A non-theorist's perspective on nursing theory: issues of the 1990s

The basis of all nursing endeavors, including practice and research, lies in theory. While nursing theorists are postulating and debating, practicing nurses are continuing with their daily routines and are often unaware that the world of nursing theory is changing. It is important, however, for all nurses to keep abreast of the latest developments in nursing theory. This article discusses some of the key developments within nursing theory based on a review of the nursing literature from 1990 through 1999.     

The nature of nursing and the education of the nurse*

The current scrutinies and criticisms of organized health services are discussed as an introduction to the need for change. The care/cure dichotomy in the nurse's role is focused on and the dearth of community nursing developments noted, as are the pathology-orientated hospital-centred nursing education programmes. The author believes that nursing needs to go forward and develop in depth the body of nursing knowledge and technology. This will require radical reforms of nursing education organization in Europe. But the author is enthusiastic about the possibilities of developments resulting from the extension of nursing education courses in European universities and institutes of higher education.     

New developments in international nursing ethics

This article has described numerous activities in nursing ethics at international levels. It acknowledges the larger context within which nurses practice by focusing on selected issues involved in resource allocation and death and dying, cross-culturally. The questions raised about universally shared moral principles reflects the larger questions of cultural and ethical relativism. The discussions of new developments in international nursing ethics focuses on international conferences, the teaching of nursing ethics, national nursing associations, and other professional groups that are actively involved in health care or nursing ethics. Finally, the development of international nursing ethics research studies is providing new knowledge about the scope of ethics within nursing and the nature of nursing care worldwide. Nurses are involved in some aspects of these new developments in nursing ethics in all countries. As they examine and reflect on ethical principles, virtues, and on an ethics of caring, they bring a new dimension to their work as nurses. This new dimension stands as one of the oldest and most central foundations in professional nursing.     

Nursing research and regionalization in the Midwest

This article describes developments in nursing research in the Midwest and events that led to regionalization of nursing activities. It emphasizes the special characteristics of the Midwest that have influenced nursing research, results of federal support programs for nursing research, and centralization of research effort in some schools of nursing. It traces the events leading to regionalization of nursing research, the formation of the Midwest Alliance in Nursing, establishment of the Midwest Nursing Research Society, and anticipation of centralization of regional nursing activities under the aegis of MAIN.     

Retaining the retiring nurse: Keeping the nursing shortage at bay

Not a day goes by in the life of a nursing executive without contemplation of the omnipresent nursing shortage. While chief nursing officers are distracted with perhaps more intriguing activities such as exciting clinical developments, building projects, or new service lines, the nagging concern is constant about how to ensure that there are enough nurses to sustain these activities.     

Changing foci in American nursing education: primary and transcultural nursing care.

Two major movements in the USA–transcultural nursing and primary care nursing–are discussed. They are considered to be exciting, challenging and promising developments to advance nursing education and practice. These movements are placing new and heavy responsibilities on nurse educators. The author argues that both transcultural nursing and primary care nursing movements need to be part of local, national and international health education and care systems.     

The idea of nursing science

This paper addresses the question of whether or not nursing can legitimately be considered as a science. It is proposed that an adequate answer to this question requires consideration of recent developments in philosophy of science (as urged by Paley). It is shown that such developments call into question the 'rational image' of science. However, a defence of the legitimacy of the scientific enterprise has been attempted by Laudan, an advocate of the 'historical turn'. Two conditions necessary for the applicability of this 'turn' are identified. It is shown that although they apply relatively unproblematically to science, they do not readily apply to nursing. Hence the conclusion is drawn that claims for the integrity of nursing science stand in need of much further development.     

Rust out and therapeutic reciprocity: concepts to advance the nursing care of older people

This paper considers the issue of the quality of nursing care for frail elderly patients in continuing-care environments The continued failure to raise the standards of such care is explored and potential explanations sought It is argued that the application of models of nursing do not represent the best solution and that there is a need for a fundamental re-appraisal of sources of job satisfaction for nurses working with such patients Using the results of an evaluation of a respite care service two concepts,'rust out' and 'therapeutic reciprocity', are identified as offering the basis for future research, education and practice developments in this field     

From miasma to fractals: the epidemiology revolution and public health nursing

If public health nursing is truly a synthesis of public health science and nursing science, then nurses must keep track of current developments in public health science. Unfortunately, the public health nursing literature has not kept pace with revolutionary developments in epidemiology, one of the sciences that informs population-focused nursing practice. Most epidemiology chapters in community health nursing texts do not reflect the intellectual development that has taken place in epidemiology over the past two decades. The purpose of this article therefore is to facilitate an updated synthesis by (a) reviewing the development of epidemiology and the focus of public health nursing practice through three historical eras, (b) discussing current controversies and tensions within epidemiology, (c) introducing an emerging paradigm in epidemiology based on an ecosocial perspective, and (d) discussing the congruence of this perspective with the evolving theory and practice of public health nursing.     

A time for reflection*

The nursing profession in the United Kingdom is faced with great opportunities for significant developments. To make best use of these it is necessary to reflect on the past, to meditate on key issues which are current, to plan wisely and well for the future and then to press ahead with determination. Key issues highlighted are in the spheres of education, management and practice; the need for research is emphasized. The pay structure can either support or impede developments, as can the attitude of the medical profession; the nursing and medical professions are complementary and interdependent, understanding between them is essential and effective communications are core to its realization. A general goal identified is the achievement of a more cohesive profession, a modification of the divisions between education, management and practice which, it is contended, have intensified as developments have taken place in each of these spheres. Objectives for development are put forward in the context of current circumstances which, it is argued facilitate their promotion. Signs that the nursing profession now recognizes the need for unified action to achieve its objectives are seen as encouraging, and confidence is expressed that the profession will exploit the opportunities now within its grasp.     

The nursing education system in the People's Republic of China: evolution, structure and reform

This article provides a comprehensive account of the nursing education system in the People's Republic of China within its historical, economic and sociopolitical contexts. The article argues that the Western world, the United States in particular, had a profound impact on the early development of nursing education in China in the late 19th and early 20th centuries, that nursing education in China has been heavily influenced by medical education in terms of structure, curriculum and faculty training, and that challenges are enormous for Chinese nursing education to meet international standards of nursing education. Comparisons of nursing education systems between China and the United States are made when appropriate and possible. Recent developments and reforms in Chinese nursing education are also described and assessed.     

Toward a theory of nursing ethics

The development of nursing ethics as a field of inquiry has largely paralleled developments within the field of biomedical ethics. However, there is growing evidence that the development of a theory of nursing ethics might not necessarily follow a similar pattern. The value foundations of nursing ethics are derived from the nature of the nurse-patient relationship instead of from models of patient good, rights-based notions of autonomy, or the social contract of professional practice as articulated in prominent theories of medical ethics. The value foundations of nursing are analyzed, and a moral-point-of-view theory with caring as a fundamental value is proposed for the development of a theory of nursing ethics.     

The multifaceted influence of gender in career progress in nursing

The complex web of gender influence in the workplace results from a multifaceted interplay of factors [Walby et al. (1994) Medicine and Nursing. Sage Publications, London]. Literature reports that in nursing men's success compared with that of women is disproportionate and substantial evidence of gender-based disadvantage is found [Women in Management Review13 (1998) 184]. However, studies have not addressed the specific reasons for this and little is known of how or what influences nurses' career decisions and developments [Journal of Advanced Nursing25 (1997) 602]. Those studies which examine career developments and patterns are mainly found in the private business sector.     

Developing a department newsletter

Effective communication and recognition of individual excellence are important in any profession. We in nursing have recognized this fact and often incorporate these into our professional practice. An inhouse hospital nursing newsletter is one of the most recent developments that hospital departments of nursing use to meet these goals. This article attempts to demystify the process of establishing an editorial board, identifying topics, setting deadlines, working with a printer, and formulating a budget.     

Nursing in transition: an analysis of the state of the art in relation to the conditions of practice and society''s expectations

The discipline of nursing is in a process of rapid transition. In this paper, the developments are discussed that have affected nursing in its advancement to a full-grown profession. Nursing and medicine are the products of Cartesian thinking that has fragmented our perspectives on man and his living world. The consequences of this scientific viewpoint are reflected in all aspects of life. Attention is paid to advances in nursing practice and education, the development of nursing research and the emergence of a nursing science. These aspects are discussed in the context of professionalization and the position of nursing in the health care system and in society. The study findings of the Styles Report Project on the Regulation of Nursing (1985) serve as a framework of analysis. Links are made between the recommendations given in this report and the development of primary health care, the new tomorrow of a modern discipline.     

The relationship between research and the nursing process in clinical practice

The nursing process was originally adopted by the North American nursing profession from the general systems theory (GST) and quickly became a symbol of contemporary nursing as well as a professionalist nurse ideology. In contrast its initial introduction in the United Kingdom (UK) was not a complete success. This could be attributed to the mode of its implementation, which utilized a power-coercive change strategy, that is, comprising of imposition from above without sufficient time for education regarding its scientific and philosophical foundations. Consequently the nursing process was initially regarded as a professional and educational mandate rather than an organizational component of nursing care delivery. It has been maintained that the theoretical basis from which the nursing process was derived, together with the theoretical developments in diagnostic and intervention studies, has established the nursing process as a key element of the nurse's role in research, education and practice. This paper will briefly review the early theoretical developments and fate of the nursing process as a tool for clinical practice and research. It will then examine recent attempts to revitalize and modernize the theory for practice through research into nursing diagnosis.     

Interpersonal relations in nursing: a philosophical-ethical analysis of the work of Hildegard E. Peplau

Interpersonal relations in nursing: a philosophical-ethical analysis of the work of Hildegard E. Peplau ¶ Nursing typically has been viewed as a moral practice, for instance by new developments in the ethics of care. Nevertheless, many philosophical-ethical presuppositions of nursing theories remain to be clarified. This paper presents a philosophical-ethical analysis of the work of Hildegard E. Peplau. Analysis of the philosophical-ethical background of Peplau's works illuminates a view on nursing practice that is relevant today. Three main components are analysed more deeply, i.e. the professionalization of nursing, the philosophical underpinnings of Peplau's view on nursing science, and the nurse–patient relationship as the central event in nursing.     

Canadian nursing in the genomic era: a call for leadership

With developments in genomics, there is an urgent need for Canadian nurses in all settings to be informed and involved in the incorporation of this new knowledge into healthcare. The purpose of this paper was to synthesize the literature on genetic nursing roles to provide a foundation for Canadian nursing leaders as they take on the challenges of nursing in the genomic era. A comprehensive review of 98 articles published between 1994 and 2004 revealed strong support for genetic nursing roles and recommendations for levels of genetic nursing practice. The few studies on genetic nursing roles suggested that nurses and other health professionals support the integration of genomics into nursing practice. Issues that need to be addressed related to nursing practice, education and research are offered to engage nursing leaders in advocating for the incorporation of genomics into nursing in Canada.     

对护理人员掌握临床管道护理相关知识情况及态度的调查

目的 了解护理人员对临床管道护理方面的知识掌握情况以及对管道护理的态度,为进一步开展有针对性的管道护理培训提供依据.方法 以方便取样的方法选取我院外科护理人员91名进行问卷调查.结果 护理人员对临床管道护理方面的知识平均得分为（32.47±4.66）分,经单因素方差分析结果显示：年龄、工龄、职称及所在科室工作年限与护理人员管道护理方面知识掌握情况以及对管道护理的态度有关.结论 护理管理者应加强年轻护理人员临床管道护理方面知识的培训和再培训,特别是在管道护理新知识、新进展方面,应有侧重点并系统地进行.     

Return of the "intimate outsider": current trends and issues in family nursing research revisited

This article reviews family nursing research published from 1996 to 2011. This is a follow-up to a review published in the Journal of Family Nursing in 1995. Findings from the first review are compared with this one, trends in family nursing scholarship are identified, and predictions and suggestions for future directions are offered. The latest generation of family nursing scholarship is conceptually and methodologically sound, and there is evidence of more multidisciplinary and interdisciplinary research conducted by family nursing researchers. Scholars are paying more attention to issues of diversity and family context at present than in the past, although there are still aspects of diversity that need more attention. Strong research programs in family nursing exist worldwide; an international synergism has helped promote rapid expansion of family nursing research and theory development. A vigorous movement to promote research to practice initiatives and greater attention to family interventions are exciting developments.