I *do* recognize the need for nursing theory

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SmilingBluEyes

20,964 Posts

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I find professors expecting such things insulting, 1Tulip. You seem to do fine without having to incorporate "buzzwords" into your articulate communication. I find this all very discouraging, frankly, about higher education.

1Tulip

452 Posts

It was a long time ago, and I hope that academic settings are not as rigid as they were then. (It was kind of mid-70's and Nsg. Theory was the big hot thing. Delores Krieger had just published her paper in AJN where she was able to increase subjects' Hct. by touching them... thus supporting a lot of these "energy field" kind of theories. She was never able to replicate her findings, however, and was roundly criticized for her lack of controls)

Anyhow... if I learned to abhor buzz words in that class, it's probably made me a better writer. So in a perverse way the class did me a lot of good.

Speaking of Krieger... I think she perfectly illustrates how spiritual-ish, metaphysical theories canNOT be proven empirically. Don't know if anyone on this thread wants to walk that far into the past, but I think it was a telling episode in this debate, one which the spiritual/metaphysical/gnostic theoreticians have tried to sweep under the rug.

Kelly the Great gets her say because (1) it's well reasoned and (2) as an undergraduate she has to deal with Nsg. Theory in her curriculum and (3) AllNurses is a completely egalitarian place.

OK... GrannyNurseFNP asked the question:

"I do not understand what you mean by punishing those that refuse to acceot it." "It" being Nsg. Theory.

What I mean is being threatened with an F in an upper division graduate course in my MSN program. More than threatened. First assignment got a big fat F. I had to do two things in order to pass. First, I had to force the prof to narrowly define what she meant on each assignment. I did this by submitting an outline for each essay and asking her to initial the outline if it did indeed conform to the requirements of the assignment. (She had a very lax mental discipline. Her assignments were very plastic, could be understood in any number of ways. She could not write a declarative sentance. Hense she would summarily fail any essay she didn't like by saying it "did not follow the assignment." So I removed that issue in advance by forcing her to acknowledge that my proposed paper fit within the parameters of the assignment. She would not be able to say after the fact that I hadn't understood her assignment.)

Second, I started using her vocabulary: paradigm, empower, carative, whollistic, metanarrative...what ever buzz word I could pick up from her. I DO NOT write that way. I HATE using that kind of verbiage. But I had no choice.

Another example: A junior faculty member (not me... someone I heard about) refused to make her students' papers and practica conform to the Nsg. Theory favored by that school. She said she didn't agree with that theory (there being a universe of competing theories) and she was fired. Proving that there is no such thing as academic freedom in that School of Nursing.

My experiences are not unique. I think quite a few of the respondents on this thread have encountered theory fascism.

I'm pleased that GrannyNurse has had more positive experiences in her academic career. It makes me believe that there are some nurse- philosopher-theorist-academics who actually welcome dialogue. That's a good thing. Maybe it's a trend that could spread.

First, in response to your comment regarding academic freedom. A college or university has the right to impose certain standards on their faculty, including teaching under the guidelines of certain theories. A faculty member is allowed to teach a divergent theory but he/she must also teach the theory under which the program has adopted. I have taken two graduate level courses, in two different programs, in two different states. And one of the course was taught by a recognized nursing theorists, I. King. If anyone was going to impose her own theory, I would have expected it to be King. She did not and I suspect it was because she felt comfortable in explaining the base for her theory. And did not feel threatened by those who disagreed with her nor did the program. We were encourage to write in support of our opinion but we were held to the same academic standards as those who agreed. In both programs, students were encouraged to chose a different theorists and present published research data, in support of their theorist. The second program was modeled on Watson's model. I chose Lenienger as my theorist because I agree with her transcultural nursing model. I was not penalized for substribing to a different theorist. I suffered no adverse penalities, in grades for papers or presentations.

As for the faculty member being fired. It lies with the individual to chose an employer whose theorical bases matchs theirs. One does not chose to work in a program that bases its theorical knowledge on King, when she believes in Watson. And one does not neglect to teach King's theory, substituting Watson's. Sorry, the faculty member was wrong and deserved her termination. She should have researched her program's theortical base before accepting the position.

As for the buzz words. A theorical base is subject to the development of a lanuage that describes the theory. Such a vocabulary is tailored to meet the descriptive needs of a theory. And they are tied into the language of the presented theory. Kant's theory has certain buzz words, to describe his theory but I see no one objecting to his use of such words.

Grannynurse

It was a long time ago, and I hope that academic settings are not as rigid as they were then. (It was kind of mid-70's and Nsg. Theory was the big hot thing. Delores Krieger had just published her paper in AJN where she was able to increase subjects' Hct. by touching them... thus supporting a lot of these "energy field" kind of theories. She was never able to replicate her findings, however, and was roundly criticized for her lack of controls)

Anyhow... if I learned to abhor buzz words in that class, it's probably made me a better writer. So in a perverse way the class did me a lot of good.

Speaking of Krieger... I think she perfectly illustrates how spiritual-ish, metaphysical theories canNOT be proven empirically. Don't know if anyone on this thread wants to walk that far into the past, but I think it was a telling episode in this debate, one which the spiritual/metaphysical/gnostic theoreticians have tried to sweep under the rug.

Perhaps because her theory concern TT is still under investigation. And I remember taking one of her presentations, at New York Hospital, in 72. I find it amusing that those who wish to diismiss the spiritual/metaphysical theoreticians are not as eager to dismiss metaphysical theories of other disciplines. Or are they?

Grannynurse

Kelly_the_Great

553 Posts

Specializes in home & public health, med-surg, hospice.

I don't think most of the posters on this thread are claiming all nursing theories (maybe a few that resemble visions of Lucy in the sky with diamonds) are invalid but that there is too much of an emphasis placed upon their importance within our curriculum.

There are too many theories first of all. Thus, it further leads to division within nursing. The exact thing we don't need!

Why don't we focus our energies on coming up with a consensual definition of nursing? And find unity within our profession, where the subsets of the system are viewed as even more valuable when considered as part of the whole. I love something I found on the Royal College of Nursing website re. the lack of our ability to define nursing: "If we cannot name it ... we cannot control it, finance it, research it, teach it or put it into public policy." Further, I believe we cannot easily promote it to potential recruits, other professions or to our prospective consumers.

Doing this and grounding ourselves in EBP instead of all of these hooky-kooky theories would allow us not only stability but growth as a profession.

What is wrong with defining ourselves in our practice? Lawyers do, so do bankers and doctors - people don't consider them vocational workers. I just don't see th' down side.

We can still have theory but it doesn't have to define who we are or totally consume our energies when they could be better spent addressing other aspects of our profession. Does this make sense to anyone but me?

tencat

1,350 Posts

It primary use in practice is to provide insight regarding nursing practice (you can substitute any profession) and to guide practice.

Grannynurse:balloons:

I agree with you there that theory should be there to guide practice, but if the theory has been proven to be irrelevant or not useful to practice, why continue hanging on to it? Theory should be fluent and able to be amended or changed to be useful to guide a profession. The problem I see is that some of those in the Ivory Towers are positive that their way is right, and any questioning of theory is seen as an attack by those that are not as 'enlightened' as they are, or not as 'intellectually capable'. Thus theory becomes stagnant and loses its credibility because it is not allowed to be scrutinized by anyone who is less than 'worthy'. And to be 'worthy' a person must totally accept that theory is the end all and be all of a profession. Blindly clinging to theory does not make one smarter than or superior to everyone else. Without the question "does it enhance practice?" theory becomes nothing more than dogma.

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

Kelly - what you stated is exactly the way I feel.

Theory has it's place to make it the be all / end all is not right. I have a saying hanging over my desk that says

"The space and time for what you want is being occupied by that for which you have settled"

The nursing profession is occupying a LOT of it's time and energy with theory that has gotten us nothing but laughed at by the masses. We have settled for theory and decided there is nothing else - or at least that's how it appears. We say we want respect from other fields, then we had better examine more closely that which they find laughable and look at what it is we need to be respectable. I dont hear the RT's, lab techs, Docs, PT's, or even psychs talking about theory the way we do! MORE FOCUS ON EVIDENCE I SAY!

And yes BlueEyes - it *IS* very discouraging - I was so looking forward to the theory class, it wasn't at all what I thought it would or could be.

ZASHAGALKA, RN

3,322 Posts

Specializes in Critical Care.
Abstraction and 'lack' of scientific evidence is not a reason for dismissing theory.

Actually, I firmly believe it is sufficient reason for dismissing theory.

~faith,

Timothy.

1Tulip

452 Posts

GrannyNurse Wrote:

As for the faculty member being fired. It lies with the individual to chose an employer whose theorical bases matchs theirs. One does not chose to work in a program that bases its theorical knowledge on King, when she believes in Watson. And one does not neglect to teach King's theory, substituting Watson's. Sorry, the faculty member was wrong and deserved her termination. She should have researched her program's theortical base before accepting the position.

Oh my! How absolutely wrong you are. Do you understand what's at stake with academic freedom? The WHOLE point of it is to keep departments from becoming little megaphones for a few prominent members! Academic freedom is supposed to be a guarentee that students are exposed to and have a chance to study in depth contrasting, even opposing concepts. If they are to do that, a faculty must employ people who enthusiastically embrace different points of view.

Imagine, if you will, the philosophy department chairman saying to a scholar in existentialism... "you can't work here, mister. WE are all CARTESIANS!!!" That would be obscenely wrong.

To accept your notion of "conceptual loyalty oaths" is to welcome .. in fact, REQUIRE ...persecution of faculty with different ideas.

No way. I can't believe you meant this the way it sounded.

As for paradigms, empowerment, metanarrative and holistic...

Naturally disciplines develop their own vocabulary. But that's not what we're talking about here because these words exist in common usage (as opposed to, for example, kinase, levorotary, carboxyl groups, etc.) What I mean, when I say these are buzz-words is (1) that they are hackneyed and used by people too lazy to stretch their vocabulary and (2) they are inexact and can be used to obscure almost better than they can be used to illuminate.

But WAIT! There is something worse than using hackneyed buzz-words and pretending they are erudite. And that is making up entirely new words for no apparent reason whatsoever! Watson has dumped her "carative factors" ,for example, and now calls them "clinical caritas processes". Now, I gotta tell you, Oxfords Dictionary of the English Language, Websters, and dictionary.com don't know what caritas is all about. Is it an adjective? Is it a noun? Who knows? Only Watson and her enlightened acolytes.

If she has a reason for doing this i.e. making up new words or using extremely obscure meanings, I can't figure it out. But, assuming she has a reason, it better be a very, very compelling one. Because the only people who use neologisms are either schizophrenic, or cultic.

In almost every instance, when I've heard or read a buzz word or neologism by nursing theorists, it either doesn't fit in the context of the sentance, or could have been easily replaced with a word that is more accessible to readers in general, or has a meaning only the user understands.

I don't think most of the posters on this thread are claiming all nursing theories (maybe a few that resemble visions of Lucy in the sky with diamonds) are invalid but that there is too much of an emphasis placed upon their importance within our curriculum.

There are too many theories first of all. Thus, it further leads to division within nursing. The exact thing we don't need!

Why don't we focus our energies on coming up with a consensual definition of nursing? And find unity within our profession, where the subsets of the system are viewed as even more valuable when considered as part of the whole. I love something I found on the Royal College of Nursing website re. the lack of our ability to define nursing: "If we cannot name it ... we cannot control it, finance it, research it, teach it or put it into public policy." Further, I believe we cannot easily promote it to potential recruits, other professions or to our prospective consumers.

Doing this and grounding ourselves in EBP instead of all of these hooky-kooky theories would allow us not only stability but growth as a profession.

What is wrong with defining ourselves in our practice? Lawyers do, so do bankers and doctors - people don't consider them vocational workers. I just don't see th' down side.

We can still have theory but it doesn't have to define who we are or totally consume our energies when they could be better spent addressing other aspects of our profession. Does this make sense to anyone but me?

Too many theories and not enough hard evidence to support these too many theories. And just who is suppose to decide which of these theories are worth saving and which should be dropped. You? Me? A floor nurse? And what do we use as criteria and who decised which criteria are acceptable. And what happens to those of us, who do not subscribe to EBP theory.

I certainly do not consider attorneys, physicians or bankers vocational workers but I do consider the scope of their basic education. All require a BS or BA, as well as a three or four year advanced degree-M.D., J.D. or M.B.A.

And what do we require--that is a whole other thread.

Believe it or not, theory is a part of the defining a profession. MBAs have several different economic theories, some of which are generally acceptable and others that are questionable. Does that mean they drop a theory because some MBAs don't agree with its premis? I don't think so. I have heard of only two definitions of nursing and they are quite clear and basically quite simple. Nursing theory, like many other theories, is not steeped in hard science. Does this mean that it is invalid. No, but there are those that believe lacking this nursing theory is not worth much. Their loss.

Grannynurse:balloons:

Kelly_the_Great

553 Posts

Specializes in home & public health, med-surg, hospice.

It all really does bear a resemblance to the thinking/reasoning/tactics of the occult (imo).

The buzz words, the ambiguity, the "secret knowledge" - only enlighted/illuminated one's can comprehend. I liked Tulip's reference of the gnostics - the mystery religions.

You know something else the occult will often do? Often they will have their members memorize long, laborious text that really have no meaning at all, that the lower members do not understand at all, that serves no direct, useful purpose at all. It's a way of "draining" the underlings' energies. I mean, look guys, I know this sounds far-fetched yet they are the one's espousing belief in things like "energy fields" and "auras." Do we wish to return our profession to the days of healing women being seen as witches? That might sound beyond belief but it certainly is not, not under the right circumstances (political, cultural or otherwise).

As gauge14iv mentioned earlier to her sign "The space and time for what you want is being occupied by that for which you have settled," dedicating so much time to these theories, let alone the manner in which we're taught to incorporate these theories into our own belief systems - without question, it's frustrating.

Like ZASHAGALKA mentioned earlier, I'm not sure if it's not dumbing us down. In today's world, I think it's much more important if a nurse knows how to obtain and access the current evidence that represents the best care for her/his patient at any given time than if they memorized a bunch of theories. Our minds are needing to evolve past rote memorization.

I agree with you there that theory should be there to guide practice, but if the theory has been proven to be irrelevant or not useful to practice, why continue hanging on to it? Theory should be fluent and able to be amended or changed to be useful to guide a profession. The problem I see is that some of those in the Ivory Towers are positive that their way is right, and any questioning of theory is seen as an attack by those that are not as 'enlightened' as they are, or not as 'intellectually capable'. Thus theory becomes stagnant and loses its credibility because it is not allowed to be scrutinized by anyone who is less than 'worthy'. And to be 'worthy' a person must totally accept that theory is the end all and be all of a profession. Blindly clinging to theory does not make one smarter than or superior to everyone else. Without the question "does it enhance practice?" theory becomes nothing more than dogma.

And you believe this Ivory Tower attitude is restricted to nursing theory only? It is not. Theory, regardless of who formulates it, is always under attack. And there are always those that defend it and take issue with the attackers. And may even insult them by declaring them intellectually impaired. I have never blindly accepted any theory, either in my MS or MBA programs, and certainly not in my nursing programs. And I have never been made to suffer, academically or in any fashion, for questioning the premises of a program. And I certainly would not remain in a program that forced such thinking on me. And I did ask questions, during my interview for my MSN program regarding the theorist and academic freedom. I was told who they had chosen and that I was free to accept any theorists but need to realize that they based their program on that theory. I understood this to mean that the program bases its education on the theory of one theorist. And that their educational premise is based on that theorists. And that I am free to disagree. However, were I to have completed by educational experience, within the education tract, then I would be required to base my teaching on the Watson Theorical Model. I do not accept her model but I understood it was the model of my program. And as such, I was required to teach based on that model. If I didn't like it, I was free to go to another program. I was willing to make the adjustment.

The fact that there are questions, as far flung as some may, adds only to strengthen a theory.

Grannynurse:balloons:

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