Moving Towards the Next Fifty Years Together

We are delighted to welcome guest bloggers representing the  Nursing Theory Collective
formed March 2019 Case Western Reserve
Nursing Theory Conference:
Chloe Littzen, Jane Hopkins Walsh  and Jessica Dillard Wright

I. Introduction

Chloe Littzen

Jessica Dillard-Wright (L) and Jane Hopkins-Walsh (R)

In March 2019, 130 nurses from all over the world gathered at Case Western Reserve University Frances Payne Bolton School of Nursing in Cleveland, Ohio for Nursing Theory: A 50 Year Perspective, Past, and Future, a landmark conference to celebrate the history of nursing theory and elicit discussion for the future of nursing. The attendees were diverse, comprised of seasoned nursing theorists and doctoral students in equal measure, participating in lively and thoughtful conversation across many domains. The future of nursing theory quickly emerged as a critical issue as nurses working at all levels of expertise expressed their concern over the loss of nursing theory at the institutional level, both academic and clinical. What is at stake in this erosion is discipline-specific nursing knowledge, in particular at this 50-year juncture as the great theorists of nursing like Drs. Peggy Chinn, Joyce Fitzpatrick, Pamela Reed, Callista Roy, Marlaine Smith, and many others approach the end of their illustrious careers. The question resonated, “who will carry the nursing theory torch forward?”

To advance the discipline of nursing, the next wave of nursing theorists and thought leaders must actively engage to advance nursing theory, improve nursing praxis, and articulate nursing’s identity leading our profession into the future. This is the rallying cry that led to the blog post you are reading today. In follow-up to this conference, doctoral student Chloe Littzen engaged other students who attended to embark on a collaborative effort to articulate our vision for the future of nursing theory. What follows is a brief discussion of our course so far, the background, plan, and desired outcomes for convening a nursing theory working group as we envision the next fifty years of nursing theory and beyond.

lI. Background

After the landmark conference concluded, a collaborative effort ensued to form a theory working group focused on promoting nursing theory and advancing nursing’s identity. This group is comprised of both scholars and students and is open to all nurses practicing in all settings. Our first meeting was held online via video-conferencing on May 18th, with a total of six participants from Arizona, Massachusetts, and West Virginia. This first meeting was an experimental think-tank where we considered ideas about the future of nursing and our professional identity. Below, we outline our mission and vision for this nursing theory working group.

III. Plan

The primary mission, as established by our working group, is to promote nursing theory and advance the identity of nursing through knowledge development for all nurses in all settings, including practice, education, research, and policy. As a group, we believe that nursing and nursing theory are dynamic and evolving to meet the needs of an increasingly complex healthcare landscape and global environment. In order to keep nursing theory and nursing relevant and current, thinking about theory must be on-going and iterative, with a continuous cycle of critique, testing, and scholarship. Failure to seriously engage these questions has dire consequences for nursing theory and the profession as nursing as it slowly cedes its identity to the economic pressures of the healthcare environment and the supremacy of biomedicine.

The following bullets summarize our discussion and desired outcomes from the first nursing theory workgroup meeting:

  • Discussion Points:
    1. We need a plan to sustain and evolve nursing theory and nursing’s identity with discipline-specific knowledge.
    2. Nursing theory must be derived from and applicable to the practice environment, not just academia.
    3. The purpose of nursing theory must be clarified for nursing practice, education, research, and policy.
    4. Nurses in clinical practice must have an educational foundation grounded in nursing theory that empowers the application of theory in practice.
    5. Nursing students must be educated and mentored in nursing theory, beginning at the pre-licensure level.
    6. This discussion must include considerations of how nursing theory is taught in the academic environment and how that can be linked to and informed by nursing practice.
    7. The need for nursing theory is global, making this an international, even planetary problem.
  • Desired Outcomes:
    1. To write a manuscript demystifying nursing theory for the nurse in the practice environment.
    2. Write a second manuscript demystifying nursing theory for the nurse educator in academia.
    3. Explore the potential of a future study identifying and describing the barriers and facilitators for using nursing theory in practice, education, research, and policy settings.
    4. Share the discussions, experiences, and findings with the community at Nursology.net.

IV. Invitation – Join us!

While we are a new workgroup, we welcome and encourage all nurses, both advanced scholars and novice theorists alike, to consider joining us in this journey in promoting nursing and nursing theory into the future. We currently meet monthly over Zoom video-conferencing. If you are interested, please contact form below to be placed on the email list for future meetings and content.

If you are planning to go to the 2019 Collaborative K.I.N.G. conference in Washington D.C. from November 14th-15th, we are planning an in-person meeting to take place. We hope to see you there as we drive nursing and nursing theory into the future. Join us!

With optimism and gratitude for the future,
Nursing Theory Collective
(Final group name pending vote at next meeting)

Footnotes:

See more information on the King Conference here.

See more information on the landmark theory conference at Case Western Reserve University Frances Payne School of Nursing here.

Please use this form to contact us if you want to join us, or for more information!

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).

Nursology think tanks, anyone?

Addendum
Notice in ANS 1:3 (April 1979) of 2nd NTTT gathering

What if we had a host of small nursology think tanks happening all over the world?  Sound impossible?  No, it is not impossible, and we have an historial model from which to build!  As Jacqueline Fawcett observes in her reflections below, this Nursology blog can be viewed as a think tank of sorts.  And, we can also envision ways for face-to-face nursology think tanks to happen! If you are inspired by this idea, don’t wait for someone else to do it – invite a few friends and colleagues, and do it!   Here is the model as Jacqui and I experienced it:

Dr. Margaret Newman

In 1978, Margaret Newman initiated a very simple idea with great influence – she called for a few of her colleagues around the country to gather at a designated airport hotel and spend a couple of days in deep discussion about the development of nursing theory.  She called the gathering a “Nursing Theory Think Tank (NTTT)”   There was no agenda, no note-taking, and no expectation for outcomes.  Everyone who was invited to participate each year made their own hotel reservation at a designated hotel near an airport hub, and Margaret arranged with the hotel to provide a small conference room for two days free of charge.  There were about a dozen people invited each year – often a handful of people who had attended in the past, and typically 2 or 3 who had not attended before and were doing significant work in the realm of nursing theory or philosophy (now of course known as nursology!). Margaret’s own book Health as Expanding Consciousness was in production at the time of the first gathering, and published early in 1979.

I attended about 2 or 3 of the gatherings – and the photo shown below is my only record of anything that happened one of the years I attended!  I know Margaret was there (she always was!), and since she is not in the photograph I am guessing that she might have taken the photo!  As you can see from the photo, this event happened in an era when nurses generally “dressed up” for such an occasion, but the fact is that the gatherings were very informal, and often peppered with humor, story-telling and sharing of life experiences.  There was always someone quick to remind the group that we were under no obligation to be “productive” – but of course, significant “productive” things happened as a result of these gatherings. Since we were all as busy as we could be with our very productive careers, we more than welcomed the opportunity to have this kind of discussion with no pressure – not even the pressure of taking notes!

My experience of these discussions had a lasting influence, affirming some of the ideas I was working on, challenging me to think at a deeper level about specific aspects of my work, and prompting me to take my ideas to a deeper level of understanding, But equally important, I had the opportunity to hear from other nursologists, learn about their perspectives, and come to appreciate not only who they were as individuals, but the importance of their ideas. So I have always carried with me the importance of this kind of free-flowing opportunity to just talk, challenge one another and deepen our understandings of our ideas and of one another as individuals.

It was at the NTTT that Jacqueline Fawcett and I first met in person – probably in about 1981 or 2.  When I founded Advances in Nursing Science  in  1978, someone suggested that Jacqui was a young scholar who would be a wonderful addition to the review panel – and she has served faithfully in this capacity ever since! While we have known one another all these years, serving together on the management team for Nursology.net is our first opportunity to work closely together.  Here are Jacqui’s reflections of the NTTT:

My notes indicate that that the Nursing Theory Think Tank (NTTT) began in
1978 and ended in 1988. My recall of the decade of existence of the NTTT
are as follows.

The NTTT was begun by Dr. Margaret A. Newman. The first meeting, in 1978,
was at State College, PA, when Margaret was on the faculty at Pennsylvania
State University. I was exceptionally honored to be invited to join the NTTT in 1978. The members, including those who were invited and those who joined later,
included Margaret, of course, as well as Ellen Egan (Margaret’s former NYU
classmate), Ardis Swanson (Margaret’s former NYU faculty colleague), June
Brodie and me (former students in Margaret’s NYU theory development course),
Beverly Hall, Lorraine Walker, Kay Avant, Elizabeth See, Peggy Chinn, Afaf
Meleis, and Barbara Carper. We met approximately once each year, typically
for a weekend in the fall season, at a hotel near an airport.

The NTTT discussions focused on the current and desired future state of
nursing knowledge. Most discussions were informal and wide-ranging; others
were more formal discussions, based on papers presented by NTTT members. I
presented a paper for discussion at the NTTT meeting in Dallas, TX, in
September 1982, which was published along with a critique by June Brody in
1984: Fawcett, J. (1984). The metaparadigm of nursing: Present status and
future refinements. *Image: The Journal of Nursing Scholarship, 16*,
84‑87; Brodie, J. N. (1984). A response to Dr. J. Fawcett’s paper: “The
metaparadigm of nursing: Present status and future refinements. Image: *The
Journal of Nursing Scholarship, 16,* 87-89.

I presented another paper for discussion at the NTTT meeting in Austin, TX,
in October 1986, which was published in 1989: Fawcett, J. (1989). Spouses’
experiences during pregnancy and the postpartum: A program of research and
theory develop­ment. *Image. The Journal of Nursing Scholarship, 21,*
149-152.

Although the NTTT ended in 1988, many of the members have continued to
contribute to the development of nursology. To the extent that the blog
posts on nursology.net might be considered a contemporary NTTT, all
nursologists are invited to submit blogs and publish their ideas about all
matters nursology in journal articles, book chapters, and books.

Addendum – added to this post on December 2, 2018 – I discovered a notice published in ANS 1:3 (April, 1979) describing the first NTTT in October, 1978, announcing the second think tank planned for March 1979, and inviting interested nursologists to contact Margaret Newman.

“Seated, L to R, Peggy Chinn, Beverly Hall, Jacqueline Fawcett, Elizabeth See
Standing, L to R, Afaf Meleis, Kay Avant, Lorraine Walker, Ellen Egan, Ardis Swanson”