CLARIFYING THE DISCIPLINE OF NURSING AS FOUNDATIONAL TO DEVELOPMENT OF PROFESSIONAL NURSING

As Nursing projects itself forward into an evolving unitary world view, it is important to critique and explore some dynamics of advancing nursing professionally as a distinct caring-healing health discipline. Worldwide, health care has to be responsive to the caring-healing needs of humanity, transcending hospitals, industrial institutional practices, and bureaucratic systems controlled by medical technical dominance.

Nurses and nursing are challenged to grow and sustain its foundation as the healthcare profession, globally. However, it cannot move forward to fulfill its social mandate without clarity of its disciplinary foundation. In other words, the discipline of nursing is different from, but intersecting with the evolution of the profession of nursing.

Without a clear disciplinary orientation and foundation to guide the development of the profession, it is easy to lose the way. The Nursing profession, without the disciplinary foundation for knowledge and practice, can easily be guided by a hospital culture and pressure to conform to medicalized, clinicalized views of humanity. This medical technical view of human experiences in health and illness is in contrast to nursing's unitary disciplinary worldview, e.g., a committed worldview based on timeless values, a philosophical orientation to unity of mindbodyspirit, whole person health, and human caring - healing knowledge that sustains global humanity.

Theories and philosophies of science are the foundation for discipline specific knowledge. It is the foundational philosophies, values, and worldview they transcend specific events, and seek to provide universal explanations that can reflect the ethical-philosophical foundation and values for the entire field of study.¹-² Likewise, theories contain underlying ontological-philosophical-ethical assumptions; epistemological assumptions about knowledge, what counts as knowledge, how we pursue knowledge, and values about of what does it mean to be human?

Discipline specific approaches to knowledge and knowing address such questions as: What is the nature of human caring-healing, health experiences? How do we sustain human caring when threatened? What is the relation between and among human-environment, global planetary health and science generally?

Nursing scholars, educators, clinicians, researchers, and policy makers have a responsibility to sustain nursing as a distinct caring-healing-health discipline, guided by extant and dynamically evolving nursing theoretical frameworks, foundational to nursing knowledge development.

As Nursing meets the future, it is important to clarify the difference between the discipline of nursing and the profession of nursing.

When people have difficulty articulating: What is nursing? or What is nursing science? or more recently What is Caring Science? there often is a void and nurses are not able to give voice and language to nursing's knowledge and as a distinct discipline.³

The following are identified as essential aspects of the discipline of nursing:²

• The discipline of nursing is what holds nursing's timeless values, its heritage and traditions, and knowledge development toward sustaining caring, humanity and health for all.

• The discipline is what holds and honors ontology of whole person - the unity of mindbodyspirit and a relational unitary worldview.

• The discipline is what adheres to nursing's philosophical orientation toward humanity and nursing's ethical global covenant with humanity to sustain human caring-healing-health for all.

• The discipline is what holds the theories, the orientation toward knowledge development, and what counts as knowledge, expanding conventional Western science and medical epistemologies.

• The discipline is what holds nursing's research traditions and diverse and evolving approaches to knowledge development; the discipline-specific orientation to knowledge, critiques "what counts as knowledge".

• The discipline addresses expanded, diverse, creative, and innovative methodologies and methods consistent with human caring-healing health - illness experiences and phenomena.

• The discipline holds grand, middle range, and situation-specific theories to provide a shared evolved, unitary world view, whereby health is related to social-moral justice, and whole person/whole system processes and outcomes; acknowledging human caring and eco-caring are one - e.g., humans and planet are connected. This reflects a distinct disciplinary position.

All nursing theories take a position on disciplinary knowledge and this collective building leads to professional identity and visibility of nursing knowledge. Without identity, disciplinary clarity, and commitment to support and promote substantive nursing knowledge development, nursing will not exist.

The Nursing profession, in recent years, with rise of external crises of economics, management science, technology, medicalized, hospital-based practices and policies, has been detoured from its disciplinary foundation. It has been defined by hospital technical industrial nursing practices and sick care. But nursing is much more than conforming to hospital institutional controls; nursing is directly accountable to individual and group human-community experiences. Without a clear disciplinary orientation and foundation to guide the development of the profession, it is easy to lose the way. Any profession that does not have discipline specific language to give voice to its role in society, becomes, and remains invisible; indeed it may not exist. At this turning point, all nurses in the world are invited to advance nursing as a distinct human caring healing-health science discipline or we shrink back into very good professional technicians, working within a totally transformed global health care system.

REFERÊNCIAS

• ¹
  Watson J. Caring Science as Sacred Science. Philadelphia (US): FA Davis; 2016.
• ²
  Watson J. Unitary Caring Science: the Philosophy and Praxis of Nursing. Boulder, CO (US): University Press of Colorado; 2018 [in process].
• ³
  Watson J, Pharris M, Jones D, Turkel M, Cowling R. Task Group American Academy Nursing, Expert Panel Theory-Guided Practice, 2016 [Draft Manuscript].

Publication Dates

• Publication in this collection
  2017