I *do* recognize the need for nursing theory

Nursing Students Post Graduate

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but I am a bit appalled by the theory and research classes requird for my NP program while we covered the entire cardiovascular system in 1.2 hours of Patho. Why is that ??????????????????

We have Nursing Theory, Research and Research and Theory.

How are other programs compared to this one ?

Bookworm wrote:

I'll give just a brief example that has meaning for me: If I care for a demented, vegetative, or even brain-dead patient, it makes a big difference to me how I define the term human. In the long run, I have to deal with this.

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On the contrary...

I think the Rogers/Watson axis of nursing theory actually obscures the humanity of our patients and impoverishes our view of humaness. Let me explain...

I've referred to these Nsg Theories in earlier posts as "gnostic". The gnostics were vestiges of the Greek mystery religions that competed with Christianity in the first couple of centuries AD (see, for example, Richard Tarnas, The Passion of the Western Mind, Ballentine Books, 1991) The mystery religions can be summed up in two main characteristics: 1) Spirit was good, physical bad. The goal of knowledge, philosophy, religion, was to transcend the dirt of the earth, and the daily decay of the body. 2) To find pure spirit-knowledge you had to learn at the feet of the enlightened Masters. A common mind could not apprehend the Great Mysteries.

There you have Rogers/Watson: They give a nod to physical illness, but basically seem embarrased by the dirty reality in the beds before us. They are the Enlightened Masters. Common nurses and non-nurses cannot grasp the profundity of their knowledge and anyone who wants to Master Nursing (as in a graduate degree) must learn from their Wisdom.

Countering gnostics were the early Christians. They had the outrageous belief that G-d had taken on human flesh. Moreover, they believed G-d would one day redeem their bodies as well as their souls. They saw the sacred even in the worst physical suffering.

For good or ill, Christians won that argument and (eventually) all of nature, physical and otherwise, became a fit subject for study. Science as we know it grew out of the renaissance and the reformation. To fall back into gnosticism now is a shameless retreat from reason.

Frankly, I do not think Rogers/Watson can help me see my duty as a human to other humans whose bodies are weak and failing. I think their theory is a mile wide and an inch deep. So superficial as to be all surface. Totally inadequate to enable the nurse to see meaning in the gritty reality of disease and suffering. Incapable of explaining the simultaneous divinity and depravity of humankind.

In vino veritas. I shall pour myself another glass.

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Oh my tulip, how I would love to be as articulate and have such a broad and thorough knowledge. You really have hit the nail on the head. I too spoke of the ever present trench between theory and practice (though not nearly as eloquently...) but what you describe is nothing I have ever put together. I mean I have studied the renaissance and history, but WOW! You are completely accurate. Most theories are a mile away from me and other average joes in the trenches...especially the theories like Rogers and Porifice.

Kudos, Kudos Tulip.

--K

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Specializes in ICU, ER, HH, NICU, now FNP.

"I think their theory is a mile wide and an inch deep. So superficial as to be all surface. Totally inadequate to enable the nurse to see meaning in the gritty reality of disease and suffering. Incapable of explaining the simultaneous divinity and depravity of humankind."

:yeahthat:

Yes - precisely!!!

As I heard it phrased once "...the range of a pellet gun and the depth of a slip and slide"

I have to say - this is one of the most thought provoking and interesting threads ever!

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Specializes in Critical Care.

The reason why you can't make heads or tails of theory is that it is perfectly vague to protect it from scrutiny. If you disagree, then there is plenty of room to argue that you just didn't understand. Duh! Nobody understands this junk!

That, and in order to get a phD in nursing, you have to buy into the garbage. There's no way you can receive your degree otherwise. It's the old 2 rules of college: 1. the instructor is always right, 2. if you want to pass, see rule #1.

And if you criticize the work, then you don't have the education to offer that opinion, because you're not a phD. Oh, if only us bedside nurses had the education to truly understand the total milieu of our base of knowledge . . .

It's a very insular catch 22. The result is that NOBODY can tell these so-called leaders how idiotic they are because nobody but them are qualified to judge OUR body of knowledge.

No wonder we aren't considered professional! The so-called basic tenets of our profession are protected from any rational scrutiny.

And so the ivory towered elitists have indeed successfully defined nursing: as an unprofessional body of tripe.

If only nursing could be defined by what the trenches ACTUALLY do for a living: now that's professional work.

In the meantime, we are being undermined by our so-called leaders. We are being quite successfully and systematically inculcated away from professionalism. And the maddening part of the whole thing: those that deny us a true professional body of knowledge do so in the very name of professionalism.

I would be thrilled if nursing theory was required to be in line with the buzz words of the medical field today: that they simple be evidence based.

~faith,

Timothy.

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I've been thinking about it, and there do seem to be theories in medicine. Consider:

Allopathic

Osteopathic

Homeopathic

Chiropractic

Avurevedic

Some are very different, others not so. But they do represent different theoretical bases.

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Specializes in ICU, ER, HH, NICU, now FNP.

And just how respected are most of these in scientific circles?

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Specializes in ICU, ER, HH, NICU, now FNP.

sorry - pc crashed....

In addition - none of these medical theories purports itself to be the underlying basis upon which all medicine is practiced.

These theories are divisions (division being a rather key term) of medicine - nursing theory tries to apply itself to ALL of the practice of nursing by everyone in every situation.

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Actually, some of these theories are well accepted. Certainly the Osteopath is almost as well accepted as the MD. (In my state, the Osteopathic School is very highly respected. ) And some people (many, in fact) accept Chiropractic medicine.

I do not think that it is correct to call Chiropractic a branch or variation of regular medicine; I believe it has an entirely different theory base. From what I've read about the origins of Chiropractic and Osteopathy, they spring from distinct philosophic perspectives. ( However, I think that Osteopathy has come very close to the mainstream.)

I do not mean to argue about the problems caused by nursing theory, but I think that theory is implicit in medicine, nursing, etc, even if we can't identify it specifically.

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Sad to say, there is no venue where nsg theory could be openly critiqued. It would be nice if there existed a professional journal with the cajones to publish a few scholarly challenges.

I think such a challenge would have to start with some data. A questionaire could be carefully crafted in a manner that does not slant responses. Administered to nurses working directly with patients, it could measure (1) general knowledge about nursing theory (2) use of nursing theory in clinical practice (3) impressions nurses have about theory.

Respondents to the questionaire would, of course, have to be kept annonymous. Unfortunately the authors would have to use their real names. There's the rub. I wouldn't put my name on it unless and until I had full tenure.

Any tenured rebels out there? I don't have any experience with questionaire design. Perhaps some visitor to this thread knows how to go about getting this kind of objective data?

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My, my only the nurses in the trenches have the knowledge base to articulate theorical knowledge. How presumptive of some to believe that those holding PhDs do not currently ever practice the art of bedside nursing. If all one can do is articulate the negative and their own failure to understand, even attempt to understand, they are clearly lacking in cognitive abilities. I do not understand all the aspects of nursing theorists and there are some whom is disagree with but I do respect their attempts to articulate a theorical base. And I am assuming that many of those who have problems with nursing theory, are in the same general group that feel all nursing education should be grounded on in the physical aspects of care and who are againist higher educational standards for nursing.:chair:

Grannynurse:balloons:

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Specializes in ICU, ER, HH, NICU, now FNP.

I think you actaully have to seperate the need for higher education standards and the need for theory at this point in time.

As it is now - higher educational standards simply mean more theory, not more clinical education. Until both can be adressed on their own terms, I don't think you can say that people who are against theory are against higher educational standards in nursing. I think it is feasible to say that the whole of nursing theory needs to be critically examined before we build any houses of cards on it. There has been very little critical examination of theory. And as other posters have intimated - without critical examination, it can't be taken seriously.

It doesn't matter what theory is or isn't - if it can't be subjected to critical examination then it's worthless. Are we to believe in theory as some of us believe in God? Should nursing theory be above critical examination? In my experience, some theory thumpers seem to think so.

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For the record, I have a PhD in one of the biological sciences and have done research for 14 years with a break of 3 years to teach Pharm and Pathophys on the graduate level. I hope to start a job as a bedside per diem nurse on a neuro unit this month. I have an application in for a tenure track position in a SON and, if hired, would need up to date clinical skills.

None of which makes my opinion on Nsg. Theory any better than anyone elses'. I'm not sure I understand GrannyNurses' objection to my/our doubts about Nsg Theorists. I think she is suggesting that the anti-Theorist rhetoric is maybe anti-intellectual or anti-nursing scholarship. (She can correct me if I'm wrong.)

It is, indeed, my strong feeling that the bedside (broadly defined) is the well from which we must draw our definitions of nursing. That context and none other. If it were shown that working nurses object to, do not use, feel frustrated and intimidated by discussion of nsg. theory, then it's time to ask why we are expending a huge (HUGE!!!) amount of academic capital preserving it.

Somewhere, somehow, that discussion must take place.

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