Guest post: “Let’s talk theory”; Perspectives from the Associate Degree Nursing World

Contributors:
Emma Crocker, DNP, RN
Patrick McMurray, BSN, RN
Shelley Mitchell, BA, BSN, MS, RN
Elizabeth Mizerek, MSN, RN, FN-CSA, CEN, CPEN,
CNE, FAEN, PhD Candidate
Timothy Joseph Sowicz, Ph.D., NP-C

Authors’ Disclosure:
The authors would like to note that all members
put in equal amounts of work in this project. 


Nursing theory is the foundation of our practice, the way we differentiate nursing from other professions and disciplines. As readers of the Nursology blog, we assume that we do not need to discuss why nursing theory is essential to our practice. We would instead like to call your attention to a concerning trend – the lack of nursing theory in associate degree nursing programs. Please note that we are making generalizations based on our experience of graduating from and/or working in associate degree programs. There is a paucity of current research surrounding theory in associate degree programs.

According to the National Council of State Boards of Nursing (NCSBN), in 2019 50% licensure applicants were graduates from ADN and diploma schools of nursing; this number has historically been even higher. In other words, half of our newly practicing nurses may not have foundational knowledge of nursing theory to apply to their practice, further widening the theory practice gap. If theory content is not being integrated into the initial nursing education for half of our profession, how can we convince them it is important, let alone essential to their praxis? 

 We suspect that several factors contribute to the lack of theory in some ADN programs. Many nursing education programs are externally accredited by agencies such as the Accreditation Commission on Education in Nursing (ACEN) or the Commission on Collegiate Nursing Education (CCNE). Previous accreditation standards required nursing education programs to explicitly name the nursing theorists that guide the curriculum. This emphasis has been removed from current standards, allowing nursing education programs to use general educational theorists such as Knowles Adult Learning Theory.

 Another critical point is that ADN programs do not usually require doctoral-level preparation for nurse faculty. According to the 2018-2019 National League of Nursing’s annual survey of nursing schools, 74% of schools replied that it was “somewhat difficult” or “challenging” to hire new faculty. The primary reasons cited were an inability to offer competitive salaries and a lack of qualified candidates. ADN programs usually have fewer financial resources and do not have research missions. Therefore, they have difficulty attracting and retaining faculty with research-focused doctorates and higher educational credentials. This may result in ADN faculty who do not have the knowledge and/or experience with integrating theory into pre-licensure education.

Without the requirements of accreditation and with faculty who are not supported and enabled to the inclusion of nursing theory, it is our anecdotal observation that many ADN programs have dropped the emphasis on nursing theory. We have personally worked in nursing education programs where theory is either given cursory attention or not included in the curriculum at all. This has resulted in removing or deemphasizing nursing theory from a large portion of the nursing professional population.

 Nursing theory is currently situated in a place where it feels like it only belongs to some nurses, those embedded in academia or research, never practice. This has created a culture where most nurses and students cringe at the thought of theory-based content, with some complaining it has very little to do with “real-world” nursing practice. Nursing theory has not been made relevant to the modern nurse.

 Many nurse scholars might use this conversation as yet another reason why the entry level of nursing practice should be raised. Students seeking nursing education in the U.S. encounter many barriers, such as socioeconomic status, geography, structural racism, and more. Many of these students choose to attend ADN programs rather than seek a BSN, especially as their entry to practice. If we want to continue to grow the practice of nursing in the US, we need to support and encourage ADN programs, especially in the integration of nursing theory in practice.

The authors of this blog post greatly value the contributions of ADN programs, ADN graduates, and ADN educators. We would like to challenge all educators, scholars, and researchers to consider how we might restore nursing theory to its rightful place in all levels of nursing education. Nursing theory belongs to all nurses – not just those in higher education. 

Nursologists, what do you think?

About the contributors:

Emma Crocker

Emma Crocker, DNP, RN – CHIPS Health and Wellness Center, St, Louis, Missouri. Emma is a equity driven, population health quality improvement doctorate and advocate, devoted to ensuring the implementation of constituent-centered health policies, enabling communities to thrive located in St. Louis, Missouri. Twitter: @EmmaCrockerDNP.

Patrick McMurray

Patrick McMurray, BSN, RN – Adjunct nursing faculty, Robeson Community College, Lumberton, North Carolina. Patrick is a Adjunct Nursing Faculty at Robeson Community College, in N.C. Patrick is patient about community college nursing education and championing social change via equitable access to nursing education. Twitter: @nursePatMacRN.

Shelley Mitchell

Shelley Mitchell, BA, BSN, MS, RN – Professor of Nursing, Austin Community College, Austin, Texas. Shelley contains multitudes. She teaches full-time in Austin Community College’s Professional Nursing Program, which has been voted as the best in the region for three years in a row, and she is deeply involved in the college’s equity and inclusion work. She has a BA in English from Oberlin College in addition to her nursing education, and she reads comics and writes queer romance in her spare time. Twitter: @ProfShelleyRN

Elizabeth Mizerek

Elizabeth Mizerek, MSN, RN, FN-CSA, CEN, CPEN, CNE, FAEN, PhD Candidate – Director of Nursing Education, Mercer County Community College, West Windsor, New Jersey.  Elizabeth is the Director of Nursing Education at Mercer County Community College in New Jersey. She is currently a PhD candidate at Widener University in Chester, Pennsylvania pursuing a doctoral degree in Nursing Science. Her research interests include nursing education, patient safety, and emergency preparedness.

Tim Sowicz

Timothy Joseph Sowicz, Ph.D., NP-C – Assistant Professor, UNC Greensboro, Greensboro, NC. Tim is an assistant professor at UNC Greensboro. His research is concerned with aspects of living with heroin and opioid use disorders, especially following an overdose.

How Evidenced Based Practice Supports Inequality

Guest contributor: Mike Taylor,
Member, Nursology Theory Collective

About six years ago, the Maryland Department of Health sponsored a conference for all state stakeholders with an interest in chronic disease, including nursing and medical groups, hospitals, EMS and diabetes product companies. The latest evidenced based practice models were being presented but I was only half listening because I, like most of those in the room, already knew what we were going to hear. Which is what happened, in session after session we heard that non-white patients had the highest incidence in all chronic disease states, probably related to genes or culture, and the major solutions were primarily public awareness and ethnic specific education without any mention of the role of racism.

So, I decided to shake things up and during the break went to the Department of Health table in the exhibit hall and asked the two representatives there if we were ready to tackle institutional racism or if we were still playing around the edges. Looking unsure what to say, one of them responded “we are still playing around the edges” but offered that there was a new director who may be willing to talk with me and she would send her over to my table. She never came and the chance for a different conversation ended there.

While the department of health representatives didn’t deny the existence of institutional racism, unless evidence of institutional racism and other inequalities are allowed to be presented as part of the discussion nothing will change.

In addressing institutional racism, we tend to spend 80% of our time on awareness which is only 20% of the problem and not on changing institutions which is 80% of the problem. In this first of a series of blogs, I will argue that evidenced based practice (EBP) is a key component of the institutional structures that support racial and economic inequalities. The evidence about any clinical subject is often contradictory even in well-designed studies which is not a problem but simply a feature of the difficulty of doing science. The fact that the evidence found in scientific journals provides a range of possible answers, requires practioners, practice organizations and health systems to make choices about what evidence to include and not to include in their own practice and in practice guidelines. The science of EBP may appear to be objective but the process of choosing the subject and design of studies along with what evidence to use and how to use it is inherently subjective and open to bias that perpetuate economic and racial inequalities.

Institutional selection of what evidence to include in policy and practice is based on the degree of fit with an existing institutional theory. The institutional theories that support inequalities in race and poverty, are unspoken but widely accepted theories of health without theoreticians and based on unquestioned assumptions which can make them hard to challenge.

If we in the Nursing Theory Collective specifically and in nursing in general, are to undertake this fight to change the intertwined histories of these inequalities we must concentrate on changing the institutions and the false assumptions they are based on, and demand alternatives. Follow-up blogs will examine the use of EBP in supporting three areas of institutional inequalities including the maintenance of structural racism, control of nursing practice and control of patient autonomy. Please reach out to me and tell me what assumptions you have found in your work that you feel need to be questioned.

About William (Mike) Taylor

Mike Taylor is an independent nursing theorist specializing in the application of complexity science to health and compassion. His Unified Theory of Meaning Emergence takes a major stride in connecting the mathematics of complexity with self-transcendence and compassion. He has spoken at international, national and regional conferences on complexity in nursing, health, and business. He is a member of the board of the Plexus Institute where he is the lead designer of the Commons Project, a web based platform for rapid social evolution in climate change.

Virtual Nursology Theory Week March 17-24, 2021!

View Nursology Theory Conference Site!
Invitation to discuss terminology
!

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?
  • Open Discussion
Monday, March 22 – 10 am to noon (Eastern)
  • Student/Early-career Scholars Panel: Emerging Possibilities for the Focus of the Discipline
Wednesday, March 24 – 10 am to noon (Eastern)

The planning team members for 2021 are:

  • Leslie H. Nicoll, PhD, MBA, RN, conference planner extraordinaire! and Nursology.net management team member
  • Deborah Lindell, DNP, MSN, RN, CNE, ANEF, FAAN, Case Western Reserve Frances Payne Bolton School of Nursing faculty and Nursology.net management team. member
  • J. Carolyn Graff, PhD, RN, FAAIDD, University of Tennessee Memphis faculty
  • Wendy Likes, PhD, DNSc, APRN-Bc, FAANP, Dean, College of Nursing University of Tennessee Health Sciences Center
  • Peggy Chinn, RN, PhD, DSc(Hon), FAAN, Web manager for Nursology.net and NursingTheoryConference.com

Never a Guardian: Remembering Breonna Taylor

Want to learn more about Nursing and Racism? Read the following Nursology blogs: Nursing and Racism and Decolonizing Nursing.

Artwork used with permission of the artist Ariel Sinha

The Guardians of the Discipline is a series featured on Nursology.net as a way to commemorate the giants whose shoulders we stand on as we forge our nursing paths. Today, we – the Nursology Theory Collective – would like to memorialize someone who never had the chance to join the discipline, though we understand that she intended to be a nurse (Oppel & Taylor, 2020). Her name is Breonna Taylor. Murdered by the police executing a “no-knock” warrant, Breonna Taylor, a Black woman, was murdered as she slept in her home. Startled by the unannounced and forced entry of Louisville law enforcement, Breonna Taylor’s boyfriend – a licensed gun owner – began firing his gun, assuming their home was being invaded. The police returned fire, striking Breonna who died six excruciating minutes later, no aid ever rendered (Simko-Bednarski et al., 2020). Final analyses showed the police had invaded the wrong home and that she remained alive for minutes without critical aid being offered. Lack of further investigations suggests that  Breonna Taylor’s life has seemingly been brushed aside. To date, no one has been held accountable for her murder. The no-knock policy remains uninterrogated (Oppel & Taylor, 2020).

We wish to honor Breonna Taylor, recognizing the structural missingness her death signifies in our profession (Hopkins Walsh & Dillard-Wright, 2020). NTC members Jane Hopkins Walsh and Jessica Dillard-Wright (2020) “synthesized the concept of structural missingness to capture the state of exclusion from healthcare due to inequalities within a system, a country or globally” (p.1). The concept was imagined to capture the injustices and inadequacies of talking about healthcare as a structurally-sound starting place for any kind of analysis, recognizing the people and groups who are all too often missing in colonized and capitalism driven spaces. In this blog post, we wish to extend this concept, recognizing the implications that the murder of Breonna Taylor has for nursing, acknowledging that nursing will never have the opportunity to learn from her knowledge and experience. 

Breonna Taylor’s murder is a structural missingness double-jeopardy. Her murder points to violent systemic racism, inequities and injustice. As a discipline, nursing is part of the racist system, and carries this internalized and systematized racial prejudice (Barbee, 1993; Barbee & Gibson, 2001). Nursing bears the hallmarks of normative whiteness, part of the hidden curriculum of nursing enacted through practices rooted in the received values around respectability; what are accepted dress codes, hairstyles, body art, leading to gatekeeping, professionalism codes, and civility policing that narrowly define what a nurse looks like (Allen, 2006; Puzan, 2003).  Scholar Ibraham Kendi refers to this implicit racist system as the “White judge” (Kendi, 2017 p. 4). Nursing professor @UMassWalker recently spoke to this idea in their critique of the vague and subjectively worded term “good moral character” bound within their university’s prelicensure nursing syllabus (see Twitter post from July 22, 2020). Dr. Walker’s blog post the next day further expanded upon the issues of institutional racism in the system of nursing education. These enshrined messages and images of how nurses ought to look, speak and act connect back to our received historical narratives- the stories that tell stories (Haraway, 2016). 

The Nightingale chronicles are an example of how this image of normative whiteness in nursing continues to be the dominant legend for all who enter the profession. The reified Nightingale history embeds systemic values that intersect race narratives alongside received norms for behavior, gender, sexuality, and class. Mary Seacole who self identified in her writings as a Creole person, was a Jamaican nurse and peer of Nightingale’s who was awarded international medals for her service in the Crimean war. She was a published author, commented on political issues of slavery and racism, made scientific observations around cholera and diarrhea, but historical letters suggest she was deemed unsuitable for service by Nightingale and other British authorities. Her contributions to nursing are underreported, diminished and debated to this day (McDonald, 2014; Staring‐Derks et al., 2015).

Breonna Taylor will never graduate from nursing school. Murdered in her sleep, she has been rendered structurally missing by virtue of her death by brutal aggressive police actions, a victim of the very institution that purports to serve and protect. Breonna is forever erased from our discipline. We recognize this injustice and by honoring her memory, we refuse to ignore the political ideologies that fail to interrogate aggressive policing systems that neglect to bring her killers, who are still free, before the court. Her death speaks to the complex and structurally violent structures that silently continue to collude, reifying nursing’s hegemony through systematic exclusions and injustices surrounding Black people who are systematically oppressed and erased. We, the discipline of nursing, are not immune from the effects of police brutality, and as a result a future nurse and colleague is missing. Furthermore, nursing is not immune from perpetuating racist systems. We must actively work towards a more just, equitable, and inclusive discipline, recognizing that the minimum bar of humanness demands actively protesting and opposing police brutality and the unacceptable murders of Black people, including Breonna Taylor.

What can you do to support Breonna Taylor, who never got to be a guardian of our discipline?

  1. Learn more about Breonna Taylor and her murder.
  2. Sign a petition demanding justice for Breonna Taylor’s murder.
  3. Read the Nursology Theory Collective anti-racism statement and commit to be actively anti-racist. 
  4. Use the platforms you have to name, address, and dismantle racism and white supremacy in the systems in which you work and live.
  5. Contact your local, state and federal elected officials weekly to inquire about legislation they are enacting to combat violent police practices against Black people and other Non Black People of Color.
  6. Consider running for elected office to embody the change we want to see.
  7. Constructively critique existing nursing theories and philosophies to deconstruct the effects of colonization of our formal knowledge base and to understand the ways that racialized systems and structures influence the development of our discipline.
  8. Use these insights to develop anti-racist research, theory, education, practice and policy that is aimed to decolonize nursing.

References

Allen, D. G. (2006). Whiteness and difference in nursing. Nursing Philosophy, 7(2), 65–78. https://doi.org/10.1111/j.1466-769X.2006.00255.x

Barbee, E. L. (1993). Racism in US nursing. Medical Anthropology Quarterly, 7(4), 346-362. https://doi.org/10.1525/maq.1993.7.4.02a00040

Barbee, E. L., & Gibson, S. E. (2001). Our dismal progress: The recruitment of non-whites into nursing. Journal of Nursing Education, 40(6), 243-244. https://doi.org/10.3928/0148-4834-20010901-03

Haraway, D. J. (2016). Staying with the Trouble: Making Kin in the Chthulucene. Duke University Press.

Hopkins Walsh, J., & Dillard-Wright, J. (2020). The case for “structural missingness:” A critical discourse of missed care. Nursing Philosophy, 21(1), 1–12. https://doi.org/10.1111/nup.12279

Kendi, I. X. (2019). How to be an antiracist. One world.

McDonald, L. (2014). Florence Nightingale and Mary Seacole on nursing and health care. Journal of Advanced Nursing, 70(6), 1436–1444. https://doi.org/10.1111/jan.12291

Oppel, R. A., & Taylor, D. B. (2020, July 9). Here’s What You Need to Know About Breonna Taylor’s Death. The New York Times. https://www.nytimes.com/article/breonna-taylor-police.html

Puzan, E. (2003). The unbearable whiteness of being (in nursing). Nursing Inquiry, 10(3), 193–200. https://doi.org/10.1046/j.1440-1800.2003.00180.x

Simko-Bednarski, E., Snyder, A., & Ly, L. (2020, July 18). Lawsuit claims Breonna Taylor lived for “5 to 6 minutes” after being shot. CNN. https://www.cnn.com/2020/07/18/us/breonna-taylor-lawsuit/index.html

Staring‐Derks, C., Staring, J., & Anionwu, E. N. (2015). Mary Seacole: Global nurse extraordinaire. Journal of Advanced Nursing, 71(3), 514–525. https://doi.org/10.1111/jan.12559

Diversity, Equity, Inclusion, Justice, and the Future of Nursing Theory: A Webinar of Disciplinary Reflection

To learn more about the Nursology Theory Collective,
or join us in future work, please click here.
See video and full report here

On Friday, June 12th, the Nursology Theory Collective hosted a live webinar titled, “Diversity, Equity, Inclusion, Justice, and the Future of Nursing Theory.” In this webinar, Dr. Lucinda Canty and Patrick McMurray addressed the interrelated concepts of diversity, equity, inclusion, and justice in nursing. They discussed nursing’s homogeneity and how the absence of diversity in our discipline contributes to and reinforces inequity, injustice, and exclusion, even as our professional organizations purportedly value social justice and strive to reduce health inequities.

It is long past time for nurses and nursologists alike to take a stand and actively work towards an antiracist future for nursing. This is nonnegotiable and the time for action is now. We challenge you as readers of Nursology to watch this insightful webinar, reflect on your role in advancing equity and justice, and comment how YOU are going to contribute to transforming nursing into a more diverse, equitable, inclusive, and just discipline.

We understand that this topic may be uncomfortable – and if so, we encourage you to reflect and unpack that discomfort. Maybe you feel defensive as if you have done nothing personally to warrant interrogating your own positionality. Maybe this resonates with you because you see and know this truth as congruent with your own experience.In the words of Monica McLemore, “this can all be different,” if we choose to make it so. The starting place for this is critical self-reflection which paves the way for antiracist growth which creates the possibility for community-building and envisioning new futures for nursing. Embracing the discomfort we can become a more diverse, equitable, inclusive, and just discipline. As Patrick McMurray stated, “nursing is an act of justice,” and it can be if we do the work.

In Solidarity,
The Nursology Theory Collective

For more background on this webinar as well as the presenters, please click here.

Part 1 – Access to Nursing Knowledge: A Privilege or a Right?

In the practice environment, nurses are guided by evidence-based practice, policy, and procedures specific to their institutions. Comparably, nurses in academia refer to recent and relevant academic literature based upon institutional licenses. In preparation for the Nursing Theory Annual Conference, a gap was revealed among members of the Nursology Theory Collective dependent upon their work environment as it related to access to nursing knowledge. As described by a member of the Nursology Theory Collective who has worked in the practice environment, I attempted to access a nursing research article from fifty years ago and found that I would have to pay $49, when the same article was freely available to my academic colleagues through their organizational access.” This member’s experience was not in isolation, and ended up being more of a norm than a rarity. At the publishers permission the article was able to be shared by academics to those without appropriate access in practice, but this is not a permanent solution and nor should it be a norm.

The question then arose: should access to nursing knowledge be a privilege or a right? Dependent upon our organizational affiliation (or lack thereof) nurses are blocked from relevant and essential nursing knowledge. Practicing nurses then have to consider purchasing academic literature, whether per article or journal subscription, at prices that may be unaffordable for their salary. Nurses in academics face similar issues when they are limited by what specific journal licenses their organizations may have. Ultimately, this may lead to nurses reaching out to colleagues located in other institutions in order to gain access to literature that is needed for their work.

The lack of equity in access to nursing and other disciplinary knowledge further perpetuates issues in nursing, such as the theory-practice gap also, referred to as the academic-practice gap. How can nurses in practice be expected to consider recent and relevant knowledge if they do not have access to it? Some nurses may never realize what they are, and are not able, to access. For example, when nurses’ are on-boarded or oriented into their healthcare institutions, if they are not educated on their resources (such as journal subscriptions or medical libraries – also, why aren’t there nursing or nursology libraries?), how can they be expected to use it for practice, education, or research? Similarly, how can nurses in academia educate or complete research on relevant nursing issues if they are blocked by paywalls (or should we say, selective paywalls – something to consider)? Reaching out to colleagues can result in loss of time/productivity, and coincidentally can place a colleague in an awkward situation. Moreover, this lack of equity in access to knowledge perpetuates a delay in translational research. Remember the old saying that it takes 17 years for research to become practical knowledge? In this day in age where knowledge is produced at such exponential rates, this shouldn’t be the norm.

Solutions for Change: Making Nursing Knowledge a Right

Instead of perseverating on the identified gap at hand, perhaps it’s time to discuss potential solutions and make nursing knowledge a right and not a privilege. Our hope is with this blog you can begin to educate yourself on what is equitable access to nursing knowledge, including potential solutions for change. With this, perhaps you can take some of these solutions back to your institution and colleagues, and keep some in mind for your future work. The following list contains potential identified solutions to creating equity in access to nursing knowledge.

1. Blogs on Nursing and Nursology

Blogging, as well as reading nursing blogs, is a great way to engage with the global nursing community without borders. Through these interactions, you have the capability to learn more about the work of others (whether in-process or complete) be exposed to new ways of thinking, have discussions around important topics, receive feedback on your work, and be referred to relevant and available resources. For example, on Nursology.net you can find blogs on resources for teaching, sociopolitical issues, student perspectives, and exemplars for theories, philosophies, and more. Other notable nursing blogs (such as at the American Journal of Nursing or Advances in Nursing Science) offer an opportunity for nurses to read about and discuss scholarly issues without a fee. Interestingly though, many academic journals do not have an adjacent blog. Perhaps it’s time for editors to consider integrating a blog for their journal, and maybe it is time for you to consider writing a blog about something you are passionate about?

2. Journal Clubs

While journal clubs get a bad reputation for disorganization and/or low participation, they are an effective way to develop community for equitable knowledge access. Whether internal to your institution, or external with colleagues (what about a journal club for practicing nurses AND nurses in academia?!), a journal club can be a great way to help disseminate relevant nursing knowledge to colleagues who otherwise wouldn’t be exposed. Additionally, journal clubs help stimulate discussion on potentially overlooked issues and knowledge gaps, driving our discipline into the future.

3. Nurses On Boards

Often when we think about boards, we picture a dry and unproductive boardroom meeting that could have been summed up in an email (also referred to as CHBAE). This is not to say that this doesn’t occur… but, nurses are hugely underrepresented on boards across the U.S. (and probably the world). The Nurses on Boards Coalition “represents national nursing and other organizations working to build healthier communities in America by increasing nurses’ presence on corporate, health-related, and other boards, panels, and commissions.” How does this relate to knowledge equity in nursing you ask? Well, if nurses are underrepresented on boards, ultimately, what is approved as valid knowledge within an institution (think about hospitals here) will lack a nursing voice. Conversely, if nurses have a voice on boards, they can bring their unique disciplinary perspective to the institution and help drive what IS considered as valid knowledge. Think back to the medical library versus nursing library comment above, or maybe you have another example in mind? That being said, think how your voice could impact your institution on a board, and how that voice could help shape the future of knowledge equity in nursing.

4. Development of Anthology’s on Nursing Knowledge

In 1986, the book titled “Perspectives on Nursing Theory” was published by Dr. Leslie Nicoll which “is an anthology of classic and contemporary peer-reviewed articles that address various theoretical and philosophical perspectives on knowledge development in research and practice” (Reed & Shearer, 2012, p. vii). Since the original publication, there have been six editions of this book, most recently by Dr. Pamela Reed and Dr. Nelma Shearer. This book is an exemplar of what nurses in academia can do to promote access to knowledge for those in the practice environment. Dependent upon the area of expertise (whether theory or perhaps another topic) similar books can be developed that are a collection of the classic and contemporary peer-reviewed articles that address the area of interest. Moreover, as new editions are developed (hopefully faster than 17 years), practicing nurses have an ability to access essential knowledge which helps bridge the theory-practice gap, and simultaneously, translate research into practice. In addition, in light of environmental concerns related to book production, authors, editors, and publishers should consider decreased prices on electronic book versions to decrease their carbon footprint, and also to increase access to nursing knowledge.

5. Open Access Nursing Repositories and Journals

Open access journals and repositories make original research freely available via the internet. While there are concerns around the quality of articles contained within open access repositories and journals, there are acceptable options provided by notable nursing organizations. For example, Sigma Theta Tau International hosts the Virginia Henderson Global Nursing e-Repository (otherwise referred to as the Henderson Repository). The Henderson Repository “is the only repository solely dedicated to sharing works created by nurses around the world. It is an open digital academic and clinical focused service that freely collects, preserves, and disseminates full-text nursing research, educational, and evidence-based practice materials in a variety of formats and item types.” You can even find posters that have been presented at conferences, such as the Nursology Theory Collective’s poster at the King Conference in 2019. Lastly, there is also an underlying community collection that contains theses and dissertations that have been completed and defended, making it easier to access unpublished works (which is also important!). That being said, have you shared your important work with a nursing repository?

6-?. You decide!

Image copyright of Shannon Wheller

While this list is not exhaustive, this is just the beginning. If you have any further solutions to suggest on how to promote equity in access to nursing knowledge, please comment below. Remember, there are no wrong answers! We believe in the incorporation of nursing theory into practice, and practice into nursing theory, and we suggest that to support our discipline we need to close the gap in access to knowledge. Nurses in academia and practice need each other. We are interdependent and better together. We hope that in the process of closing this gap, we can foster collaboration across settings between nurses, ultimately bettering the health and well-being for all. 

Nursing knowledge should be a right and not a privilege, and we all need to work together to enable it to be that way.

Note: The Nursology Theory Collective would like to thank Mike Taylor for bringing up this important issue to discuss with the Nursology community.

References

Reed, P. G., & Shearer, N. B. C. (2012). Perspectives on nursing theory (6th ed.). Lippincott Williams & Wilkins.

Unity in Our Diversity: the KING Collaborative Conference and Nursology

         Last month, on November 14th and 15th, nurses from all over the world gathered to discuss nursing theory and the future of nursing at a landmark conference at George Washington University in Washington D.C. Hosted by the King International Nursing Group, the theme of the conference was “Nursing theories: Moving forward through collaboration, application and innovation.” Present at the conference included members of various scholarly groups in nursing such as the International Consortium of Parse Scholars, Leininger Culture Care, the Neuman Systems Model Trustees Group, Orem International Society, Roy Adaptation Association, Society for the Advancement of Modeling and Role Modeling, Society of Rogerian Scholars, the Transcultural Nursing Society, the University of Connecticut School of Nursing, the Watson Caring Science Institute, and the Nursing Theory Collective.

The above collage depicts different moments during the panel presentation at the King Collaborative Conference. On the bottom from left to right is Jacqueline Fawcett, Callista Roy, and Marlaine Smith.

         On the first day of the conference, a representative member of each of these scholarly groups presented on the nursing theory central to their organization. Each oriented their discussion toward the future of nursing as a discipline. Awareness of our habitual silos slowly emerged as each of these scholars presented, revealing our tendencies as nurse theorists – nursologists – to work in isolation. These voices were put into dialogue in a panel, convened to discuss the future of nursing theory and the discipline as we know it. From this discussion, panelists and attendees alike unanimously agreed that the future of the discipline required that we identify common ground and work collaboratively from our shared values grounded in nursing while recognizing and honoring our differences. The panel discussion concluded with a call to find unity in our diversity and recognize the strengths inherent in divergent perspectives. 

The Nursology Theory Collective at their first in-person meeting on November 15th, 2019.

      The next day, the Nursing Theory Collective had their first in-person meeting. In light of the pivotal discussion that had occurred on the previous day, representatives from different scholarly groups were in attendance to participate. One of the main agenda items for the first in-person meeting was revisiting the adoption of the term “nursology” in the group’s name, mission, vision, and values, in place of the term nursing. Achieving consensus through lively discussion on the politics and peculiarities of the term, the Collective ultimately determined that “nursology” was best suited for navigating the future of the discipline. As such, the Nursing Theory Collective has now been renamed the Nursology Theory Collective. It is our hope with this adoption that we can become more inclusive for all scholars and practitioners alike, breaking down walls towards a unified future for the discipline.

         Inspired by our shared space and time at the King Conference, looking towards the future, the Nursology Theory Collective intends to continue to advocate for the future of our discipline through practice, research, education, and policy. We hope to foster an inclusive home for nursologists from all perspectives. We ask you, as important voices in our discipline, what issues are most important to you? Though you may not attend our meetings, we value diversity, discourse, and dissensus. We want to hear from you about the future you envision for nursing. What are the theory, practice, education, policy issues you see as critical to our future? We want to hear from you, and we invite you to our next meeting on Monday, December 16th from 1:00 – 2:30 PM MST. If you wish to participate, please contact us via email at nursingtheorycollective@gmail.com

Please continue the conversation from the King Conference below in the comments, we look forward to hearing from you!

With gratitude,
The Nursology Theory Collective 

The Nursology Theory Collective at their first in-person meeting on November 15th, 2019.

Shaping the Future of Nursing Education and Practice: AACN Essentials Revision and the Next Generation NCLEX

In support of our mission “to advance the discipline of nursing/nursology through equitable and rigorous knowledge development using innovative nursing theory in all settings of practice, education, research and policy,” the Nursing Theory Collective (NTC) emailed the workgroup chairs of the American Association of Colleges of Nursing (AACN) Essentials Task Forces on September 16th, 2019. In this email, we as the NTC advanced our support for a strong nursing perspective and theoretical orientation in the planned revisions to the Essentials documents that form the basis for nursing education at all levels of study. To date, we have received positive responses from the chairs of the baccalaureate, master’s, and DNP essentials revision workgroups. We understand that AACN has invited nursing faculty to have discussions regarding the Essentials, both at their universities and future conferences. We have provided our letter below to foster open dialogue regarding the importance of nursing theory in the future of nursing education. Please join these conversations as you are able and feel free to use the points we have developed as a starting point for your thoughts as well.

In addition to the effort regarding the Essentials revision, we also reached out to the National Council of State Boards of Nursing (NCSBN) regarding the Next Generation NCLEX Project (NCSBN, 2019). As you are likely aware, the NCLEX is currently under revision with an eye toward ensuring novice nurses possess the necessary skills to detect the subtle changes in patient status, preventing deterioration, as well as avoiding errors. In pursuit of this project, the NCSBN has underscored the importance of clinical judgment and decision making in the safe practice of newly registered nurses. It is our concern that due to the absence of a framework founded in nursing knowledge and theory, the disciplinary perspective is lost such that clinical reasoning and clinical judgment devolve from a nursing skill to a generic biomedical task orientation (Bender, 2018). Moreover, the absence of nursing theory in the foundation of the Next Generation NCLEX project begs questions about our core values, how we value nursing knowledge, and to what regulation we agree to adhere (Perron & Rudge, 2015). Email communication with NCSBN about theory content and a guiding theoretical framework belied a lack of interest on their part in engaging in discussion of this issue, at least at this time. Given the role that the Essentials play in nursing education, the NTC has decided to focus on our efforts with the Essentials. We hope that, in time, with revision to the Essentials NCSBN will be motivated to consider the role of nursing theory in NCLEX and more readily engage. 

Appended below you will find our Essentials letter to the DNP workgroup, which is similar to the other two Essentials letters. Please share our letter among your colleagues to assist in the facilitation of discourse on this important topic.

Dear members of the DNP Essentials workgroup,

            We are writing to you today because of your role in the workgroup for the Revisions of American Association of Colleges of Nursing (AACN) DNP Essentials. We represent the Nursing Theory Collective. Our collective membership, made up of experienced nurse clinicians, researchers, educators and scholars, as well as graduate students, emerged from the landmark nursing conference that was held at Case Western Reserve University called Nursing Theory: A 50 Year Perspective, Past and Future in March, 2019. 

As future educators and scholars, we represent the next generation of nurses who will implement the DNP Essentials in the process of educating nurses in the decades to come. We recognize that the DNP Essentials will have a substantive influence on the future of nursing education.

We appreciate your efforts as in the DNP Essentials workgroup and the challenges inherent in taking on the task of creating this powerful and empowering nursing document. We understand that this document, when finalized, will significantly influence the curriculum and the education of thousands of nurses in our country for many years.

It is the recognition of the lasting power and influence of the DNP Essentials recommendations that brings us to write to you today. We join with the American Holistic Nurses Credentialing Center and nursing leaders from institutions of nursing education across the country to respectfully ask that you consider the following points of concern:

1. Theory and Competencies
Nursing theory, representing the wide variety of theories, frameworks, and models used in nursing and including those that provide the historical foundations of nursing, are missing from competencies within the DNP Essentials recommendations. We request that nursing theory and nursing history be included in the Essentials at every level because it is anchors us to our past, present, and future knowledge of nursing. Nursing theory, including knowing the connections to its philosophical roots, shapes who we are as nurses and highlights the critical and distinct human service of nursing that is not met by other disciplines. Education in nursing theory, along with other essential educational content, ensures a solid foundation in disciplinary knowledge and perspective for future nurses, nurse scientists, and scholars. The ongoing development of nursing theory can also lead to the creation of knowledge that can be shared across disciplines. 

2.  Disciplinary Perspective
Competency-based education in nursing must reflect our unique disciplinary perspective with a focus on protecting, promoting and restoring health and well-being, the prevention of illness and injury, the alleviation of suffering (ANA, 2015, p.1) and perspectives on humanizing the health experience (Reed, 1997; Willis, Grace & Roy, 2008). The provision of nursing theory as a foundation for nursing education reinforces our discipline-specific perspective. Nurses need to be competent in articulating the history, voice, and vision of nursing. 

3. Nursing-Centered Frameworks 
Competencies derived from the biomedical models like the Interprofessional Domains of Practice (Englander, Cameron, Ballard, Dodge, Bull, & Aschenbrener, 2013) minimize 100 years of knowledge building that evolved within nursing to define the discipline specific contributions nursing brings to the patient care experience as a science and a discipline. This undermines the existence of the historical work that has been done in nursing theory development, and impedes the future progress of our discipline.

4. Nursing Identity
Interprofessional collaboration must be built upon a strong identity as nurses, so that each nurse can articulate what they bring to the healthcare team, highlighting the priorities that are different from but complementary to the interprofessional team. Without this perspective it will be all too easy for nurses to lose sight of their unique contributions to the interdisciplinary team.

5.  Healthcare Trends 
Healthcare trends and expectations will influence nursing’s roles and practice within healthcare delivery for the next decade, as AACN has articulated, making our strong nursing identity and unique perspective on patient care more important than ever. We are concerned that some current trends in healthcare may emphasize profit, technology and disease over the importance of nursing care, including an alarming shift away from the caring, holistic, scientific, and relationship-based nature of nursing and towards an often profit-driven, technical and biomedical model of interdisciplinary focus where nurses becoming identity-less “health care professionals.”

We envision harnessing the power of nursing through carefully constructed educational essentials to actively shape a just and equitable healthcare service model in the United States of America, and provide future nurses with a clear identity as nurses. However, our future nurses must be educated in the fundamental theoretical and philosophical foundations of nursing in order to preserve the character and ethos of our profession. 

In summary, nursing has always embraced interdisciplinary teamwork. However, we believe that our essential educational competencies must remain firmly grounded in nursing values, nursing theory, and nursing history. Educational essentials and nursing competencies must first reflect our nursing perspective, not those of other disciplines. 

We are nurses and our educational competencies should reflect nursing knowledge and nursing theory. We urge you to consider our recommendations, and how framing of the DNP Essentials within a biomedical, interdisciplinary model would minimize over 100 years of scholarly work by nurses to advance a unique disciplinary perspective and identity. We further recognize the impact that DNP-prepared nurses will have in the future of nursing and the future of healthcare, underscoring the urgency of our concerns.

We acknowledge and appreciate all of the hard work your committee has put forth on this important topic. We hope that you will consider our position in your future revisions of the DNP Essentials. If you wish to have further dialogue on this issue, we as future and present nurse leaders would appreciate the opportunity to engage further.

With gratitude,
The Nursing Theory Collective   

Cosigned by:
Brandon Brown, EdD Student, MSN, RN-BC, CNL 
Ellen Buckner PhD, RN, CNE, AE-C, FNAP
Clare Butt, RN, PhD 
Jill Byrne, MSN, RN, CNOR, PhD Student
Gayle L Casterline, PhD, RN, AHN-BC
Peggy L. Chinn, RN, PhD, DSc(Hon), FAAN
Da’Lynn Clayton, PhD, RN 
Catherine Cuchetti, RN, MSN
Jessica Dillard-Wright, PhD Candidate, MA, CNM, RN
Margaret Erickson, PhD, RN, CNS, APRN, APHN-BC
Rosemary W. Eustace, PhD, RN, PHNA-BC
Jacqueline Fawcett, RN; PhD; ScD (hon); FAAN, ANEF
Pamela Grace, RN, PhD, FAAN
Consuelo Grant, PhD Student, BSN, RN
Debra R. Hanna, PhD, RN, ACNS-BC
Jane Hopkins Walsh, PhD Candidate, PNP-BC, RN
Yuanyuan Jin, PhD Student, MSN, RN
Amy Kenefick Moore, PhD, RN, APRN, CNM, FNP-BC, APHN-BC, HWNC-BC
Kan Koffi, RN, AD, B.Sc., M.Sc.
Carrie Langley, PhD Student, MSN, MPH, RN 
Patricia Liehr, PhD, RN
Chloe Littzen, PhD Student, MSN, RN, AE-C
Colleen Maykut, RN, BScN, MN, DNP
Melissa McCoy, MSN, RN
Angela Norton, PhD Student, MSN/Ed, RN
Christina Nyirati, PhD, RN
Judith Pare, PhD, RN
Marilyn Ray, RN, PhD, CTN-A, FSfAA, FAAN, FESPCH (hon.), FNAP
Pamela Reed, PhD, RN, FAAN
M. Kay Sandor, PhD, RN, LPC, AHN-BC
Phyllis Shanley Hansell, DdD
Mike Taylor RN, MHA, CDE
Billie S. Vance, MSN, FNP-BC
Sylvia K. Wood, DNP, ANP-BC, AOCNP
Rorry Zahourek, PhD, RN, PMHCNS-BC (ret), AHN-BC, FAAN

References

American Nurses Association. (2015). Nursing scope and standards of practice (3rd ed.). Silver Spring, MD: American Nurses Association.

Bender, M. (2018). Re-conceptualizing the nursing metaparadigm: Articulating the philosophical ontology of the nursing discipline that orients inquiry and practice. Nursing Inquiry, 25(3), 1-9. doi: 10.1111/nin.12243

Englander, R., Cameron, T., Ballard, A. J., Dodge, J., Bull, J., & Aschenbrener, C. A. (2013). Toward a common taxonomy of competency domains for the health professions and competencies for physicians. Academic Medicine, 88(8), 1088-1094. doi: 10.1097/ACM.0b013e31829a3b2b

NCSBN. (2019). Next generation NCLEX project. Retrieved from https://www.ncsbn.org/next-generation-nclex.htm 

Perron, A., & Rudge, T. (2015). On the Politics of Ignorance in Nursing and Health Care: Knowing Ignorance. New York, NY: Routledge.

Reed, P. G. (1997). Nursing: The ontology of the discipline. Nursing Science Quarterly, 10(2), 76-79. doi: 10.1177/089431849701000207

Willis, D. G., Grace, P. J., & Roy, C. (2008). A central unifying focus for the discipline: facilitating humanization, meaning, choice, quality of life, and healing in living and dying. Advances in Nursing Science, 31(1), E28-E40. doi: 10.1097/01.ANS.0000311534.04059.d9.

An Update from the Nursing Theory Collective

Welcome to Chloe Olivia Rose Littzen, who has now joined our
Nursology.net blogging team!
Chloe is a founding member of the
Nursing Theory Collective and
currently a PhD Student at the University of Arizona (Tuscon)

I. Introduction

In June of this year, a blog post was shared on Nursology.net by the Nursing Theory Collective, a group of scholars and students with a mission to advance the discipline of nursing/nursology through equitable and rigorous knowledge development using innovative nursing theory in all settings of practice, education, research, and policy. (Visit that post here). We are using the term nursing/nursology as at this moment in time as we continue to have discourse on the exact word choice we will use to characterize ourselves as a collective. 

To review, the Nursing Theory Collective was formed after the landmark conference, “Nursing Theory: A 50 Year Perspective Past and Future”, on March 21-22, 2019 at Case Western Reserve University. Since May, the group has met monthly to further discuss pivotal issues related to nursing theory and the identity of nursing/nursology, define their mission and vision statement, and to establish action items to drive their vision forward. Currently, the Nursing Theory Collective has 45 members from around the world including Canada, China, Colombia, and the United States, promoting a global perspective of nursing and nursing theory. 

To promote global connectivity, the Nursing Theory Collective created a WhatsApp (https://www.whatsapp.com) group for an easily accessible format that members in other countries can easily connect via their smartphones. In this WhatsApp group, members discuss pertinent issues related to nursing theory and the identity of nursing, sharing articles, actions in progress, or reminders for actions that evolved from previous meetings. Our meetings have been hosted via Zoom Video Conferencing (https://zoom.us) which enables access to participate in most countries, and has allowed us to record all meetings for future reference. A shared Google Drive was also created, enabling all members to have access previous document, to assist in the development of future action items, and to collaborate in real time. 

II. Updates 

To date, the meetings for our collective have revolved around discussions on actions items that can be taken to move the discipline of nursing and nursing theory into the future. In order to accomplish our collective goals, we have been working to define our mission, vision and values, and establishing logical action plans in the forms of scholarly writing and policy letters. In the following paragraphs, you will find a brief synopsis of all the action items that are in progress or completed. 

Mission, Vision, and Values. We have been working diligently on defining our mission, vision, and values as a collective. We recognize that this is a work in progress. We have been inspired by the vast body of prior nursing knowledge and theory work in the United States and abroad, as well as our individual philosophies of nursing. Guiding our mission, vision, and values is a concise definition of nursing theory first advanced by a working group of international nurse theorists, who proposed that nursing theory is simply “a description of what is going on” (Petrovskya, Purvis, & Bjornsdottir, 2019, p.2). Petrovskya, Purvis, and Bjornsdottir’s (2019), elegant definition, adopted from Rolland Munro, invites nurses to engage ideas beyond the theoretical paradigms most familiar to nurses educated in the United States. As this is an ongoing and open process, we invite you into the discussion and to add to our mission, vision, and values.

King Conference. In June 2019, the Nursing Theory Collective submitted an abstract that was accepted to the upcoming King Theory Conference in Washington, D.C. (King International Nursing Group, 2019). The topic of our abstract is, “Driving the Future of Nursing: A Collective Approach to Nursing Theory.” We look forward to being a part of this landmark conference. We plan to arrange a meeting of the Nursing Theory Collective at the King conference, and we welcome all members and non-members to join us for important discussions in driving nursing and nursing theory into the future. We will post details about the time and place for this get together as the date gets closer. One action item of this in-person meeting at the King Conference will be to continue the debate surrounding the adoption of the term nursology to characterize ourselves. 

III. Collaborative Efforts 

As we are a collective, we understand the importance of branching out and collaborating with individuals and groups to enable us to accomplish our mission and vision. To date, collaborative efforts have been placed into two categories: 1) Nursology, and 2) policy items related to nursing education and the future of nursing. Below is a brief synopsis of both of these efforts. 

Nursology. In 2015, Dr. Jacqueline Fawcett presented a case for changing the name of nursing to nursology (Fawcett et al., 2015). A variety of nursing scholars have echoed support for this change, but others have been questioning how this impacts on the discipline as we know it (Parse, 2019). To be mindful of all members views, we held an anonymous survey in June – July 2019 to adopt the term Nursology in our name, mission, vision and values. A total of eighteen votes were received, with 11 (61.1%) in support of adopting Nursology, and 7 (38.9%) in opposition. Members also had the option to write-in anonymously a rationale for their vote, and a variety of comments were received. For example, one member who was in support of the adoption asked “if there was an opposition for the collective to have an open discussion as to why this was.” Concerns that were raised by members in opposition included the marginalization of practicing and non-academic nurses, the validity and legitimacy of the term, and the belief that Nursology should be a term reserved for higher degrees in nursing such as the PhD. Supporters of the adoption argued that the term Nursology, while radical, would improve the strength of the identity of nursing, and has powerful implications for the general public and legislation.

Prior to the results being discussed, Dr. Fawcett kindly agreed to participate in our meeting where we discussed the adoption of the term Nursology, as well as the rationale for members in support or opposition. With this discussion, members had opportunities to further voice their opinion, and ask important questions related to the term and its meaning. For example, one member asked for whom the title nursologist should be reserved. Dr. Fawcett and other members designated the adoption of the term nursologist for all members, who have passed their licensing examination and are a registered nurse. At the end of the meeting, it was proposed as the group was undecided to adopt the term nursology into the mission, vision, and values, but also include nursing. We thank Dr. Fawcett for her involvement, and plan to keep the Nursology group updated as we move forward. Our next discussion on this topic will be in November at the King Conference in Washington, D.C.

Policy Items. In July, two members of the Nursing Theory Collective participated in a Zoom meeting with board members from the American Holistic Nurses Credentialing Corporation (AHNCC, 2019). The purpose of this meeting was to begin a discussion and collaborate on a campaign to express the need for nursing theory to be a core part of the current educational essentials, as they are being revised by the American Association of Colleges of Nursing (AACN) and the National Council of State Boards of Nursing (NCSBN). Action items from this meeting included the development of two letters focused on the educational essentials, as well as the revising of the National Council Licensure Examination for Registered Nurses (NCLEX-RN). To date, the letter to the AACN has been completed and is pending to be emailed out to key members of the essentials committee. After this, we plan to submit this letter for publication to spread the word of this important change that may impact the future of nursing. Our next step will be devising the letter the the NCSBN, we invite anyone who is interested in participating in developing this important letter. We thank the AHNCC for collaborating with us on this important project, and support them in their work as they promote a more holistic space for nurses to practice globally. 

IV. Future Efforts

While we have a significant to-do list as follow up from previous efforts, we continue to strive towards future actions in order to drive our vision for nursing and nursing theory into the future. We intend to remain vigilant about the AACN essentials, the NCSBN revision of the NCLEX, and will continue our activism aimed toward promotion of nursing theory at all levels of education. Our future actions include continuing our monthly meetings to have open discourse on the topic on nursing and nursing theory, we invite all members and non-members alike to participate. Additionally, we plan to write and submit manuscripts focused on demystifying nursing theory for practicing nurses and the educational environment. We welcome any and all ideas on how we can move forward with our goals, and hope that you would consider being a part of this movement. 

V. Conclusion and Invitation – Join us!

The next meeting for the Nursing Theory Collective is August 27th, at 2:00 PM Eastern Standard Time. We encourage all nurses and students, regardless of setting, experience, or educational level, to join us by contacting clittzen@email.arizona.edu to participate. If you are interested in joining the WhatsApp group, please email us to let us know and we will add you promptly. We also have a twitter handle, @NursingTheoryCo, and you are welcome to follow us as we plan future social media events. We plan to continue to update the community here on Nursology.net to keep everyone informed, as well as promote a movement of inclusivity to drive nursing and nursing theory into the future.

With gratitude,
The Nursing Theory Collective

References

American Holistic Nurses Credentialing Corporation. (2019). About AHNCC. Retrieved from https://www.ahncc.org/about-ahncc/

Fawcett, J., Aronowitz, T., AbuFannouneh, A., Al Usta, M., Fraley, H. E., Howlett, M. S. L., . . . Zhang, Y. (2015). Thoughts about the name of our discipline. Nursing Science Quarterly, 28(4), 330-333. doi: 10.1177/0894318415599224

King International Nursing Group. (2019). Events. Retrieved from https://kingnursing.org/content.aspx?page_id=4002&club_id=459369&item_id=976945

The Nursing Theory Collective. (2019, June 18). Moving Towards the Next Fifty Years Together [Blog post]. Retreived from https://nursology.net/2019/06/18/moving-towards-the-next-fifty-years-together/

Parse, R. R. (2019). Nursology: What’s in a name? Nursing Science Quarterly, 32(2). doi: 10.1177/0894318419831619

Petrovskaya, O., Purkis, M. E., & Bjornsdottir, K. (2019). Revisiting “Intelligent Nursing”: Olga Petrovskaya in conversation with Mary Ellen Purkis and Kristin Bjornsdottir. Nursing Philosophy, 20(3), e12259. doi: 10.1111/nup.12259.

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!