Donna Diers, PhD, RN, FAAN (1938 – 2013)*

Guardians of the Discipline

To remember Donna Diers is to bring into clear focus what it means to be a guardian of

Donna Diers

our discipline.  Donna died on February 24, 2013, but her influence on the discipline of nursing remains palpable, even for many who never knew her.  Donna was born on May 11, 1938 – just one day before the May 12th birth date shared by  Florence Nightingale and Martha Rogers.   These three figures – Donna Diers, Martha Rogers and Florence Nightingale shared many traits of creative vision and great leadership – not the least of which was sparking lively controversy that led to great leaps forward in our profession.

Donna Diers aspired to be a journalist before she decided on nursing as a career, then came to realize both as Editor of Image: The Journal of Nursing Scholarship from 1985 to 1993. She assumed her editorship the year after her tenure as Dean of the Yale School of nursing ended (1972-1984). During her deanship, she developed the first Graduate Entry Program for people without an undergraduate degree in nursing, a program that continues to this day leading to entry into speciality practice as an advanced practice nurse.

Donna was a prolific writer – she wrote one of the first nursing research methods texts, and her writing appears in almost all major nursing journals and in many texts. Her talent as a journalist came through vividly in her editorials published in Image – editorials that I anticipated and read eagerly as each issue arrived in my mail.

There is no better tribute to Donna Diers than the 2010 “Living Legend” ceremony when the American Academy of Nursing bestowed this honor on her. Her own remarks at this ceremony bring to life the amazing spark that she brought to the world and reveal the ways in which nursing and journalism came together in her career. She also shares a moving tribute to many others whom she names as significant in her own life. I urge you to take a few moments to dwell with the memory of this remarkable guardian of our discipline – Donna Diers.

* Portions of this post appeared previously on the INANE blog 

Public session of the Committee on the Future of Nursing 2020-2030

The Committee on the Future of Nursing 2020-2030 will be holding a public session onWednesday, March 20, 2019, from 1:30 PM to 4:00 PM ET, online and at the National Academy of Sciences building in Washington, DC.

This committee has been tasked by the Robert Wood Johnson Foundation to extend the vision for the nursing profession into 2030 and to chart a path for the nursing profession to help our nation create a culture of health, reduce health disparities, and improve the health and well-being of the U.S. population in the 21st century.

Through the course of the study, the committee will meet several times. This public session is one of the many processes that the committee will use to gather information and assemble evidence that members will examine and discuss in the course of making the committee’s findings, conclusions, and recommendations. The focus of this public session is for the committee to clarify the scope of the charge with the study sponsor and initiate the process of gathering relevant information related to the study. Future public sessions will focus on specific topic areas and be conducted in other locations.

This public session will be accessible via webinar and in-person attendance (seating is limited).

Please register online by 12pm ET on March 20, 2019, to receive an email with the instructions on how to join this public session.

More information about the study can be found here.

What: Public session of the Committee on the Future of Nursing 2020-2030
When: March 20, 2019, from 1:30pm to 4:00 pm ET
Where: Online and in person at National Academy of Sciences building, 2101 Constitution Avenue, NW, Washington, DC 20418
How: Click here to register online by 12 pm ET on March 20, 2019

A dozen (and one) 2019 nursology events!

When we first started building Nursology.net, one of the “sections” that we set out in the plan was a “future events” section.  We all knew of a handful of conferences related to the development of nursing knowledge, but lo and behold – we have now discovered a grand total of twelve!  And there could be more!  If you have not yet browsed the impressive list of conferences, hover over “Future Events” on the main menu, and you can scroll down for an overview that includes locations and dates!

The first event of the year is the 50 Year Perspective conference at Case Western Reserve University in Cleveland, OH, March 21-22, 2019.  This conference will commemorate the very first nursing theory conferences held in 1968 and 1969 that resulted in a number of landmark articles published in Nursing Research – articles that remain a mainstay that launched a widespread effort to develop nursing’s disciplinary knowledge. The focus of the conference will be the disciplinary perspective of nursing, and the structure of nursing knowledge.  Articles in the current issue of Advances in Nursing Science, Volume 42:1 provide a focus that will be a foundation for discussion at the conference – so whether you can attend or not, check out those articles to learn more!

From March on, we have roughly one event every month until the end of the year – occasionally more than one!   Most of these are focused on one particular theoretic or philosophic focus, but are still of general interest for many nursologists!  Many are accepting abstracts, so watch our sidebar “Due Dates” feature to keep up with these opportunities.

The November KING conference is a collaborative conference for everyone, featuring participation from a number of groups focused on the development of nursing knowledge – including:

  • International Association of Human Caring
  • International Caritas Consortium
  • International Consortium of Parse Scholars
  • Neuman Systems Model Trustees Group, Inc.
  • Orem International Society
  • Roy Adaptation Association
  • Society for the Advancement of Modeling and Role Modeling
  • Society of Rogerian Scholars
  • Transcultural Nursing Society
  • Watson Caring Science Institute

Abstracts for this Collaborative conference are not due until May 1st — so consider this great opportunity now!

The (and one) conference is the annual Nursing Journal Editors (INANE) conference in July 30 – August 2 in Reno, Nevada – an event that welcomes all of those interested in and participating in the process of editing and producing nursing literature.  The conference this year features a day-long workshop for new editors and those who want to pursue a journal editing career!

The opportunities abound!  If you cannot participate in person, watch Nursology.net for reports and resources from each of these events!  If you know of an event that we have not yet listed, please let us know!  After each event concludes, we will move the conference “page” to our “history” section and add reports, papers, photos and videos that the conference planners provide for archiving. By keeping an eye on these important resources, you can benefit from being informed of the important outcomes and advances that will be sure to enrich our discipline!

 

Notable Works on “Medicalization” by Beverly Hall and Janet Allan

Note:  we are delighted to introduce a new Nursology.net series featuring notable works exploring concepts and issues that are related to the development of nursing knowledge. As this series evolves, you can see the posts in the series “Notable Works” under the main menu “Series/Collections”

In 1988, Janet Allan and Beverly Hall, both prominent nursology scholars and leaders

Janet Allan

in the discipline, published an article titled “Challenging the focus on technology: A critique of the medical model in a changing health care system.” Drawing on a rich body of literature from nursing and other disciplines, and their own insights as nursing scholars, they called on nurses to examine and challenge the dominant model that derives from a model that views the body as a machine, one that needs to be “fixed” if something goes awry, and the process of disease as an evil force to be obliterated.  They called for nurses to question the reification of

Beverly Hall

this model, and to engage in dialogue to explore alternatives that are derived more directly from the values and goals of nursing. In particular, they pointed to the lack of established efficacy of the model (despite claims to the contrary), the serious unaddressed ethical and iatrogenic questions the model engenders, the harmful effects on health and well-being that derive from the model, and the economic consequences (Allan & Hall, 1988).

In 1996, Hall specifically addressed the challenges of medicalization in undermining nursing approaches to chronic mental illness. In her critique, she discussed the ways in which the disease framework of chronic mental illness creates barriers to understanding the person as a person, and creates an unequal power structure that draws attention away from the personhood of the patient and their experience. Stated succinctly, Hall noted: “Nursing, in its attempt to be scientific, has embraced objective theories and diagnostic schemes that are devoid of practical reasoning that has as its inherent focus humanistic values, personal meanings, and subjective language” (Hall, 1996, p. 24).

In 2003, Hall published another remarkable work that represented a departure from the purely “scientific” approach to show what can emerge from an approach that uses practical reasoning, humanistic values, personal meanings and subjective language in exploring what is recognized as the focus of the discipline of nursing- the human response, the human experience.  In this moving essay Hall draws on her own experience of having a life threatening diagnosis of breast cancer, reflecting on the effects of medicalization on her experience.  As she summarized in the abstract, these effects were “(a) giving useless treatments to keep the patient under medical care; (b) demeaning and undermining efforts at self-determination and self-care; and (c) keeping the patient’s life suspended by continual reminders that death is just around the corner, and that all time and energy left must be devoted to ferreting out and killing the disease” (Hall, 2003, p, 53).

Hall’s essay prompted three nurse scholars/practitioners, each with different experiences related to diagnosis and treatment in the current health care system, to respond to Hall’s call for ongoing dialogue.  Richard Cowling, Mona Shattell, and Marti Todd (2006)  added their own personal narrative to the dialogue — Richard as a person who experienced a mitral valve prolapse; Marti living through the experience of ovarian cancer, and Mona who has had very little experience as a patient, but wrote as a nurse and stated:

“Upon reflection on my personal experience with medicalization, I separate myself from my colleagues, to use Hall’s term, “not-yet-diagnosed, against the sick.” (Hall, 2003, p62). I am not conscious of this; however, it is a part of me. Even as I write about my support of Hall’s personal experience of medicalization, I am simultaneously betrothed, naively, to medicalization.

Naivety is not an excuse. In fact, it is what angers me most about medicalization—this overreaching power that silences me.” (Cowling, Shattell & Todd, 2006, p. 299).

Responding to Cowling, Shattell and Todd’s reflections, Hall affirmed their work, and stated: “As a reader, I feel privileged to be on an inside track with personal narrations that are conceived within such a sensitive context” (Hall,2006, p. 305).  She also observed that her own 2003 article, and in the Cowling, Shattell and Todd article, there could be a misunderstanding as to the nature of “medicalization” – that this dynamic is not about helpful or not helpful medical care.  Rather,

“medicalization is a form of organized and systemic oppression that is so culturally entrenched, powerful, and invisible, that everyone’s choices, including those practicing in the biomedical field are manipulated, and options are precluded with scant awareness on the part of any of the actors (Hall, 2006, p. 305.)

Medicalization is the exercise of a power dynamic that restricts the possibility to see any alternatives other than those prescribed by the “canon,” and that insists on excluding any other possibility.  From this frame of reference, western medicine is not the only source of “medicalization” – other forms that we sometimes call “alternatives” can be equally drawn in to the same type of power dynamic that uses the power of prescription to diminish human experience, and that destroys the possibility of an authentic human relationship that nurtures meaning and authenticity in the experience.

Parallel to the writing and deep thought that produced these notable articles, Hall was simultaneously engaged in her own nursing practice in the community, working with people who were experiencing life-threatening illness.  Drawing on her own experiences as a patient and as a nurse, she wrote and self-published a book that provides a glimpse into possibilities beyond the realms in which medicalization has taken hold.  The second edition of her book, published in 2008, explains three challenges of surviving and thriving after a life-threatening diagnosis – the challenge of preparing yourself mentally for surviving and thriving, the challenge of learning that help lies within you and all around you, and the challenge of focusing your attention on what your body needs to heal (Hall, 2008).  These challenges are relevant, as Bev shows, to anyone – whether they continue to live, or they move through dying.

I invite Nursology.net viewers to explore these notable works, and find ways to contribute to the ongoing dialogue that raises awareness of this dynamic, and in doing so explore pathways to shift our focus in the direction of nursing’s own perspectives.

Sources cited:

Allan, J. D., & Hall, B. A. (1988). Challenging the focus on technology: A critique of the medical model in a changing health care system. ANS. Advances in Nursing Science, 10, 22–34.

Cowling, W. R., 3rd, Shattell, M. M., & Todd, M. (2006). Hall’s authentic meaning of medicalization: An extended discourse. ANS. Advances in Nursing Science, 29(4), 291–304; discussion 305–7. https://www.ncbi.nlm.nih.gov/pubmed/17135798

Hall, B. A. (1996). The psychiatric model: A critical analysis of its undermining effects on nursing in chronic mental illness. ANS. Advances in Nursing Science, 18(3), 16–26.  https://www.ncbi.nlm.nih.gov/pubmed/8660009

Hall, B. A. (2003). An essay on an authentic meaning of medicalization: The patient’s perspective. ANS. Advances in Nursing Science, 26(1), 53–62. https://www.ncbi.nlm.nih.gov/pubmed/12611430

Hall, B. A. (2006). Author’s Response to “Hall’s Authentic Meaning of Medicalization: An Extended Discourse.” ANS. Advances in Nursing Science, 29(4), 305.

Hall, B. A.. (2008). Surviving and thriving after a life-threatening diagnosis. AuthorHouse.  https://market.android.com/details?id=book-giE2mx62bAwC . Also available here,

Nursing Philosophy Conference in August – and More!

We have added a new 2019 “Future Event” related to the development of nursing knowledge – the 13th Philosophy in the Nurse’s World & 23rd International Philosophy of Nursing Conference, to be held in Victoria, BC, Canada,  August 18-20, 2019.  In addition to the conference information, you will now find two important dates related to this conference in our “Due Dates” sidebar feature —

  • The abstract due date is February 28, 2019
  • Early bird registration ends on June 21, 2019

But that is not all! In addition to our regular blog posts at least every Tuesday, Nursology.net is constantly being updated with the addition of nursing theories, models, philosophies, landmark events, additions to recent past events, and exemplars. To help you keep up, we have added a sidebar “Recently Added” feature.  We hope you will visit Nursology.net often and check out the resources that are available related to past, present and future nursing knowledge development!

You can do it — contribute to the Nursology.net blog!

We hope everyone has noticed that Nursology.net has heaps of opportunities for people to  contribute – but did you know that you can contribute to our blog?  This blog is a multi-author blog (MAB), plus we welcome guest authors – which gives you an opportunity to become familiar with the process of blogging.  But wait a minute – I can already “hear” in my mind some of the push-back to this idea:  “I don’t have time to blog.” “Writing a blog does not contribute to the list of publications I need for promotion – I can’t waste time blogging.” “I need citations to my work and blog posts do not get cited.”  OK – I hear you!  But before you turn away from this idea, indulge me for a few moments and consider some good reasons you might begin in the world of blogging!

  • Blogs give you an opportunity to write in a different “voice” – a more relaxed tone that reaches people in ways that formal writing does not.  You can express your opinion, test out an idea to see if it “flies,” and ask your readers for specific feedback.
  • In fact, writing a blog post helps you develop the courage to use your voice — a challenge nurses often face.  My idea for this blog post was in part prompted by a post in an entirely different field – written by Marte C.W. Solheim from Norway, who tells a compelling story about finding the courage, as a PhD Student and then a recent graduate, to use her voice in the field of economics and political science.
  • Blog posts do not take away from the necessary work involved in your scholarship – instead the process of writing a blog post is like “thinking” time – it is an opportunity to reflect on points of particular importance to the ongoing development of your ideas.
  • Blog posts are being cited more and more often, and any social media mention of published work contributes to the “altmetric attention score” that is now displayed on published articles to indicate the amount and reach of the content in an author’s published works.  One of  the very important features that we are including throughout Nursology.net is the name of the contributor of content on any page (and on the blog), and the date the information was posted, in order that Nursology.net content can be accurately and adequately cited, with due credit to the appropriate author.
  • Your blog post provides readers an opportunity to give you feedback – much like a presentation at a conference – even if you do not invite it!  Feedback on your blog post is documented evidence of how your ideas are being received.  And sometimes they contribute to the development of your ideas.
  • Writing a blog post is not nearly as hard as you might think!  Blog posts are short, to the point and can include any kind of commentary or opinion that you want to include.  Of course if you draw on another source for some of your ideas (as I have done in this post) – there are no style manuals or formating requirements – as long as you find a way to point accurately to your sources, you are good to go!
  • Blog posts have the potential to reach an audience that you would never reach in a published article — nursology colleagues who might never see your published articles,  important scholars in other fields, and most important, the public whose interests your work is intended to serve. As Patrick Dunleavy pointed out on a recent LSE Impact blog, having invested hours and hours of time on your work, why not spend a couple of hours crafting an accessible blog post that has the potential to reach a broad audience?
  • Writing for blogs is rapidly becoming a new form of scholarly communication that draws on many of the ideals of the open-access model – blogs are also referred to as short-form digital publishing.  They are intended to broadcast your ideas as widely as possible.
  • You do not have to trudge through the long and arduous process of journal or book publishing, especially if you blog on your own blog!  Blogs are open to “public review” – a form of review that is not replacing the very valuable process of anonymous peer review, but is increasingly valued as a way to determine the worth of ideas in a public forum. If someone takes issue with your ideas, in all likelihood you will find out about it in short order.  This is a huge benefit — you cannot adequately address what you do not know is “out there” and blog readers are one of your best sources to explore the landscape of opinion related to your ideas.

The nursology.net  multi-authored blog (MAB)  team members are committed to writing regularly for the blog in order to have a new post at least weekly, and to provide a diversity of perspective, style, and content!  Some of our bloggers write their posts directly, using the handy “add a post” feature on wordpress.com (where our site is hosted). Others  send me the content for their blog either by email or using our handy blog submission form (also a sub-menu item under “Blog Home” on our main menu!). You can see who is on our team in the right sidebar, showing everyone’s name and a link to their most recent posts.

As the lead blogger,  I  make sure the links and other details are in order, and schedule each post 2 to 4 weeks in advance. If your post is time-sensitive, we will post it at whatever date is optimal. If I have any questions about something that is not clear, or if I detect something that needs to be double-checked for accuracy, either I, or someone else on our management team will be in touch to make sure your post is the best it can be. We might do a bit of light editing to correct spelling or obvious grammatical errors, but we do not aim for perfection!  What we do NOT do is revise or change your own message – we want your post to reflect your own ideas, your own voice.  We welcome controversial content, especially when you include sound rationales for your perspective and welcome open discussion.  The only thing we will intervene with is anything that is disrespectful or harmful, or “flaming” of other individuals or groups.

So this is our invitation to you!!  Use this opportunity to try your hand at blogging!  Let me know about your idea and we will assist you in every way possible to become a published short-form digital author (or if you prefer, a published blogger)!

 

 

The Experience of Nursology.net

Just before the holidays, my long-time friend, Sue Huether, said to me after spending some time on Nursology.net – “Peggy, this is not just a website – it’s an experience!” Her comment inspired our new site tagline because in fact, Nursology.net has indeed turned out to be an experience!

Even for those of us building the site, it has been an experience. We have all been involved in the work of developing and teaching nursing ideas for many decades, but the experience of the website has led us to new appreciation for the depth, the breadth and the significance of our discipline.

We invite you to experience Nursology.net often! Spend some time clicking around in every section, following links to information all over the web! Follow our blog, and visit the site often because we will have new content just about every week. Most important, we have built in ways for you to participate in every section! Not sure how to get involved, just let us know!

Scholarships for the National Nursing Ethics Conference

Scholarships Available for National Nursing Ethics Conference (NNEC) March 20-22, 2019 

NNEC wishes to thank Ann Hamric, PhD, RN, FAAN, American Association of Critical-Care Nurses and the Hospice and Palliative Nurses Foundation for their support of nursing ethics education.

  • The American Association of Critical-Care Nurses (AACN) is offering up to $3,000 per person scholarship to attend the Sixth National Nursing Ethics Conference. Visit the AACN Continuing Professional Development Scholarships page to learn more.  You must be a member of AACN to apply. For questions, please e-mail scholarshp@aacn.org
  • Hospice and Palliative Nurses Foundation Conference Scholarship –  National Nursing Ethics Conference
    This single conference scholarship opportunity will be provided to a qualified applicant by the Hospice and Palliative Nurses Foundation and include a full conference registration of $515 plus a reimbursable travel stipend of up to $500 to attend the National Nursing Ethics Conference March 21-22, 2019 at the Luskin Conference Center, UCLA. Please review eligibility requirements at https://advancingexpertcare.org/NNEC.  We welcome questions at info@hpnf.org.
  • Ann Hamric Graduate Student NNEC Scholarship Award
    Three scholarships have been provided to support graduate students who have demonstrated an interest in ethics. Travel funds of $500 will be available to each student to attend the National Nursing Ethics Conference.  Please submit a short bio and a brief description of your interest in healthcare ethics (no more than 150 words) to EthicsCenter@mednet.ucla.edu with subject heading “SCHOLARSHIP”
    Eligible students must reside outside of California.

Update on early nursing theory think tanks facilitated by Margaret Newman

On November 13th, I posted information about early nursing theory think tanks organized by Margaret Newman!  A few days ago, I happened to be looking for something entirely unrelated in the early issues of Advances in Nursing Science and discovered a little notice announcing the second nursing theory think tank!   I have added the link to the announcement as an addendum to the November post, but also believe it is important to add here the information in this notice for its historic significance.

The ANS notice confirms that the purpose of the  first nursing theory think tank in October 1978 was to “bring together persons involved in theory development in nursing to explore areas of needed theory development and to devise a means whereby continuing dialogue between theorists can occur” (page 105).

The October 1978 think tank participants were:

Margaret Newman, facilitator (The Pennsylvania State University)
June Brody (Herbert Lehman College),
Carol Deets (Indian University),
Ellen Egan (University of Minnesota),
Rosemary Ellis (Case Western Reserve University),
Jacqueline Fawcett (University of Pennsylvania),
Joyce Fitzpatrick (Wayne State University),
Beverly Hall (University of Washington),
Margaret Hardy (Boston University),
Joan Rinehart (The Pennsylvania State University),
Elizabeth See (Wayne State University)
Marilyn Sime (University of Minnesota),
Ardis Swanson (New York University),
Gertrude Torres (Wright State University), and
Lorraine Walker (The University of Texas).

Values and Ethics: Foundations of Nursology.net

There are sections of many websites that are seldom visited – the mission, goals, or “About” pages that set forth the purposes that shape the content, focus and direction of the site.  Nursology.net is no exception, other than the fact that many first-time visitors may be intrigued by the name of this site and might explore the “About” menu item to learn more!

We have recently added to our “About” page a section we believe to be central to this project – our “Values and Ethics.”  These statements of value are not just words – they are the principles that guide every decision and that shape the content of this site.  Notice that central to what we value is your involvement!  Nursology.net belongs to every member of our discipline, and we welcome you to respond to any part of this site, including our statement of values and ethics!  Here is what we have posted – let us know your thoughts and ideas!

Values and Ethics

The development and maintenance of this site are guided by the following values:

  • We take every step possible to assure accuracy of content on this site by
    • Assuring review of content by members of the management team prior to activation of pages and posts.
    • Securing review and approval from any nurses who are central to the content presented (e.g. authors, key nurses involved), if those individuals are available.
    • Inviting corrections and updates from viewers who have the best information available.
    • Welcoming feedback, discussion and critique from viewers where there are issues of controversy or different points of view.
  • We assure accountability and transparency of the content on this site by:
    • Showing the name or names of the contributors who have provided the information displayed on specific pages
    • Providing the dates when content was initially posted and revised.
    • Providing links or references to sources from which content is derived, or is quoted.
  • We welcome submissions of content for each section of the website and have provided submission forms tailored to each section.  These forms are found on main pages of each section.  In addition, we welcome:
  • We will respond promptly to all communications, including requests to correct, change or remove any content that violates our commitment to  be accountable and transparent in using content from other sources.