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NURSING THROUGH THE LOOKING GLASS 2
Begin at the beginning," the King said, very gravely, "and go on till you come to the end: then
Nursing and global healthcare are in constant evolution at a rapid rate and nursing as a
discipline has been a challenge to anticipate, predict, and guide the adaptation of the profession
to these changes and transformation. This paper will explore and investigate deeper on the
historical roots, currently accepted paradigms and the future direction of the discipline to help
understand and explicate the concept crucial in the adaptation of the profession to the ever
changing universe. Scholarly articles made by the different nursing scientist, scholars and
theorist will be dissected, specifically, these articles include: to the discipline of nursing:
historical roots, current perspectives, future directions by Maureen C. Shaw (1993), knowledge
for the good of the individual and society: linking philosophy, disciplinary goals, theory, and
practice by Mary K. McCurry, Susan M. Hunter Revell and Sr. Callista Roy (2009), the
significance of the relationship between a discipline and its practice by Mary Grossman (1992),
and nursing knowledge: womens knowledge, a social perspective by Elizabeth I. Haggel (1989)
Understanding the different paradigms, looking into the historical roots, and linking
theory and practice will help explore the essential knowledge foundation for the profession and
generate new theories essential the acceptance of the nursing as a science and as a discipline.
Intellectual investigations have been the highlight in the development of nursing as a profession
and as a discipline over the years. The dialogues, arguments, and scholarly debates are still
present up to this time and are widely accepted as a means of advancing nursing. Shaw (1993)
together with other nursing scholars believed that the discipline of nursing is slowly evolving
from the traditional role of women, apprenticeship, humanitarian arms, religious ideals, intuition,
NURSING THROUGH THE LOOKING GLASS 3
common sense, trial and error, theories, and research as well as the multiple influences of
medicine, technology, politics, war, economics, and feminism. This transition is reflected in the
Shaw (1993) in her paper presented that the latest development in nursing science and
research has made a huge impact in nursing education and clinical practice and most recent ways
of looking into phenomena have led to the re-examination and refinement of the previously
known concept on the different metaparadigms in nursing. Shaw (1993) examined the
development of nursing discipline as a unique body of knowledge from three viewpoints as to its
historical roots, current perspective and the possible future direction of the profession. Shaw
(1993) cited Florence Nightingale (1969) the founder of modern nursing who viewed nursing as
one having a separate organize concept and relevance different from medicine. Henderson
(1965) was also cited who describes nursing as a unique, complex service with an independent
practitioners who are authorities on nursing care. Since the development of modern nursing
numerous theories and conceptual framework emerge as a means to describe the nursing
profession.
Shaw (1993) therefor concludes that the goal of nursing theory is to contribute to the
wealth of knowledge required for clinical practice in different settings. Shaw (1993) finally
suggests that as nursing is approaching the 21st century, theory development must consider the
changing needs of the clinical population. The society and consumers should be actively
involved in the creation of theories and new avenues for theory development and research. It is
also emphasized in the paper the importance of client outcomes and evaluation as essential to the
NURSING THROUGH THE LOOKING GLASS 4
nursings social mandate, discusses disciplinary goals as they relate to the good of the individual
and society, and demonstrate how theory can guide the practice. Knowledge in a discipline is
enhanced when philosophy, disciplinary goals, theory, and practice are linked together. Nursing
to be accepted as a profession must contribute to the good of the society through knowledge-
based practice. The integration of theory to practice is accentuated in the papers as it serves as a
guide to achieve the goal of the nursing discipline which is promoting health and preventing
illness. When nursing goals are directed are directed at a synthesis of the good of the individual
and the society, nursings social and moral mandate may be achieved (McCurry, Hunter-Revel,
& Roy, 2009). Linking philosophy, disciplinary goals, theory and practice is the future of the
nursing future profession with the primary goal of healthcare for all.
Grossman and Hooton (1992) argued that the absence of conceptual consensus across the
university and its sectors is largely responsible for the growing gap between the goals of the
discipline and its practice. They pointed the emphasis that university and practice should have a
symbiotic relationship that is both should have a shared framework that would transcend
university and service structures. A professional discipline is defined by shared value orientation,
social relevance and a conceptual structure (Donaldson & Cowly, 1978). Basing on this
definition of a discipline Grossman and Hooton (1992) suggested since nursing is a diverse
Hagell (1989) in her paper questions the direction in which the profession is moving. The
feminist perspective is used in critiquing basic assumptions about science, scientific method, and
scientific knowledge. This uses sociological and feminist theory to support the idea that nursing
as a discipline has a distinct knowledge base which is not grounded in empirico-analytic science
and its methodology but which stems from the lived experiences of nurses as women and as
nurses involved in caring relationships with their clients. Hagell (1989) cited sociologist
Holtzner (1968) who further explored the relationship of social framework and knowledge. He
describes knowledge as the mapping of experienced reality by the observer of the phenomenon.
The notion that all knowledge originates in an observer makes it necessary to specify the
Hagell (1989) concluded that nursing knowledge is based in part on their situation as a
woman in a patriarchal society and in part as a woman involved in a specific gender defined
occupation which is given little value in the society. The author also concluded based on this
assumption that nursing knowledge is different from scientific knowledge and therefore not
given the scientific knowledge status. This idea suggests that nursing science is not a mature
science since the characteristics of a mature science (Kuhn, 1970) is made by the perceptive of a
male. The ambivalence that has characterized the relationship between nursing and feminism
should exist no more. Nursing can embrace the movement because of equality benefits
individuals, society, and, thus, the recipients of nurses care. We no longer need to hang back,
fearful that feminism will drive more talented students away from nursing and into other
professions. We can use our considerable creative skills to design ways to invite men into
nursing and to develop programs that make full use of all of the societys talented members who
Lauden (1984) as cited by McCurry, Hunter-Revel, & Roy (2009) explains that
knowledge is based on the theories made in the discipline, while problems constitute the
question, thoeries constitute the answer. Meleis (1987) as cited by Shaw (1993) defined theory as
a powerful, dynamic, yet focused source of professional autonomy and clinical challenge and
doing things in a conventional way would mean the acceptance of nursing in the scientific
community this also sparks debates. Shaw (1993) cited Hardy (1978) who advocated of having a
completing theory and adapting a specific paradigm in order to bring unity in the profession.
McCurry, Hunter-Revel, & Roy (2009) qouted Grace (2002, p.67) who stated that practicing
better care than practice without guides. Grossman and Hooton (1992) also emphasized the
importance of having a conceptual consensus that would bridge the gap between university and
service unit but having a conceptual consensus would limit the growth of nursing as a
professional discipline.
Then again, contemporary authors proposed diversity and plurality in nursing philosophy,
science and practice. In the unconventional perspective, not only is adaptation of a specific
behavior, but theoretical consensus is quite unlikely in a discipline that values the role of
perceptions, uniqueness and individuality in health and illness (Shaw, 1993). These different
views towards nursing knowledge fuel healthy differences among nursing scholars and theorist
that helps in the continuous improvement of the profession. The unique synthesis of the art of
caring and the empiricism of science is what distinguishes nursing from other health profession.
NURSING THROUGH THE LOOKING GLASS 7
Conclusion
Nursing is in a constant evolution. Continued research and quest for knowledge is the
hallmark of the profession and it should not stop. Cody (1995) anticipated that there will be
changes in the nursing perspective in the coming years. Feasibly according to Cody there will be
emerging knowledge that will abolish the reductionist, natural science model of nursing. He
views that in time there will be a middle ground in the nursing profession.
The ability to analyze, reason, and evaluate is important in the modern health service to
provide care based on the best available evidence (Holt & Clarke, 2000). Hence, there is a need to
let future nurses think on their own, examine assumptions presented, and provide reasoned
Holt and Clarke (2000) suggested the introduction of philosophy to the nursing curriculum
as a way to address the needs of the students to develop skills in critical analysis, evaluate
published literature and how nursing theory can be relevant to practice. This will now bridge the
gap between universities and practice sectors. They also point out that nursing practice should be
an association of theoretical knowledge and philosophy. This can be applied in case studies, related
Therefore, nursing knowledge needs to consider and reflect on the uniqueness of nursing
and welcome pluralism in its practice. The inference that the scientific field in isolation is
extremely limiting and restrictive to thoroughly explore, describe and predict the nature of nursing
and its practice, leads to nurses needing to explore knowledge from a combined art and science
standpoint: inextricably linked in such a way that the whole is more than the sum of the two (Rose
References
Bruce, A., Rietze, L., & Lim, A. (2014). Understanding Philosophy in the Nurse's World: what,
Cody, W. K. (1995). About all those paradigms: Many in the universe, two in nursing. Nursing
Donaldson, S. K., & Cowly, D. M. (1978). The discipline of nursing. Nursing Outlook, 113-120.
Grossman, M., & Hooton, M. (1992). The significance of the relationship between a discipline
Holt, J., & Clarke, D. (2000). Philosophy and Nursing a useful transferable skills. Nursing
Philosophy, 76-79.
McCurry, M. K., Hunter-Revel, S. M., & Roy, C. (2009). Knowledge for the good of rhe
individual and society: linking philosphy, discilinary goals, theory, and practice.
Newman, M. A., Sime, M. A., & Corcoran-Perry, S. A. (1991). The focus of the discipline of
Rose, P., & Parker, D. (1994). Nursing: an integration of art and science within the experience of
Shaw, M. C. (1993). The discipline of nursing: historical roots, current perspertives, future
http://www.eleanorsullivan.com/pdf/feminism.pdf