Knowledge: A Priority for Creating Nursing s Future

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1 Bartlett CHAPTER 2 Structuring Nursing Knowledge: A Priority for Creating Nursing s Future Bartlett Rozella M. Schlotfeldt, RN, PhD, FAAN Nursing s future will be created only as the discipline underlying nursing practices is identified, structured, and continuously updated by systematic inquiry. The kinds of knowledge contained SALE within OR the DISTRIBUTION discipline are identified and an approach to its structure is proposed. Source: Schlotfeldt, R. (1989). Structuring nursing knowledge: A priority for creating nursing s future. Nursing Science Quarterly, 1(1): Reprinted by permission of and copyright 2002 Sage Publications, Inc. 15 century, nursing s body of knowledge will be identified, selected, verified, and agreed upon by qualified Jones professionals & Bartlett the field, effectively structured, and continuously updated to reflect newly discovered knowledge. Also, knowledge judged to be There can be little doubt that one of the erroneous, inadequate, and outdated should highest priorities for creating an appropriate future for nursing is that of identifying, from basic and clinical scientific nursing be deleted. This knowledge will be derived Bartlett structuring, and continuously advancing the research, SALE both quantitative OR DISTRIBUTION and qualitative, knowledge that underlies the practices of from philosophic and historical inquiries, professionals in the field. That statement and from evaluation research designed to can be made because a consensus has not yet establish valid criterion measures, devices, rning, been attained concerning the subject matter and approaches to establishing Jones the efficacy & Bartlett Le that must be mastered by those who seek and value of nursing s caring functions SALE OR D to practice general and specialized nursing. as they are relevant to the health, function, comfort, well-being, Surely by the beginning of the twenty-first productivity,..

2 Bartlett 16 Chapter 2: Structuring Nursing Knowledge: A Priority for Creating Nursing s Future societies whose members give them positive sanction for two major reasons: (a) the services learned professionals render are judged to be essential and beneficial for all mem- Jones bers & of Bartlett society during particular times in their lives, SALE and OR (b) DISTRIBUTION members of each learned self-fulfillment, and happiness of human profession have identified and come to a beings. consensus about the knowledge that practitioners must master and use selectively, cre- The thesis of this chapter is that only qualified professionals in the field, including general and specialist practitioners, educators, in providing those essential services. As a atively, humanely, effectively, and ethically Jones administrators, & Bartlett investigators, historians, second criterion, Jones each profession & Bartlett must support a cadre of investigators SALE whose OR role DISTRIBUTION is to philosophers, SALE OR and theorists, DISTRIBUTION should be given responsibility by the profession (however that advance its knowledge continuously with a is defined) to identify, verify, structure, and view toward improving its practices. continuously update the extant content or The traditional learned professions have Bartlett subject matter that, at the minimum, should Jones included & the Bartlett clergy, lawyers, and physicians. SALE OR be DISTRIBUTION included in the intellectual armamentaria The clergy SALE have OR been DISTRIBUTION valued and supported of all professional nurses. This responsibility because they are expected to be knowledgeable and skillful in providing spiritual com- of the profession is essential to four functions: (a) the creation of comparable programs of fort and well-being for all those who consult study at the first Jones professional & Bartlett degree level; (b) them. Lawyers are expected to master Jones coded & Bartlett Lea control of the profession s SALE goals, OR mission, DISTRIBUTION and law and to apply their discipline fairly and SALE OR D accomplishments; (c) a valid procedure for skillfully in fulfilling the goal of preserving social harmony and justice. Physicians licensing (not registering) all who quality as professionals in the field; and (d) certification have been valued because knowledge of Jones of bona & Bartlett fide nursing specialists. human ills and Jones disabilities & Bartlett and their causes and knowledge of the means SALE to OR eliminate, DISTRIBUTION attenuate, or manage them and alleviate Nursing as a Profession their noxious consequences are considered essential to the well-being of society. Are Two major criteria must be fulfilled by Bartlett Jones the caring & Bartlett functions and mission of nurses, any occupational group whose members namely, appraising and optimizing the earn and achieve the status of a profession, health, function, comfort, independence, or more appropriately for nursing, a learned and potential of human beings, any less valued than spiritual comfort and well-being? helping profession. First, a profession must have an institutionalized goal or social mission. Learned professions are valued by the mony and justice? Are they any less Are they any less desirable than social har- important than finding causes for, diagnosing, and treating human ills? Unfortunately, the caring functions typically provided by nurses were for too long considered to be mere extensions of the duties and obligations of wives SALE and mothers, OR DISTRIBUTION for..

3 Bartlett Knowledge of the Discipline 17 which large amounts of professional knowledge were not considered essential (Reverby, The efforts that have been made toward establishing the discipline represent significant steps toward achieving the goal SALE OR D 1987). Lay members of societies have typically not recognized and nurses themselves of identifying, organizing, and achieving have been remarkably tardy in identifying a consensus concerning the specific body Jones and & organizing Bartlett the several kinds of professional SALE knowledge OR DISTRIBUTION that are fundamental to practices. It must be noted, SALE however, OR DISTRIBUTION that of extant knowledge Jones that & Bartlett underlies nursing executing the caring functions that nurses there has not yet been a concerted effort typically provide. to identify and obtain agreement about the The essential and often crucial nature of currently available knowledge that is fundamental & Bartlett to nursing s growing number of Bartlett nurses caring functions in promoting the Jones SALE OR health DISTRIBUTION and well-being of all human beings is declared SALE specialties OR or DISTRIBUTION even to obtain a consensus about the requisite knowledge and finally being recognized by thinking people, including scholarly nurses. There is now general agreement (at least verbal agreement) are. It must be recognized also that the sub- skills that define what nursing s specialties that nursing s Jones social mission & Bartlett is to appraise and ject matter that constitutes the Jones discipline & Bartlett Lea assist human beings in their SALE quest OR to DISTRIBUTION optimize has not yet been identified and structured, SALE OR D their health status, health assets, and health and agreement has not been reached concerning appropriate and needed inclusions potential (Fawcett, 1983). Furthermore, general agreement exists that there is or should from qualified professionals in the field. Jones be a & body Bartlett of structured knowledge that professionals SALE in the OR field DISTRIBUTION agree represents the disnizing the several kinds SALE of knowledge OR DISTRIBUTION con- This paper presents Jones an & approach Bartlett to orga- cipline that is fundamental to general and tained within the discipline, a possible next specialty nursing practices. step toward having qualified professionals Nursing scholars have discussed, select and structure the specific extant subject matter Bartlett described, and characterized the discipline Jones & Bartlett of the discipline about which (Donaldson & Crowley, 1978), and in the agreement is needed. recent past, the American Association of Colleges of Nursing (1986) has reported findings from a national effort to define Knowledge of the Discipline the essential knowledge, practice, and values that the baccalaureate nurse should possess Figure 2-1 shows the kinds of professional knowledge contained within the dis- (p. 1). Panel members expressed the belief that the essentials so delineated can be cipline, which is depicted as a large sphere achieved within the traditional baccalaureate having a permeable and expandable membrane (represented by the second sphere) degree program in nursing and that the baccalaureate represents first-level professional to permit the continuous Jones & Bartlett addition of newly preparation SALE in OR nursing. DISTRIBUTION discovered knowledge and SALE the OR deletion DISTRIBUTION of..

4 Bartlett 18 Chapter 2: Structuring Nursing Knowledge: A Priority for Creating Nursing s Future Bartlett FIGURE 2-1 The Nursing Discipline that found SALE through OR DISTRIBUTION systematic inquiry to be and systematic study to SALE be relevant. OR DISTRIBUTION Nurse erroneous, inadequate, or irrelevant. investigators have also been adding to nursing s scientific knowledge by testing the rel- The largest segment of the sphere (Figure 2-1a) represents nursing s scientific evance and utility of theories generated by Bartlett subject matter. Therein belongs all of nursing DISTRIBUTION science (i.e., the verified facts, principles, (Chinn, SALE 1984). Few OR investigations DISTRIBUTION have yet Jones basic scientists & Bartlett in clinical nursing situations SALE OR and laws that have been discovered through been reported that test scientific theories scientific inquiry to be valid, relevant, and regarding human phenomena that are of useful for nursing practice); included also particular concern to nurses but not to basic are extant scientific Jones theories & Bartlett that guide scientific investigations in nursing and those that there is little agreement among nurses scientists (Silva, 1986). A plausible Jones reason & is Bartlett Le that have been proposed by scholarly nurses concerning the human phenomena that are as promising explanations of phenomena of concern to nurses and how they should be that are of particular concern to nurses. characterized and classified and how knowledge of them should be advanced. To date, much of nursing science has been discovered by basic scientists and subsequently found through empirical evidence human beings are biopsychosocial In general, nurses accept the notion that beings..

5 Bartlett Knowledge of the Discipline 19 (Engel, 1977). It is proposed here that circumstances, and events that have shaped that development. Included also is the history of nursing knowledge as it has been SALE OR D the subjects that nurses serve also exemplify assets of the human spirit of which relevant knowledge is inadequate. Those transmitted to generations of practitioners. assets surely include human spirituality and The third section of the sphere (Figure Jones other & qualities Bartlett of the human spirit, such 2-1c) represents Jones philosophic & Bartlett nursing knowledge. Included are the profession s SALE OR accepted DISTRIBUTION as determination, verve, courage, beliefs, hope, and aspiration. Nurses surely hold values and codes of professional behavior. responsibility for advancing knowledge of Included also should be the several philosophic theories that have been tested, found those health-seeking assets. In sum, human Bartlett beings health-seeking mechanisms and Jones useful & and Bartlett relevant to nurses work, and SALE OR behaviors, DISTRIBUTION beliefs, and propensities can be accepted SALE as philosophic OR DISTRIBUTION guides to practice. classified as biological, psychological (both Illustrative are selected theories of value, emotional and cognitive), and sociocultural justice and morality, and ethical theories. and as assets of the human spirit; all of them Because nurses are encountering increasing are directly Jones relevant & to Bartlett the natural efforts numbers of moral and ethical dilemmas Jones & and Bartlett Lea by humans to seek SALE and attain OR DISTRIBUTION optimal because nurses are increasingly manifesting SALE OR D health. Because so much scientific nursing knowledge remains to be discovered, it of philosophy, it is predicted that nursing interest in becoming scholars in the discipline is safe to predict that nursing science will knowledge henceforth will include increasing Jones likely & always Bartlett represent the largest and most amounts of tested Jones and & relevant Bartlett philosophic rapidly SALE changing OR DISTRIBUTION aspect of the discipline. knowledge that will be incorporated SALE OR into DISTRIBUTION the Furthermore, nurses are increasingly recognizing the relevance of scientific knowledge The fourth section of the sphere (Figure discipline. from disciplines not traditionally judged 2-1d) represents knowledge of nursing strategies, approaches, Bartlett to be relevant for nursing. Included, for Jones & Bartlett and technologies along with example, are concepts, principles, and the scientific and artistic principles essential theories from economics, political science, to their execution. Included also is knowledge of the prevailing health care system. administration and management, and computer science. The science fundamental to Relationships between the goals and caring education has long been incorporated as an functions of nurses and the goals and practice integral part of the discipline of nursing. functions of other health professionals in the A second important segment of the existing health care systems represent another sphere representing the nursing discipline important segment of the discipline. is historical knowledge (Figure 2-1b). Another significant segment of nursing s Included is knowledge of the heritage of the body of knowledge has always been knowledge of factors that influence the health occupation and the developing profession of nursing, SALE including OR DISTRIBUTION knowledge of people, status, health assets, and SALE health potential OR DISTRIBUTION of..

6 Bartlett 20 Chapter 2: Structuring Nursing Knowledge: A Priority for Creating Nursing s Future human beings, both favorably and unfavorably (Figure 2-1e). Included is knowledge of an approach demonstrates the vast and growing amounts of knowledge that professionals SALE OR D biological, physical, and cognitive abilities with which people are natu-rally endowed in the field must master and be able to use selectively, creatively, artistically, humanely, and knowledge of environmental factors, economic & and Bartlett social circumstances, and changes Nursing should Jones be recognized & Bartlett as a learned and skillfully to provide exemplary care. Jones associated SALE with OR normal DISTRIBUTION development, including helping profession and a respected SALE OR academic DISTRIBUTION the aging process. In the nursing perspec- tive presented here, pathologies and medical discipline. Surely nursing scholars will ensure the attainment of those goals by the beginning of the twenty-first century. Crucial to diagnoses and treatments are factors that Bartlett affect the health of human beings. Nurses Jones their attainment & Bartlett is identifying and attain- ing agreement SALE about OR DISTRIBUTION the human phenom- SALE OR must DISTRIBUTION have adequate knowledge of these factors: such knowledge is an integral part of the discipline that must be mastered by nurse practitioners. ena that are of particular concern to nurses, enhancing scholarly clinicians involvement in generating promising relevant theories, There is Jones yet another & Bartlett kind of knowledge and testing those theories as the Jones means & to Bartlett Lea that is directly relevant SALE to and OR essential DISTRIBUTION for discover knowledge through which to continuously SALE OR D nursing practice. It is the knowledge that professionals must gain from relevant data concerning each person being served and Jones that & obtained Bartlett through astute and perceptive improve nursing practices. Such an approach will ensure the availability of valid nursing knowledge in the twenty-first century and its Jones currency & during Bartlett all centuries observations. SALE OR Personal DISTRIBUTION knowledge of individuals to come. and groups of persons is needed for nurses to respect the uniqueness of those for whom they provide exemplary services. References Bartlett For that reason, there can be no prescriptive nursing practice theories or professional American Association of Colleges of Nursing. approaches to nursing care that are universally (1986). Essentials of college and university generalizable. In summary, conceptualizing the discipline education for professional nursing. Washington, DC: Author. of nursing as an expandable and perme- Chinn, P. (1984). From the editor. Advances able sphere made up of segments of varying in Nursing Science, 6(2), ix. size provides an approach to classifying and organizing the several kinds of knowledge that constitute the nursing discipline. Such Donaldson, S., & Crowley, D. (1978). The discipline of nursing. Nursing Outlook, 26,

7 Bartlett References 21 Engel, G. (1977). The need for a new medical model: A challenge for biomedicine. Reverby, S. (1987). A caring dilemma: Womanhood and nursing in historical perspective. Nursing Research, 36, SALE OR D Science, 196, Fawcett, J. (1983). Hallmarks of success in nursing theory development. In P. Chinn Silva, M. (1986). Research testing nursing theory: Jones State of & the Bartlett art. Advances Jones (Ed.), & Bartlett Advances nursing theory development SALE (pp. OR 3 17). DISTRIBUTION Rockville, MD: Aspen. Nursing Science, 9(1), SALE OR DISTRIBUTION Bartlett Bartlett..

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School of Nursing Philosophy (AASN/BSN/MSN/DNP)

School of Nursing Philosophy (AASN/BSN/MSN/DNP) School of Nursing Mission The mission of the School of Nursing is to educate, enhance and enrich students for evolving professional nursing practice. The core values: The School of Nursing values the following