our discipline is a huge challenge, and further focusing our gaze on these possibilities and priorities is at the heart of what matters for our own discipline.