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Authors

  1. Fulton, Janet S. PhD, RN, ACNS-BC, ANEF, FCNS, FAAN

Article Content

Nursology-It is not a new idea, having found its way into our classrooms, conversations, and literature for the past 50 years. Never heard of it? Well then, it is time for a more formal introduction.

 

Nursology is a name given to our discipline. A discipline is a branch of knowledge typically studied in higher education involving the generation of knowledge. Nursology includes our nursing body of knowledge, research methodology, and a practice methodology about and for phenomena of concern to nurses (https://nursology.net/about/definitions/). The word nursology was first proposed in 1971 by Paterson1 to designate the development of nursing theory. Around the same time, Roper2 independently used nursology to name the nursing discipline. Nursology comes from the Latin, nutrix, nurse and the Greek, logos, science.3 The discipline, nursology, provides the foundational theory, research, and practice methodologies for guiding the practice of nursing. Using the term nursology distinguishes nursing theory and science from other disciplines, especially other health professions, grounding our unique contributions to patient care in a unique branch of knowledge.

 

Nursing is a verb; it denotes action, the doing of something; we practice nursing. Universities have schools of nursing among its other unique branches of knowledge, such as chemistry, physics, and psychology, but our knowledge-generating work is called nursing, same as the profession. That is not the case for all disciplines that guide a practice profession. Sociology, the discipline, is distinguished from social work, the profession. Why not distinguish nursing practice from knowledge guiding practice? Would this distinction facilitate including more of nursing's theoretical foundations in our schools?

 

In ever-crowded curricula, nursing programs have not devoted much content, undergraduate or graduate, to discussing nursing's historical roots, theoretical foundations, or scientific discoveries. In graduate school, nursing theory and science frequently lack depth and is too often not the knowledge applied to guiding practice. For example, the rich body of nursing science related to symptom management largely is missing from advanced practice nursing curricula, replaced by disease diagnosis and pharmacology courses where the right answer to a symptom-related complaint is to prescribe a pharmacological agent.

 

In an increasingly complex and overlapping clinical care context, how does a student nurse come to understand nursing's unique perspective and contributions to patient care? Some years ago, while teaching undergraduate students, and mostly out of curiosity, I placed a test question on the midterm examination to probe their ability to identify nursing practice responsibilities. The question involved a patient in an ambulatory care setting who, upon assessment, reported symptoms of sleeplessness and a physical finding of elevated blood pressure, which he attributed to an impending tax audit. The possible interventions (multiple-choice options) involved prescribing pharmaceutical agents for sleep and blood pressure, referring to a tax attorney, reviewing the tax documents for accuracy, or cognitive reframing for stress reduction. Without fail, the students chose the stress reduction answer. Did they intuitively know this was an appropriate nursing intervention grounded in nursing science, or did the process of elimination suggest the alternatives belonged to other professions?

 

Following a review of the curriculum and finding no hint of nursing theory or the historical work of our theorists, a faculty colleague exclaimed that students must think nursing sprang from the head of Zeus! More recently, Chinn4 reflected that nursing has begun to doubt the value of our legacy work of theories and philosophies, which is compromising our efforts to build strong and lasting presence in society and in healthcare. In graduate education, our efforts have been shifting to all things practice-advanced practice competencies, regulation of practice, practice residencies, practice privileges, reimbursement for practice, and so forth. These initiatives to promote nursing practice are important; however, the practice that these efforts promote often fails to reflect our theoretical knowledge and scientific discoveries.

 

It is confusing to use the same term, nursing, for both the profession and the discipline and it obscures our rigorous knowledge generating work. We need to take the time to consider the nature of the knowledge we use to guide our practice and what we call the collective effort of generating unique knowledge. Perhaps, nursology is not the best term for our discipline, but it is time to have a larger discussion about distinguishing the discipline from the profession/practice. Clinical nurse specialists should be engaged in the discussion, and the first step is to develop an informed opinion. Check out the Nursology blog at https://nursology.net/.

 

References

 

1. Paterson JG. From a philosophy of clinical nursing to a method of nursology. Nurs Res. 1971;20(2):143-146. [Context Link]

 

2. Roper N. A model for nursing and nursology. J Adv Nurs. 1976;1(3):219-227. [Context Link]

 

3. Fawcett J, Aronowitz T, AbuFannouneh A, et al. Thoughts about the name of our discipline. Nurs Sci Q. 2015;28(4):330-333. [Context Link]

 

4. Chinn PL. Keynote Address: The Discipline of Nursing: Moving Forward Boldly. Presented at: "Nursing Theory: A 50 Year Perspective, Past and Future"; March 21-22, 2019; Case Western Reserve University Frances Payne Bolton School of Nursing. https://nursologycom.files.wordpress.com/2019/03/2019-03-21-case-keynote-7.pdf. Accessed July 8, 2019. [Context Link]