History and Evolution of

Nursing Science

Maria Girlie D. Jordan, MSN

History & Evolution of Nursing
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History and Evolution of
Nursing Science
Feminism
Feminist theories
Liberal Feminist Theory
Impartiality
No special privileges
Equal opportunity
Objectivity
Value-free criterion
Basically, no special treatment, kind of like
affirmative action
History and Evolution of
Nursing Science
Feminism
Feminist theories
Socialist feminist theory
Marxist view
Knowledge is not value free
No vested interest in maintaining status quo of a
paternalistic society
Recognizes that women have social positions not
available to men
Womens unique social experience guides research
Knowledge is useful when womens interests are not
subordinate to those of men
History and Evolution of
Nursing Science
Historical perspective
Mainstream feminism has been somewhat
suspect of nursing for a long time
Nursing viewed as subservient and not
interested in equality
Nursing viewed as a nurturing, feminine
role that is an extension of womens work
By the mid 1800s, ladies would never
consider lowering themselves to care for
others
History and Evolution of
Nursing Science
Development of nursing in North
America
At the turn of the century (1900), nurses
tried to become autonomous, equal
caregivers
They were unsuccessful due to the class
differences between nursing, hospital
administrators and paternalistic male
dominance
History and Evolution of
Nursing Science
Nurses training in the US was
traditionally very demanding with long
hours
The hierarchy within the school made
individual decision making difficult
Physicians and hospital administrators
viewed schools of nursing as sources of
cheap labor
History and Evolution of
Nursing Science
A class system within nursing began to
develop
Elite educators
Nursing administrators
Bedside practicing nurses
Nurses began to accept the subservient
roles taught to them in training
History and Evolution of
Nursing Science
Nurses and Physicians
At the turn of the 20th century, medical
education was fragmented and
unregulated
Nurses had a greater influence in patient
care than physicians
1910 The Flexner report
Resulted in closure and/or reorganization of 92
medical schools
History and Evolution of
Nursing Science
Nurses and Physicians
Medicine aligned with science and research
Teaching hospitals and university affiliations
Consolidated the domination of health care
Flexner identified the criteria for
characterizing a profession
Eluded to clergy, law, and medicine
Men were motivated by money
Women were motivated by social virtues
History and Evolution of
Nursing Science
Nursing and professionalism
Limited body of knowledge
Many front line workers
Very little research
Many liberal feminists thought that since
nursing was a female dominated
profession, they had a significant voice to
affect change, but chose not to.
History and Evolution of
Nursing Science
Knowledge development
In the early 1900s, Columbia Teacher
College was the only university to offer
college nursing courses
Most study was linked to education
Academically prepared nurses were required to
teach which kept them from the bedside
This phenomenon increased the divide between
bedside and academia
History and Evolution of
Nursing Science
Knowledge development
WWII opportunity for nursing to affect
change
Nurses interested in upgrading their education
were considered a threat by the mainstream
hospital trained nurses
1951 Journal of Nursing Research
1976 1st time more clinical articles than
educational articles
History and Evolution of
Nursing Science
Research and Theory Development
Early approaches followed the biomedical
model
Nurses at that time felt that using a similar tool
as physicians would make them credible
scientists (Nagle & Mitchell, 1991)
Scientific method insufficient for addressing
many of nursings concerns.
History and Evolution of
Nursing Science
Theory development
As nurses began doctoral preparation in
the 1960s, a lack of theoretical base was
evident
Logical and empirical basis for theory
development
Scientific method inadequate for such
abstract concepts as health and illness.
History and Evolution of
Nursing Science
Theory and nursing practice
Basis for professional development
Early theorists felt they needed
frameworks that encompassed both the
measurable and unmeasurable factors
Reciprocity between theory and practice
Do you think that autonomy is fostered by
having our own frameworks?
History and Evolution of Nursing
Science
History and Evolution of
Nursing Science
Do you agree that professionalism is a
male contrived invention?
Do you believe that nurses in practice
have a more legitimate perspective than
those in education or research?
Do you think social feminism can
change the existing social order of
health care?
History and Evolution of
Nursing Science
Myth
A traditional story that attempts to unfold
or explain a practice, belief or
phenomenon
An ill founded belief held uncritically,
especially by an interested group
(Websters New Collegiate Dictionary)
History and Evolution of
Nursing Science
Myth 1: The myth of the ultimate truth
True is true because it is true
Truth is conceptualized as a reality
Assumptions are not always truths
It is OK to disagree with current
assumptions
Just because everyone thinks a particular
way doesnt make it the best way
History and Evolution of
Nursing Science
Myth 2: Objectivity
It is impossible to be value-free
Nothing is exempt from subjective
influence
Someones opinion of what is normal
It is generally known as(by whom?)
Nightingales environment theory in Crimea
is a good example
History and Evolution of
Nursing Science
Future Search
Debunking the myths in nursing theory and
research with the following assumptions:
Nursings world view is both reasonable and
valuable
The scientific method is useful but not for all
questions
Stop looking at things as scientific and
nonscientific
Alternative methods and logical systems are OK
to use
History and Evolution of
Nursing Science
Myth 3: The perfect method
What today seems like the perfect way to
do something should not keep us from
looking at alternatives
Standards are subject to change
Research can change universally accepted
methods
Dont allow yourself to look at things as
already done
History and Evolution of
Nursing Science
Myth 4: Scientific supremacy
Science is not the only method of gaining
knowledge
Just because it is scientifically sound
doesnt make it useful or accepted
Using nursings patterns of knowing
encourage nonscientific thought
Empirical observations deserve validation
History and Evolution of
Nursing Science
Myth 5: Empirical evidence
Just because a phenomenon does not have
a sensory experience doesnt mean it
doesnt exist
Recognize that empirical evidence has its
limitations
Justification of an observed phenomenon is
not always empirical
History and Evolution of
Nursing Science
Myth 6: Higher authority
Authoritative literature is not gospel
Anyone can manipulate, coerce, or
withhold information for the purpose of
proving a point
Subjectivity contaminates the value of the
norm
We make conclusions based on
experimental reality
History and Evolution of
Nursing Science
Myth 7: Significance
Just because research results reach
statistical significance, we cannot assume
that it is truth
Application of the test of importance
Research may contribute nothing to
current knowledge
Statistical significance is just that.
History and Evolution of
Nursing Science
What constitutes Nursing Science?
Nursing knowledge vs. nursing science
Theories may overlap
Theories need to synthesize the scientific
with the nonscientific
Facts alone do not constitute science
Nursing observations contribute to nursing
science
History and Evolution of
Nursing Science
Nursing Science in the Global
Community
Knowledge development is frequently
imbedded in what are cultural norms or
values
Diversity and ethnic mix in the US
continues to increase
Current nursing theories are not always
globally applicable
History and Evolution of
Nursing Science
Western parochialism and
ethnocentrism
Most theories written by educated white
American women post WWII
US social movements have influenced
nursing
Most available research is American
without global characteristics