Authored by Atte Faith*
Building the Science of Nursing
The last decade has seen a rise in the calls for advancing the science of nursing [1-3]. However, the definition of the term science of nursing, even though familiar to many nurses, continues to be unclear, in part due to its numerous interpretations [4]. In addition, nurses often find themselves in situations where they have to answer the fundamental question “What do nurses do?”. There is little doubt that nurses are the center of a patient’s wellbeing and often use their expertise to participate closely in the healing process of both the sick and their families. Nevertheless, the nurse’s expertise in this process is sometimes not fully understood, thus resulting in the use of terminologies such as intuition and gut feelings by some, which ultimately renders the nursing knowledge more mystical than professional [5]. Although at times the work of nurses can be explained by activities such as administering medication, teaching, providing psychosocial support, assessing the health status of an individual, and use of therapeutic touch, the essence of nursing involves difficult to define ideas and practices [6]. Daly et al., [7] warned that nursing’s difficulty in articulating its unique nature in health care settings continues to put the survival of nursing as a distinct discipline at risk.
A more important underlying quality that needs attention is the knowledge that supports nurse responsibilities and recognizes nursing as a distinguishable profession [8]. Being cognizant of the underlying knowledge base captures both the special education and experiences associated with being a nurse, as well as the foundation for accountability embedded in the nursing care provided. For many decades, clinicians, researchers and nursing scholars have argued that the ability to fully describe the work of nurses and articulate the goals of nursing will provide the public and other disciplines a greater understanding of the nature of nursing. If clear articulation of the nature of nursing fails to occur, [9] warned that nursing will remain invisible as a distinct discipline or be viewed as a subset of medical science or social science.
It is therefore not surprising that one of the fundamental goals of nursing has been the development and recognition of nursing as a professional discipline. The topic of whether nursing is a discipline, a profession, or a professional discipline has been prevalent throughout the recent history of nursing, bringing with it considerable arguments and confusion. As a discipline, nursing seeks to expand the knowledge about human experiences through conceptualization and research [10]. According to Doheny, Cook, and Stopper, “each discipline has a knowledge base that is distinct from that of other disciplines and provides a foundation for practice”. Parse emphasized that the roots of discipline-specific knowledge is fostered in the academic settings where research and education shift the knowledge to new dimensions. In similar vein, Smith and McCarthy stated that each discipline is identifiable by a specific body of language that is developed, studied, and advanced by its students and members.
The history of nursing epistemology reflects a period in time where nursing knowledge was derived mainly from other disciplines [11]. However, if nurses rely on other disciplines to generate necessary knowledge, there is considerable risk that fundamental questions about nursing and the human person will not be addressed. This is because nursing as a discipline has a unique phenomenon of concern for human life and dignity from which all nursing knowledge is derived [12]. Nursing’s phenomenon of concern focuses on the wholeness of a person (individual, family, and community) within the context of a changing environment, health, and caring [4]. Nursing seeks to address the human experiences, while preserving the human dignity and providing protection when rights are violated [13]. The social contract that nurses have with the society, to provide care and nurturing both to the healthy and ill person while integrating the science of nursing (ANA, 2010), provides the discipline-distinct knowledge that demonstrates the uniqueness of nursing in comparison to other health care professions.
Nursing as a profession involves people who are educated within the discipline according to the nationally defined and monitored standards and regulations [12]. Toulmin [14] defined a profession as an “organized set of institutions, roles, and people whose business it is to apply or improve the procedures and techniques” of the discipline. In lieu of this definition, discipline and profession are inseparable. Without a profession to continue to use and enhance the knowledge contained within a discipline, a discipline would not advance or change and may eventually fade into obscurity. In the same way, a profession without the discipline would be blind. Nursing is therefore a professional discipline “embodying a knowledge base relevant to all realms of professional practice and which links the past, present and future”.
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