Over the past year those of us managing the Nursology.net website have experienced two unintended consequences – growing awareness of the importance of fundamental nursing/ public health knowledge and action, and the imperative to examine the structural and interpersonal dynamics of racism. As the web manager of this Nursology.net site as well as the NurseManifest.comwebsite, the home of “Overdue Reckoning on Racism in Nursing,” I have had a front-row seat from which to witness and participate in these two complimentary processes.
From the NurseManifest sphere, we have addressed (explicitly and implicitly) questions such as: “How does our activism contribute to our discipline?” “What are the fault-lines in nursing created by our failure to address racism in nursing?” “How can we engage in authentic reckoning with racism in nursing?” “How can this reckoning shift nursing to more fully engage in facilitation of humanization for those who have historically been harmed by racism?” “How can nursing knowledge be decolonized to fully embrace the knowledge and wisdom of Black, Indigenous, Latina/x, and other nurses of color?”
From the Nursology.net sphere, we have addressed (explicitly and implicitly) questions such as: “What does decolonization of nursing knowledge mean?” “What dynamics have persisted to bring us to this point in history where the scholarship and theorizing of Black, Indigenous, Latina/x and other nurses of color are strikingly absent from our historical record?” “How can we move away from performative action, to fully abandon white privilege in nursing, and to welcome nurse scholars of color to the center of our discourse?”
I do not have direct answers to any of these questions. In fact I believe there are no specific “action” prescriptions that can provide “answers.” The response to all of these questions is what I believe to be critical emancipatory process — a process that begins with a recognition of the fundamental realities of racism and dedication to the hard work of deepened awareness and action for change. In the first chapter of the text “Philosophies and Practices of Emancipatory Nursing,”(1) Kagan, Smith and Chinn identified the following characteristics of emancipatory knowledge and critical theory that informs emancipatory action, as revealed by the chapter authors who contributed to the text:
What is “critical’ –
Interrogating historical/social context
Framing/anticipating transformative action
What is “emancipatory”
Disrupting structural inequities
Taken together, these characteristics point to a deep understanding of what it might mean to bring knowledge and action together as one – the process and understanding that emerges from “knowing what we do, and doing what we know.” In my experience growing up and becoming an “elder” as a fully colonized white woman, I know all too well the experience of separation of mind and body, of understanding and experience. But there is a glimmer of recognition when I encounter instances – my own and those revealed to me in stories others recount – when experience and understanding come together as one – when we recognize the importance of personal knowing and doing. And, recognize when that unified experience reveals new knowledge, new understanding. This process of action/reflection is theorizing at its best. African American scholar Anthony James Williams described this process of theorizing that he observed in his mother and grandmother:
Everyday black women theorists are often forgotten, undervalued and rarely considered theorists due to their lack of formal training and scholarly publications. But for my maternal lineage, the social patterns they observed became lessons. Those lessons then became theories about the social world they incorporated into their daily lives. Keen observation on their part lead to mental maps of where it would be safe to walk as black women, raise their children and avoid white violence. As the wife of a man in the military, my grandmother inevitably had her own theory of residential redlining based on her lived experience well before any academics published on the topic. (2)
Now is the time to engage in the critical emancipatory act of centering the voices of nurses of color who have been undervalued and discounted, only rarely recognized as theorists. The privileged white gaze from which nursing scholarship views the world recognizes only that which appears consistent with white experience, white culture. To face the realities surrounding white complicity that perpetuates racism is a possibility that is either far too frightening, or simply not comprehensible. But comprehend we must if we are to ever move to a reality where all experience is celebrated as valid and valuable, where skin color is not a determinant of whether you live or die.
The time has now come for all in our discipline – nursologists, nurses, students, educators, administrators, policy-makers – to make a strong and unequivocal turn away from all words and actions that render advantage for those whose skin is “white” and that disadvantage all of those with dark skin. It is time to abandon performative words and actions that claim to care for all, and turn instead to dismantle dehumanizing forces of racism and restore full humanization for all. For those who have white skin, it is time to reckon with your own complicity, unveiling the fault-lines (rifts, splits) created by the persistence of racism, and engage in the healing that must be done. For those who have dark skin, it is time to gather the courage to speak your truth, calling on your keen capabilities to discern injustice. For all of us together, it is time to form strong bonds of connection and support for this difficult path. It is a difficult path, but it is the path that will lead us to mental maps – to theorizing the healing that must take place. As we have experienced in our “Overdue Reckoning on Racism in Nursing” journey, it is also a path that is lined with moments of pure joy!
Kagan, P. N., Smith, M. C., & Chinn, P. L. (2014). Introduction. In P. N. Kagan, M. C. Smith, & P. L. Chinn (Eds.), Philosophies And Practices Of Emancipatory Nursing: Social Justice As Praxis (pp. 1–20). Routledge Taylor & Francis Group.
Q – How on earth can we have a dynamic theory conference with 70 breakout sessions – on Zoom?
A – We are nurses — we will find a way!
And find a way we did!
Thanks to the amazing leadership and expert organizing skills of Leslie Nicoll (Editor of CIN: Computers Informatics Nursing), we found a way! Every day from March 17th through March 23rd, 140 nurses tuned in to one or more of the sessions scheduled throughout the week. There were three general sessions – one on the first day of the conference, another on the 6th day, and the final on the last day to close the week. The remaining sessions were 30-minute long “breakout” sessions based on the abstracts that had been submitted for the 2020 conference that had to be canceled due to the COVID pandemic. The presenters and attendees ranged from students and early-career scholars – to well-established and well-known nurse theorists. You can browse the detail of all of the sessions here!
Even though we are over a year into “pandemic culture” when everything has gone virtual, the technical challenges of doing this were huge. After all, we are not instructional technology experts! But Leslie organized each and every detail of the conference, and discovered a wonderful technology expert to give support for all technology aspects of the conference – Ray Harwood of Goodclix. Ray was tuned in to every moment, always ready to step in and solve each technical challenge, but also engaged with us to help make each session run smoothly for each presenter and for all of us attending. Ray says on his website: “Frankly, it’s not what I do, it’s how I do it that counts” – and nothing could be more true!
To compensate for the disappointment of the canceled 2020 conference and taking advantage of the virtual capabilities, Leslie laid out a daily schedule with no overlap in the breakout sessions, so that speakers had a full 30 minutes for their breakout sessions, and attendees were able to attend every single one of the sessions! Of course, hardly anyone was able to do this – but for those of us who were present for every session (or almost all), every moment was interesting – and also inspiring!
Here are a range of comments and responses from the evaluations:
This conference was the most enriching and enlightening conference that I had attended in a long time. This is a great contribution to the growth of the profession.
You did an excellent job and I was surprised and pleased by the breadth of the presenters and the depth of some of the discussions. I loved hearing what the other nursologists were doing and it gave me hope to see nursology being supported and growing!
Holding it on zoom and for an entire week was just too much. We are already zoom fatigued and while you had no option, I think the conference would have been manageable if shorter duration. Our lives at our home offices don’t stop for virtual conferences; if we were on site, we could focus better and not worry about home duties. All conferences are experiencing this, I realize. Thank you for all your good work.
In person conference would be better. If it is virtual, should be condensed, not so spread out, I appreciate your efforts. I know this zoom presentations are all new for everyone
It would be nice to have a remote option for next year
Ray was very supportive. The richness of this conference was incredible!
Structured well, solid content, great dialogue
This is just a busy time for me. The planning and program for this were excellent. I’ve heard from many how much they enjoyed this. I’m glad I have guidebook to look up what I missed. Really excellent work on this. I do like that it was on zoom. I am finding organizational memberships and conferences to be costly so I like this zoom as an option.
Let us think about a virtual nursing theory week every other year and an in person conference the other alternate year. I would not want to lose what we had with this VNTW by always having in person conferences. Or perhaps we can have a virtual component to in person conferences, so that colleagues who cannot travel can still participate.
I did not expect to enjoy the conference as much as I did. I learned so much. Not only about theory, also about who I am and ways that I could use nursing theory to informed nursing education and clinical practice. I liked not having to choose between two or more workshops.
I have loved the zoom format. I am surprised at the depth of connections with my colleagues through this format.
Awesomeness! Inspiring! Hope for the Future of Nursology!
If the next conference is offered in a hybrid format, I will definitely attend. I hope that it is and I highly encourage this conference to remain in some form of virtual format. This material is critical to the future of nursing as a discipline.
The recent spotlight on police brutality and killing of Black Americans prompted widespread reflection and change toward social justice and racial inequities in almost all sectors of society – including the realm of scholarly publishing. The “Scholarly Kitchen,” blog of the Society for Scholarly Publishing, posted a notice of an “Antiracist Framework for Scholarly Publishing” on August 6, 2020 that serves as a guide to re-shape policies and practices in the production of scholarly literature.
I am delighted to share the outcome our initiative to examine and revise guidelines and practices for Advances in Nursing Science. As Editor, I established a workgroup of scholars of color who serve on the ANS Panel of Reviewers to take a deep dive into the journal’s “Information for Authors”. Together we created major anti-racist changes that have now gone into effect.
The changes that we made begin with a fundamental acknowledgement of the power of the published word to shape thought and power structures, and the responsibility of authors in situating their work within existing power structures:
Published scholarly works play a major role in shaping thought and power structures. We encourage authors to include a standpoint statement that describes your position relative to power relations of race, gender, and class. This is particularly important if your work involves disadvantaged populations or issues of social determinants of health and health equity. Examples include:
“The authors Identify as white middle-class nurses. We have drawn on literature authored by scholars of color to inform the design, interpretations and conclusions reported in this article.”
“Our work arises from our experiences as able-bodied nurses, as well as our identities as mixed-race descendants of immigrants from Central and South American countries.”
The following is a new section that specifically addresses guidelines related to racism:
The ANS leadership – Editor, advisory board members, peer reviewers and Publisher recognize that published scholarly works are vehicles that can challenge systemic racism and intersecting forms of power inequities. ANS expects an explicit antiracist stance as a means to provide scholarly resources to support antiracism in research, practice, education, administration, and policymaking. To this end, we offer the following guidelines:
Remain mindful of the many ways in which white privilege is embedded in scholarly writing, and engage in careful rereading of your work to shift away from these explicit and implied messages. As an example, general “norms” are typically taken to reflect white experience only; this is revealed when the experience of people of color are taken to be “other” or “unusual” or worse yet “unhealthy”
When race is included as a research variable or a theoretical concept, racism must be named and integrated with other intersecting forms of oppression such as gender, sexuality, income, and religion.
If your work does include race,
Provide a rationale that clearly supports an antiracist stance.
Be careful not to explicitly or implicitly suggest a genetic interpretation.
Explicitly state the benefit that your work contributes on behalf of people of color.
Refrain from any content that explicitly or implicitly blames the victim or that stereotypes groups of people; situate health inequities clearly in the context of systemic processes that disadvantage people of color.
Focus on unveiling dynamics that sustain harmful and discriminatory systems and beliefs, and on actions that can interrupt these structural dynamics.
We also added a new criterion on which all submissions are evaluated during the peer review process:
Acknowledgement of and challenges to power relations involving race, gender, class, ableism or any other systematic disadvantage.
Please visit the complete ANS Information for Authors to review these changes. We welcome your feedback, comments and questions! Please respond below!
Deep appreciation to the following team of ANS peer reviewers who developed these guidelines:
Anyone alive today (except the yet unborn!) will forever relate a memorable end to this sentence . “2020 was the year . . . “! For a handful of humans all over the globe, there will be those who end this sentence with “2020 was the year I was born, and I survived the great pandemic.” Some will also add that someone in their family did not survive , or someone was permanently affected by the ravages of the virus – a fact that will follow them in all the years to come. Of course how we each end that sentence (and the paragraphs that follow that sentence) will change with time, but our nursology.net team members pitched in to share how we are remembering this unprecedented year as it comes to a close in this and in the first few posts of 2021.
2020 was the year that my 5-year old Cuban/Chinese/Hawaiian/Haole grandson Dylan started kindergarten in daily zoom “classes” with his 24 classmates and fortunately with a very talented kindergarten teacher! His parents and I reflect mournfully on what he is missing by not going to his physical school – a school they selected because it is a public dual-language (Spanish/English) immersion school. The school is located in a zip code with one of the highest rates of COVID-19 cases and deaths in the city Oakland CA, and where racial tensions between police and the community have escalated. But they are both public school teachers, deeply committed to social equity and to ending social disparities, and are seeking to be part of the solutions to the many challenges faced in disadvantaged communities. So here we are at the end of 2020, in the midst of so much suffering that could have been prevented if the situation had been managed differently – suffering that is tragically amplified in disadvantaged communities. Like public school teachers and so many other public servants, as nursologists, we know so many ways in which the knowledge of our discipline could re-direct and re-shape the experience of the COVID-19 pandemic, and how our perspectives – our values and priorities as nursologists – could be mobilized to end health disparities. The growing response to Nursology.net over the course of the year suggests that 2020 may have been the year when widespread recognition and respect for the discipline took hold, when nurses all over the world began to see the significance of our disciplinary knowledge. Just as 5-year-old Dylan has learned the basics of reading and writing (in both Spanish and English) in the face of unprecedented circumstances, so too may it come to be recognized that nurses, in 2020, have learned anew the “reading and writing” fundamentals of our discipline.
2020 was originally destined to be the year of the nurse and midwife, but it really turned out to be a year of uprising. A year of change and adaptation. A year of learning and unlearning. It was a year of putting action behind our thoughts and words, questioning what we know, and standing up for what’s right — even in the most difficult and darkest of times. We protested, marched, wrote letters, and voted. We began to question our role as nurses in the oppression and marginalization of patients and each other. In 2020, I am proud to call myself a nurse but I know that I, and we, still have a lot of work to do. I hope that we never lose the awareness that 2020 has given us and that we can carry it on to the future to better ourselves, better each other, and better the world.
On a personal note, 2020 has catapulted my private and professional life in many directions. In July, my partner graduated from his emergency medicine residency program after spending the previous 4 months straight caring for COVID-19 patients on the frontline during Ohio’s first wave. I won’t lie that I was (and still am) worried about his health and well-being on the frontlines. Simultaneously, he was (and is!) worried about bringing home COVID-19, as I have underlying health conditions that place me at heightened risk. It is not phased on me that many nurses, physicians, and other healthcare providers have lost their lives during the pandemic working on the frontlines. I am grateful that so far we have both maintained our health, and I hope that with a vaccine around the corner that soon we will be able to provide better protection to our frontline workers and the patients they care for.
Since he graduated my partner accepted a job in Washington state as a physician in the emergency room. Because of this, we ended up moving from Ohio to Washington in July. Prior to us moving, I submitted my IRB application for my dissertation, and to my surprise as we crossed the state line into Washington my application was approved! Since then, we got married (outdoor Zoom wedding!), I have completed my data collection, and currently I am diligently working on my data analysis. I hope to defend my dissertation, (probably over Zoom, note the theme here) in the Spring of 2021. But with all of this, I think what I have taken to heart is the only constant is change… and while that change may not have been what you wanted it to be, if you are willing, open, and present, change can have a positive impact in your life – greater than you ever imagined. I can honestly say if you had asked me where I would be five years ago, I would have given you a completely different answer. I am grateful for where I have ended up, but I am excited to see where 2021 takes me (and us).
The year 2020 was my year of sustained close encounters o f the healthcare system kind. Although these encounters were not of the third kind, these were potential for encounters with those who could have been aliens to me. These encounters began on February 10th, when my husband, John, fell on ice outside our house in Maine. I was at UMass Boston at a lunchtime seminar when I received a phone call from a stranger – a woman who was driving by our house and saw John on the ground. She stopped, called 911, and then called me. The local ambulance crew took John to the local hospital about 15 miles away. An x-ray revealed he had a fracture of the proximal end of his left humerus. The orthopedic surgeon on call discussed options, and he and John decided on a closed reduction. So far, a seemingly reasonable decision, so to avoid surgery.
I changed my flight reservation (I typically fly on Cape Air between Maine and Boston) to that evening and saw John at the hospital at about 9 PM. He was in some pain controlled by opioids. He was discharged home the next day with referral for home PT and OT, which were helpful. I arranged for some grab bars to be installed in the house to ease John’s walking between our living quarters (we have a large house that also contains our toy museum) and the bathroom –excellent help from the across the road (we live on US Route !) hardware store staff. PT and OT continued until February 20th when John’s pain became intense. So, another call to 911, another trip to the local hospital, this time seen by a different orthopedic surgeon. X-ray revealed that the closed reduction had failed. Mutual decision to have surgery, especially when the MD told us that he “loves shoulders!” Surgery on February 24th followed by OT and PT while still in hospital, until March 1, when John woke up at about 2 AM with intense pain, soon discovered to be a massive hematoma. Off to surgery that day (even though it was a Sunday). Finally to a skilled nursing facility at a very nice life care community for rehab on March 3rd until John finally came home on April 9th with referrals to home nursing (John experienced a 3 cm dehiscence of the surgical site, so dressing changes were needed) and PT. I am very pleased to let you know that John has recovered almost completely now. The surgical site closed eventually, PT and home RN were not needed by about early May (the home health RN continued longer than I thought necessary, as I can change surgical dressings!), and his arm has almost full mobility. He was finally discharged from orthopedic follow-up visits in September, so no more trips to his office. John now walks very hesitantly so as not to fall, which is a good thing, although difficult for me to witness.
My close encounters with the healthcare team members were much more positive than I would have expected. I did not even have to advocate for John, as his medical and nursing care were efficient, effective, and caring. The second orthopedic surgeon (I had not met the first one) included me in all discussions about John’s condition without my asking for this information, even calling me once when I was at work at UMass Boston. The PT and OT persons included me in their plans of care for John. The hospital and skilled nursing facility staff nurses were caring, expressed their concerns about John, and were receptive to my talking with them about nursology – I gave each one of them our nursology.net card, of course!
The most difficult aspect of the healthcare system encounters came on March 12th, when Covid-19 came to Maine, and I was no longer allowed to visit John at the skilled nursing facility. We tearfully said good night that evening, and I promised to call him every day at 5 PM. John does not enjoy talking on the telephone, so I was surprised that he agreed to my calling him. Obviously, he needed contact with me. Indeed, when I occasionally called a few minutes after 5 PM, he expressed concern that I had had an accident. So, here we are in November 2020, with me at home in Maine all the time—UMass Boston has been doing remote teaching/learning since March 23rd (end of our spring break). Although occupied by teaching and lots and lots of zoom meetings with colleagues – I think we may have invented extra meetings to maintain contact while not on campus together—and my usual writing projects, the second half of spring semester and all of fall semester has seemed like a sabbatical – no commuting to work, more time for self-care, less worry about the possibility of John falling when I am not at home. 2020 is not a year I would like to repeat but it has not been too challenging for me, for which I am forever grateful.
Jane K. Dickinson
2020 was the year with no break.
I work in diabetes, and we often discuss how there is no break from diabetes. Even then, we find little ways to take “breaks” – have a family member help out; cut down on the number of daily fingersticks for a few days; carb out on a holiday; etc. I recently got an email from an organization that was announcing they are taking a break from December 19th to January 3rd. They are giving their entire staff this time to “rest and rejuvenate.” Reading this message really made me stop and think about how we all need a break. And how many nurses don’t get a break – from working on the front line exposed to health and human trauma, to literally not having time to eat a meal or go to the bathroom.
2020 was the year with no break from uncertainty. Often nurses work with people who are dealing with uncertainty and this year nurses had to deal with uncertainty in so many ways themselves – all the while helping their patients, students, staff, and family members handle the chaos that everyday life dealt us.
2020 was the year with no break from upheaval. Things were constantly changing – messages, scientific reports, numbers, job security – and yet we just kept going.
2020 was the year with no break from distraction and loss. The kids who are supposed to be at college came home. The kids who are supposed to be in elementary, middle, and high school, began homeschooling. Parents became teachers. Teachers became online instructors. People lost jobs and businesses and loved ones.
2020 was also the year with no break from accomplishment and innovation. Nonprofits and churches and schools got creative. Boards met virtually and made important decisions for their organizations. National and international conferences went online and delivered valuable content. Families and friends met through video conferencing – sometimes groups who hadn’t seen each other in a very long time! More and more nurses have become familiar with Nursology.net. They are accessing its abundant resources to further nursing knowledge to improve nursing education, research, and practice and ultimately the human health experience.
My wish for 2021 is that all nurses get some sort of break to rest and renew, and know that our work is vital to humankind. Happy New Year!
In the early 1980s when Maeona Kramer and I first began to put together ideas for a text on theory development in nursing, we were committed to addressing nursing knowledge development beyond the typical boundaries of empirical research and theory development. We had both completed, in 1971, doctoral degrees in Educational Psychology (Maeona at Wayne State University in Detroit, and me at the University of Utah) focusing on theory development in education (nursing doctoral degrees at the time were few and far between). For that first edition we drew on the work of a psychologist named Zygmunt Piotrowsky (1971) who had proposed that the development of knowledge required contributions from scholars with different personalities, some who were drawn to theoretical abstract thought, and some who were drawn to concrete empirical “laboratory” science.
In 1987 when we embarked on the 2nd revision of our book now titled “Knowledge Development in Nursing” we introduced Carper’s fundamental patterns of knowing in nursing, which gave us a starting point for narrative clearly grounded in the discipline of nursing. In the 3rd edition (1991) we turned our attention to revising our language from the stilted tradition of what was once considered scholarly writing to language that was more accessible and gender neutral. By 1999, we realized that simply listing and describing Carper’s patterns of knowing fell short; we needed to project ways in which knowledge is developed for each pattern of knowing. This evolution made it possible to articulate our belief that nursing knowledge encompasses so much more than that which can be studied empirically. However, we continued to have this sense that something was missing, and in 2008 we articulated the emancipatory pattern of knowing.
It was the growing and compelling body of nursing literature focused on critical social theory, socio-political knowing, and social justice that gave us the impetus, in 2008, to develop the emancipatory pattern of knowing. We see this not as simply a fifth pattern of knowing, but rather as the fundamental human capability to see a situation, recognize that something is amiss, and create ways to change the situation – an ongoing process in creating nursing knowledge that is necessary for the development of knowledge related to any of the four fundamental patterns of knowing.
We had finally arrived at the intersection of social activism and the development of nursing knowledge. But what does this really mean? It is now over a decade since we first conceptualized what emancipatory knowing means, and the possibilities that this pattern of knowing holds for the future development of nursing. We have been puzzled by the fact that it took us so long to see the connections and have speculated why this might be so (the long-standing subservient positions of women and nurses, the socialization to avoid that which is political, the dominant concern with one-to-one “bedside” care, etc. etc.).
The fact has been that nurses, dating from the earliest days of the profession, have engaged in social and political activism, but have remained reticent to fully embrace social activism as a core nursing concern. Maeona and I both had been actively involved in the 1980’s effort to advance feminism in nursing through the work of “Cassandra: Radical Feminist Nurses Network.” In 2000, Richard Cowling, Sue Hagedorn and I wrote “A Nursing Manifesto: A Call to Conscience and Action,” acknowledging that at its core, nursing itself is “political” in the sense that politics is the ability to advance one’s own values in a public context. Every time a nurse acts to bring nursing values into action, bends over backwards, jumps through hoops, and does cartwheels to obtain what individuals and families and communities need to be healthy, we are acting politically. We are activists.
The values of our discipline, expressed eloquently in the theories and conceptual models that form our foundation, guide our thoughts, words and actions. At the same time, our intimate engagement with others as we practice nursing, also informs what we think and do, opening awareness of ways to challenge, question and re-design the nature of our discipline. The social and political contexts we face in this moment call for a new awareness of distortions, prejudices, stereotypes, social injustices amplified by racism. What is happening in this moment of time has raised alarm bells and demands that we turn our gaze on ways in which we nurses, individually and collectively have been complicit. The situation we find ourselves in today calls for nurses, and particularly white nurses, to finally recognize the dynamics of racism that infect our own “house” and start the tedious, and yet ultimately rewarding, process of healing.
In facing this challenge, we will begin to understand the dynamics of the widespread public health crisis of racism in ways never before attempted. The development of knowledge demands that we understand the problem, explore the dynamics that sustain the problem, seek new ways to prevent and change those circumstances that perpetrate the crisis, and heal those who are affected. There are theories and philosophies of our discipline that can guide us as we move forward. Here are a few to consider:
This website – Nursology.net – is accomplishing the very important purpose of bringing to the fore the rich traditions and values expressed in the theories, models and philosophies of our discipline. And now the time has come to recognize the ways in which the practices, attitudes, philosophies and thought patterns that derived predominantly from white perspectives are lacking. This reality now calls for activism of a type not often recognized – a sustained and determined challenge that can change our own disciplinary ways of thought and action. This does not mean in any way that we discard or denigrate our foundation, or that we disrespect the ways in which our own scholarly work has real value. What it does mean is that we examine our accomplishments through a new lens, and recognize ways in which we need to re-direct course.
Take as an example my theory and practice of “Peace and Power.” This theory was inspired in part by the Brazilian scholar and activist Paulo Freire (1970), and is closely aligned with practices commonly used in native American cultures and in Quaker communities. Yet people of color have also challenged this process as reflecting colonized white privilege – despite the commitment embedded in the processes that seek to dismantle power inequities in group processes. Part of this challenge came from the early descriptions of the process that clearly reflected the concerns of white women and defined by white feminists. The fact is that the lens through which I view these ideas bear “decolonization.” What this means exactly is still in process, requiring a deep deconstruction of the Euro-centric assumptions on which the theory and process is built. How this will affect the theory itself remains to be seen, and may be actually accomplished by scholars of the future!
The time has come to shift this process in to high gear – to recognize the ways we have silenced the voices of many of those we claim to serve, ways in which we have excluded nurses of color from participating in our efforts to develop the knowledge of the discipline, and ways in which white nurses have in fact dehumanized, disrespected and excluded nurses of color from full participation in the practices, leadership and development of the discipline. This is not an activist project that can happen in one or two “training” sessions addressing “diversity, inclusion and equity.” Nor can it be accomplished by performative actions such as recruiting more people of color, or curriculum revisions. Although of course these kinds of actions are warranted and need to happen they will not in themselves end the inequities and injustices of racism. There are no formulas.
I believe that the activist commitment of all nurses now and going forward is to learn all we can about the mechanisms of both systemic and everyday racism, question each choice we make in light of our growing awareness, challenge one another with loving kindness, and create spaces that challenge white privilege. The “Overdue Reckoning on Racism in Nursing” discussion series has now ended but in those discussions we established a starting point, including important resources for becoming well informed about the challenges we face. Now we have new actions to continue this work, centering nurses of color and engaging white nurses in meaningful processes consistent with the ideals of “truth and reconciliation.”
While these actions are labeled as “activism” they are also vital in shaping nursing knowledge going forward. Becoming immersed in social and political activism to address the public health crisis of racism, guided by the values of our discipline, we provide the best of nursing care to heal ourselves, to heal the damaging effects of racism in our communities, and build a stronger future. We create the ‘hermeneutic circle” of thought and action – where our actions inform how we think, and how we think shapes our action in a constant process that changes and shapes both thought and action going forward.
Freire, P. (1970). Pedagogy 0f the oppressed. Seabury Press.
Piotrowski, Z. A. (1971). Basic System of All Sciences. In H. J. Vetter & B. D. Smith (Eds.), Personality Theory: A Source Book (pp. 2–18). Appleton-Century-Crofts.
Details for a Virtual Nursology Week 2021 have just been announced on the Nursology Theory Conference website! This virtual conference will be a combination of the March 2020 program that was interrupted by the COVID-19 pandemic, and a transition to what we can anticipate when we are able to gather at the University of Tennessee in Memphis, which we hope will happen in the spring of 2022!
Since our 2021 conference will be a virtual event, we decided to deviate from the intense 2-day format that works well when we all travel to be together in one place, but creates an unbearable experience of staring at our screens for far too many hours at a time! There will be three general sessions from 10 am to noon (Eastern) on Wednesday March 17th, Monday March 22nd, and Wednesday March 24th. Every day of that week, there will be a schedule of stand-alone 30-minute sessions during which the breakout sessions will be available! Attendees will be able to attend as many of the sessions as you wish – even every single one of them if you so desire!
We are in the process of setting up the details of this plan, and have been in touch with everyone who had an abstract accepted for 2020 so that they can select the time for their breakout session. There will be times available for a few additional breakout sessions, so we will be announcing additional abstract submissions soon.
If you registered for the 2020 conference and asked to have your registration held for the 2021 conference – you are all set, and you will receive confirmation of your registration soon. Registration for those who have not yet registered will be open by November 1st – so watch for details coming soon! Links to all of the conference activities will be available to those who register on an “honor system” basis!
Follow the Nursology Theory Conference website for details on abstract submissions, registration, and breakout sessions! Here are the details for the general sessions to wet your appetite for attending this series of important events!
Wednesday March 17, 10 am to noon (Eastern)
Panel discussion honoring the contributions of Rosemary Ellis
Keynote address by Patricia Davidson, PHD, MED, RN, FAAN. Professor and Dean, School of Nursing, Johns Hopkins University – topic: Is STEM and Nursing Theory an Oxymoron?
Monday, March 22 – 10 am to noon (Eastern)
Student/Early-career Scholars Panel: Emerging Possibilities for the Focus of the Discipline
. . . . it is worth reiterating the point that compared with atheoretical actions, those that are conceptually grounded have a higher probability of achieving their intended consequences. Not just because they are contemplated more intentionally but because the vast majority of . . . . theories/frameworks pay heed to the important messiness of context and the use of power. (1) Patricia Butterfield (2017, p. 9)
With a strong conviction of the vital importance of nursing’s own theories and frameworks, the Nursology.net management team embarked on the development of a website to provide current and accurate information about discipline-specific knowledge. We started the development of the site in the summer of 2018, with the goal of publicly announcing the site once we had at least 20 theories/models on the site, and at least 1 Exemplar in each of the “Exemplar” sections! We met that goal and officially launched the site on September 18th, 2018! Today, we have
Plus, a new section dedicated to nursing philosophy, a host of resources related to nursology knowledge development, a record of past nursology-related conferences (including proceedings, photos and other materials related to the conferences), information about events that will be happening in the future (despite the pandemic), and an unbroken record of blog posts every Tuesday!
I, Peggy Chinn, have served as the architect of the site and am responsible for the nitty-gritty work of putting it all together, but all of this is only possible because of the work of members of our team of nursology scholars who have identified and composed the content.
Here are reflections from members of our management and blogging teams in response to two questions:
How has nursology.net influenced your approach to teaching, research, or practice?
What do you anticipate for the future of the discipline, and the role of nursology.net in shaping that future?
How has nursology.net influenced your approach to teaching, research, or practice?
Jacqui Fawcett The website is exceptionally useful as a resource for the PhD students I have the honor to teach, as well as all other students in our program., and as resource for colleagues who are “thirsting” for information about nursology discipline-specific knowledge. In addition, I cite the blogs in many of my publications—journal articles, book chapters—and presentations at conferences and as a guest lecturer for other nursology programs.
Marlaine Smith When I’m with any student or faculty group I call attention to the nursology.net site and describe the many resources available. I’m teaching a course now for PhD students, Evolution of Nursing as a Professional Discipline. In the first module I introduced students to Nursology and they were invited in the discussion board to respond to a question related to the Nursology site. I have received so many comments from students and faculty who are amazed at and grateful for the many resources on the site. The Nursology blogs offer short position/perspective pieces that can spark meaningful discussion.
Rosemary Eustice Nursology.net is a vehicle that highlights the contribution of nursology wisdom to health and health care issues. The website continues to influence my teaching by enabling me to find new teaching and learning strategies that foster students’ acquisition of nursing knowledge to understand nursing phenomena of interest. One thing that inspires me everyday when I share this website with my students, is to see how much the students appreciate the value of nursing theories and how much they wish for ‘good’ mentors and educators to support the next generation of competent nursologists. On the other note, as a nurse researcher, nursology.net has increased my curiosities on nursing knowledge development and how nursologists can utilize research in clarifying and developing new concepts/ideas using nursing lenses.
Dorothy Jones I am impressed with the global response to the nursology.netwebsite. When I have shared this information with faculty and students at a University in Spain where I consult, the reaction has been inspirational. Doctoral students love having “free” access to the nursing theorists and their work in one central space. Faculty describe the site as “a way to connect with the nursing community “globally.” Dr. Emiko Endo from Japan recently translated a nursology blog “Covid 19- What would Margaret Newman Say” into Japanese for her students. She also presented the information to participants attending a virtual Nursing Theory Conference. Dr. Endo reported how moved the audience was by the message. When I shared the web site with a group of International Gordon International Scholars at Boston College, from Italy, Brazil and Africa they were excited to learn about the site and immediately shared it with the other faculty and students. They noted that they now had immediate access to information about nursing theory never available to them before. The responsiveness of the site to contemporary issues makes nursology.net a living document that promotes nursing knowledge and its potential impact on the health and wellbecoming of all.
Jane Flanagan I am teaching a new course this year – Philosophical Inquiry for Knowledge Development in Nursing. I introduced my students to nursology.netas well as the faculty of a companion course – Strategies for Knowledge Development in Nursing. For my course, we will be using the site for the many resources it offers. I have encouraged them to read and respond to the blogs. I think if I was to have a re-do on my syllabus, I would actually have an assignment include a meaningful contribution to the site. These students are our future nurse leaders and I know like many on this site, we want to hear from them. We have only had one class thus far, but based on the great dialogue, I think they will be joining in on the conversations on nursology.net
Jane Dickinson I am pointing students to nursology.net in the Nursing Knowledge in Nursing Education course I teach for doctoral students in our Nursing Education program. I also have them write a blog post and an exemplar (if applicable) for submission to nursology.net as course assignments. Nursology.net is an amazing resource where students can learn about nursing theorists and their work. It also provides a wonderful opportunity for them to think and write about their own experiences with nursing knowledge.
Chloe Olivia Rose Littzen As a PhD candidate, Nursology.net has influenced both my nursing education and the ways in which I know the world. Specifically, Nursology.net was one of the few references I was able to use for specific theory related nursing knowledge content in studying for my comprehensive exams.The organization of theory-related content made it easy for me to find what type of information I needed, and I knew that the information included was substantive in nature. As a nurse, Nursology.net has also informed the ways I know the world by keeping me up-to-date on current issues and events, while simultaneously giving me access to new nursing knowledge content I may have never come across during my own reading.
Danny Willis In the PhD course “Nursing Knowledge Development” I have been teaching at the University of Wisconsin-Madison we used the resources on nursology.net to guide our thinking. PhD students were thirsty to explore the philosophical, conceptual, theoretical, and empirical aspects of the discipline in research, education, practice, and policy. Great examples are showcased on the website, which they enjoyed! As these PhD students prepare for their research and future programs of disciplinary knowledge development as leaders in the discipline, through the website they were better able to understand the value of grounding their work in the discipline, which feels like a Wonderful move in the right direction. Nursology.net is recognized as a go-to resource with the potential for nursologists to contribute to ongoing conversation, like none other!
Patrick Palmieri The emerging role of nursology.net in low- and middle-income countries is impactful due to our limited access to nursing knowledge. Unfortunately, knowledge is too expensive for many nurses throughout the world. The limited financial resources in many countries negatively impacts access to nursing literature, including published papers and nursing textbooks. Through nursology.net, student nurses and professors throughout the world have immediate access to contemporary nursing knowledge, including timely theoretical discourse related to current trends and events. Most importantly, nurse scholars such as I, are able to translate the resources, without copyright issues, for immediate application in our courses. This year, we continued to advance a project to translate resources from Nursology.net into Spanish for the history of nursing and theory of nursing courses. Through the efforts of the leaders and many donors at Nursology.net, the barriers to accessing knowledge have been removed. Nursology is linking scholars to students throughout the world!
What do you anticipate for the future of the discipline, and the role of nursology.net in shaping that future?
Jacqui Fawcett I am both pessimistic and optimistic about the future of nursology—I am very concerned that our disciplinary knowledge will not survive as a continuing way to guide disciplinary advancement—there always is a tension to focus on pragmatic aspects of issues rather than the philosophical, conceptual, and theoretical aspects, and there is much too much emphasis on empirical methods—the primacy of methods for so many people is of great concern to me. In contrast, I am encouraged by the number of people who have been accessing nursology.net and by the continued publication of multiple editions of several books about nursology conceptual models and theories. Nursology.net serves as an ongoing resource for all nursologists, with blogs and other content already shaping what nursologists think about our discipline. We definitely are living our mission to be a repository for all things theory in nursology!
Marlaine Smith While I can despair at the lack of valuing of nursing theories/models in our research, the lack of content related to nursing theories within the curricula, and the frequent absence of a clear nursing perspective in advanced practice and interprofessional practice, I’m encouraged by signs that there is a renewed appreciation of the importance of generating nursing qua nursing knowledge and practicing from nursing’s disciplinary perspective. Some of those signs… the committed group of scholars who have been attending and contributing to the annual Nursing Theory Conferences…the growing number of AAN members joining the Nursing Theory-Guided Practice Expert Panel…the recognition by CNOs about the value of practicing from a nursing theory-guided model…the lights in the eyes of students who “get it”. Nursology.net will continue to support this emergence. The site has global outreach and can bring the nursing community together around the critical issues of expanding disciplinary knowledge development and application.
Rosemary Eustace I am optimistic that the future of the discipline and the role of nursology.net will continue to find a voice in health care, especially in the area of policy making. However, this process will be timely if we continue to value and acknowledge the uniqueness of nursing knowledge in influencing health care outcomes. When I think back at what we have learned so far and are learning each day with the wake of the Covid-19 pandemic, I see a window of opportunity for nursologists to advocate for this unique STEM discipline and use nursing knowledge to make positive changes in health care systems and population outcomes.
Dorothy Jones As a discipline we continue to experience many issues, even resistance to articulating nursing science within nursing curricula, research and care delivery. Emphasis on preparing nurses with essential content that focus on role development with little grounding in philosophical and theoretical underpinnings of the discipline challenges knowledge development and compromises the visibility of nursing’s impact on care delivery. While the interdisciplinary / intra professional focus on contemporary issues is critical, the unique voice of nursing is essential to informing and reshaping responses to global health concerns. While the threats to advancing nursing science are apparent, there is also indications of a renewed interest in nursing’s identity and expansion of nursing knowledge. Increasing membership in nursing theory groups, attendance at nursing theory conferences and active progress by groups such as the AAN Expert Panel of Nursing Theory Guided Practice to link nursing’s knowledge and policy, offer signs of hope for the future. Nursology.net has been an important catalyst that has supported this renewed dedication to nursing knowledge. The site provides an essential platform for all nurses to share in our history, explore our future, and increase our awareness of new opportunities for nursing’s voice to influence issues of global concern. Thank you nursology.net!
Jane Flanagan I think we are in a time that has raised our social consciousness and many nurses are questioning our role in power dynamics, sociopolitical movements, structural racism. They are asking are we going to be part of the problem or mobilize and act? Foundational to our discipline is our ethics aimed at striving for the greater good, health and healing for all people. We can no longer tolerate an inequitable society or health care system that does not meet the needs of those we say we are committed to serve. Nursology.net is a forum that created the space for us to have the dialogue, work through the sometimes awkward, sometimes obvious and at other times not so obvious issues. It is a safe place that allows all nurses to think, write share and activate. Our future is in not only finding our voice, but in leading the way. Nursology.net is the format and catalyst to accelerating our movement toward a universally experienced wellbecoming.
Jane Dickinson I see nursing knowledge (and all five ways of knowing!) becoming more prominent in nursing education, research, and practice as we move further into the 21st century. Nursology.net is the preeminent source for nurse educators and leaders in research and practice to share their work, and to inspire newer nurses to take the next step in further developing and refining what we know and what we do.
Chloe Olivia Rose Littzen I anticipate that nursing theory and philosophy, including our unique disciplinary perspective, will come to the forefront of importance in our nursing practice, research, education, and policy. Additionally, I believe that nursing theory and philosophy will be revealed to play a significant role in the well-being of our nurses and the healthcare environment. I believe Nursology.net will support nurses to be confident and grounded in their own unique disciplinary perspective, promote the use of nursing theory and philosophy in all settings, and provide a forum in which nurses can gather from across the globe to stay up-to-date on relevant issues and events in nursing.
Danny Willis The future is in our hands and the website will continue to play a major role in orienting nurses and our PhD, DNP, Masters, and Baccalaureate students. Nurse leaders and educators in practice settings would benefit from having this website as a part of their orientation. Therefore, I see it as my responsibility to let every Chief Nursing Officer I meet with know about this resource and offer to speak to anyone in educational leadership roles in practice settings about the website. Faculty leaders must also be aware and able to speak to the substance of the discipline, which the website acts as a vehicle for. Nurse leaders will be called upon to champion ready access to the fundamentals of nursing depicted on the website and to further the ongoing evolution of disciplinary thought and communication. The future of the discipline can be bright as we nurses promote humanization, caring, healing, relationship, love for one another, diversity, belongingness, transitioning through living and dying, meaning in living and dying, and well-becoming. The future can be bright if we nurses promote openness, dialogue, healing transformative power with each other, critique, intellectual curiosity, community, and nursing ethics of our shared humanity and a deep commitment to the greater good for all of humankind and planet Earth in all its complexity and beauty. Onward nursologists!
Our Nursology.net community is committed to addressing the burning issue of racism, how this systemic condition has influenced the development of nursing knowledge, and how this situation can be changed (see our statement on racism in the sidebar for more information). The NurseManifest project has just announced a series of web discussions “Overdue Reckoning on Racism in Nursing” that will interest many nursologists! Starting on September 12th, and every week through October 10th! This initiative is in part an outgrowth of the 2018 Nursing Activism Think Tank and inspired by recent spotlights on the killing of Black Americans by police, and the inequitable devastation for people of color caused by the COVID-19 pandemic.
Racism in nursing has persisted far too long, sustained in large part by our collective failure to acknowledge the contributions and experiences of nurses of color. The intention of each session is to bring the voices of BILNOC (Black, Indigenous, Latinx and other Nurses Of Color) to the center, to explore from that center the persistence of racism in nursing, and to inspire/form actions to finally reckon with racism in nursing.
Lucinda Canty, Christina Nyirati and Peggy Chinn have teamed up to create the plan – you can see the details here; it is also easily accessed from the NurseManifest main menu!
One of the first “lessons” in my now-long-ago nursing education was “the nursing process.” This was in the early 1960s, almost a decade before anyone spoke of nursing theory, but the University of Hawaii (my alma mater) had modeled the curriculum on that of the University of California at Los Angeles (UCLA) which was designed around the ideas of Dorothy Johnson. These ideas would ultimately become known as Dorothy Johnson’s Behavioral Systems Model (See also the history of the UCLA School of Nursing, pgs 43-48).
Of course this same problem-solving process is widely used in many walks of life, and many see it as a mere pragmatic outline for making good decisions and forming appropriate action – a necessary process but several degrees removed from developing foundational knowledge of the discipline. In reflecting on the situation in which we find ourselves today I fear that as a discipline we have not adequately faced the realities before us as a discipline and as a society – both as a problem, and as a health experience. As I wrote in my January 20th post titled “Decolonizing Nursing”
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 (see https://nursology.net/2020/01/14/decolonizing-nursing/)
I know that I am not alone in recognizing this challenge, but I continue to wonder — when and how will this begin to change? This is not merely a “political” matter — it is a matter of life and death, of health and sickness. It is a pandemic of proportions far beyond the COVID-19 pandemic, and it has been infecting our lives for decades. In recent weeks we have witnessed the public killing of George Floyd by a Minneapolis police officer, of Ahmaud Arbery shot down while jogging in February, and Breonna Tayler, an EMT with plans of becoming a nurse, killed by police in her own home in March. Then just a few days before this post published, the killing in Atlanta of 27-year-old Rayshard Brookes, shot in the back several times by police after indicating that he was able and willing to walk home to his sister’s house.
These tragic murders in plain sight, coupled with widespread recognition of the over-proportioned number of Black and Brown people suffering from COVID-19 – give us a glimmer of opportunity to finally act. The calls for change are so pervasive and so sustained, that those of us ready and willing to make change have a real opportunity to do so. And so I return to my earliest nursing education and the foundational ideas that have been baked into my very fabric – the processes of active listening and observation that are vital to assessing and “diagnosing” a problem(1).
One of the notable signs that appears in all of the protests says “I see you, I hear you.” For me, this is a key to meeting the challenge before us. It starts with our interactions among our own colleagues. Throughout my nursing career I have seen many Black nurse colleagues come and go, and every single one of the nursing faculty I have served with have repeatedly decried how “difficult” it is to recruit and retain Black nurse faculty. Yet all too rarely have I witnessed concerted, deliberate efforts by the predominantly White(2) faculty to stop, step away from our privilege, seek the authentic stories of our Black colleagues, and actively hear (understand) their experience. Equally egregious is the fact that there are myriads of situations that, viewed through a lens of anti-racist awareness, could be instantly recognized as potentially harmful to a Black person, even dangerous. But over and over again we turn a blind eye, and fail to act. I have all too often been just as complicit in all of this as anyone else – we have all been caught up, and participate in a systemic web of injustice. And I suspect that this pattern is not unique to academics – that it runs deep in every setting where nursing is practiced.
Further, there is the all-too often deflection of the problem by the insistence that the “problem” is not unique to Black people – that all lives matter. Of course all lives matter and Black people are not the only ones who suffer injustice and discrimination. But this sentiment turns the lens away from the specific voices, experiences, and challenges faced Black people. We can listen to all people – but until we listen to, and sincerely seek to understand, Black people and recognize the experiences of trauma and harm that Black people uniquely suffer, and how we participate, we will not be able to truly understand the problem.
It is undeniable that the prejudice and hate toward Black Americans, and people of African descent in many other countries is profound and amplified by the historical trauma of slavery and in the United States, the fall-out of the civil war fought to end slavery in the United States. I hear many White nurses in my circle expressing true outrage about this situation and we are all sincere in our desire to see it change, yet the problem persists. Until we White nurses face the reality of our privilege and the injustices that flow from this, until we learn ways to step away from our privilege and engage in serious anti-racism work, until we create spaces in which we can authentically engage with our Black colleagues to understand the problem, the injustices in our own house will remain.
We can all shift in the direction of being part of the solution. There are signals that point us in the direction of actions we can all take – particularly those of us who are White – to seize this moment, start to address the scourge of racism in our own house, and make real change. The circumstance of the COVID-19 shift to virtual reality offers ample opportunities for all of us to engage in antiracism work! Here are a few examples that I can personally recommend – if you start searching, you will find many many others!
Nurse Caroline Ortiz organized a “platica” (Spanish for discussion) held on March 9th over Zoom. Caroline recorded the session, which you can access here: https://vimeo.com/397047962. You can organize similar discussions – we are all now expert Zoom organizers!
Practice generosity of spirit toward your nursing colleagues – each of us are being challenged in this moment to examine our own attitudes, actions and words. Many of us are just starting on this journey. This demands kindness and understanding toward one another as we work together, often in uncomfortable situations, to make meaningful change. Let us call forth the best we can be, and support one another with compassion and understanding when we mis-step.
Consider how application of many tenets of our own nursing theories can be activated in the quest to address racism. Consider Peplau’s approach to meaningful interpersonal relationships, the very important insights from Margaret Newman “Health as Expanded Consciousness,” and any one of several theories of caring such as Watson’s Theory of Human Caring, or Boykin and Schoenhofer’s Theory of Nursing as Caring, While these and other nursing theories were not created specifically to address racism and social injustice, we certainly can draw on their wisdom to bring nursing perspectives to the center in our anti-racism work.
Make your own video, as a nurse, speaking to these issues and how your values, ideas, nursing perspectives inform your actions to fight racism! Post it on YouTube or Vimeo .. and then share it with us – we can consider posting on Nursology.net or another nursing website. See this wonderful video (below) by de-cluttering expert Mel Robertson for inspiration!
Ultimately the concept of active listening formed a basis for the essential processes of “critical reflection” and “conflict transformation” in my heuristic theory of Peace and Power.
See this excellent article from the Center for the Study of Social Policy on the capitalization of the terms “Black” and “White,” which I consulted in refining this post: Nguyễn, A. T., & Pendleton, M. (2020, March 23). Recognizing Race in Language: Why We Capitalize “Black” and “White” | Center for the Study of Social Policy. Center for the Study of Social Policy. https://cssp.org/2020/03/recognizing-race-in-language-why-we-capitalize-black-and-white/