Joumal of Advanced Nurstng, 1990,15, 825-828

Thoughts on the discipline of nursing as we

approach the year 2000
Sharon Moore RN MEd
Insirudor in Posi Basic Menial Healih Nursing and Geroniology, Mouni Royal College,
Calgary, Alberia, Canada

Accepted for pubbcahon 4 November 1989

MOORE S (1990) Joumal of Advanced Nurstng 15, S25-S28

Thoughts on the discipline of nursing as we approach the year 2000
A disaplme is 'charactenzed by a unique perspective, a distinct way of viewmg
all phenomena, which ultimately defines the limits and nature of its mquiry'
(Donaldson & Crowley 1978) Further, Chmn & Jacobs (1987) define disciplme as
a 'branch of mshiiction, a body of knowledge and of systematizmg that
knowledge withm an area of concem or domam of inquiry' The position taken m
this paper is that nursing, as it approaches the year 2000, is an evolving disciplme
that IS 'dedicated to the advancement of knowledge which contnbutes to the
pursuit of excellence of care' (AARN 1985) The wnter agrees with Jenmngs'
(1987) posihon that theory gives defirution to nursmg's body of knowledge, and
direction to research and practice This paper addresses some of the issues and
concerns related to the development of nursmg knowledge which serves as a
cornerstone for the disaplme It goes on to consider bnefly a few tasks that face
nursing as it approaches the year 2000

CENTRAL CONCEPTS OF NURSING of its disaples' (Vismtainer 1986) That nursmg is a disa-
plme, has received much support m the hterature (Adam
Fitzpatndc (1987) along with other theonsts identifies the 1933, Adam 1985, Fawcett 1983, AARN 1985, Hoon
central concepts of the disaphne of nursmg as person, 1986^ chinn & Jacobs 1987, Ton-es 1980, Donaldson &
environment, health and nursmg There is considerable Crowley 1978)
agreement m the nursing hterahire that the hohstic per- Nursmg, as a disaplme, not only encompasses knowl-
spective taken charactenzes the uniqueness of nursmg as a edge, but how that knowledge is h-anslated into practice
disaplme (Fawcett 1983, Engsh-om 1984, Chmn & Jacobs Several authors suggest that the body of knowledge
^'^^'^) charactenstic of a disaplme occurs through the develop-
There IS, however, some controversy as to whether ment of theory (Engstrom 1984, Fawcett 1983, Sorensen
nursing achially is a disaplme, as seen m articles by Sleicher 1956, Meleis & Pnce 1988, Chinn & Jacobs 1987, Chmn
(1981) and Feldman (1981) who suggest that the 'well- 1983) and'nursmg uses theory to direct the expbration and
defined and well-organized body of knowledge' that char- manipulation of its domam — providmg care' (Visintamer
adenzes a profession 'is not here yet' Disaphnes do not 1986) Shefiirthergoes on to say 'it is at this junchire —
happea they are aeated Smce Ntghhngale, back m the between the queshons denvedfi'omprachce and the need
1800s, first spoke with k m convidion about the nahire for new mfonnation, for rules for mtegrating borrowed
of nursing and the need for knowledge distmct fi-om knowledge and for the invention of new perspectives —
mediane, nursmg has been estabhshmg itself as an 'lnven- that nursmg's disaplinary woric of conduchng research
tor of theory, a discoverer of knowledge and educator and building theory hes' Tbs posihon emphasizes the
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theory

825
S Moore
Hoon (1986) further emphasizes this when she says,
'theory must become a part of the practice or we are left in
the condition Perkins (1965) descnbed "He who knows
theory but not the practice does not know the whole
theory"'
PURPOSE OF THEORIES
The purpose of theones is to assist in answenng questions,
explain relationships, predict consequences and to pre-
scnbe actions (Meleis & Pnce 1988, Chinn & Jacobs
1987) Much discussion and debate have taken place about
theones and research m nursmg and can be conceptualized
withm the areas of convergence, divergence and reassur-
ance Qermmgs 1987) While areas of agreement can give
stability, areas of disagreement are also a necessary part of
growth and can foster further development, research,
mquisitiveness and cunosity
The analogy of human development is useful m descnb-
mg the current state of nursing — it is merely expenencmg
maturational cnses and nursing must leam to accept its
growing pams as a normal part of growth and development
as it matures
An important query m nursmg's maturation has been
whether or not to accept one theory to explain all of
nursing phencanena Stevens (1979) argues that one theory
would help to bnng consensus and coherence to nursmg
as a disaplme Others have suggested that there is not
sufiftaent development m nursmg as a body of knowledge
(Sleicher 1981, Feldman 1981) for it to be considered a
discipline
From this wnter's perspective, there is more evidence to
suggest that nursmg must, as we face the 21st century,
move beyond the notion that it is possible to explam all of
any disaplme's phenomena with one theory Nurses need
to be open to many theones and models, not to accept
them wholeheartedly, but to contest and corroborate them
through research and philosophical mquiry The concept of
theoretical pluralism has received support m recent years as
more valuable, m that it uses multiple perspectives to view
the entirety of human behaviour that gives nursmg its
nchness (Meleis & Pnce 1988, Engstrom 1984, Fawcett
1983, Hardy 1986, Hoon 1986, Lemmger 1969, Knstjanson
etal 1987, Whall 1988, Chnstman 1983)
UNIQUENESS OF NURSING THEORY
Another important question that is relevant to a discussion
of theory related to disaplme is the question of whether
nursmg theory is umque? Fawcett (1983) suggests that
nursmg theones may be umque or they may be borrowed
826
from other disaplmes Johnson (1968) defined unique
nursmg theory as 'that knowledge denved from obser-
vation of phenomena and the askmg of questions unlike
those which charactenze other disaphnes' She defmed
borrowed theory as 'that knowledge which is developed m
the mam by other disaplmes and drawn upon by nursmg'
Gohnson 1968) Several conceptual models such as Orem,
Rogers, Roy and Kmg have been used to generate imique
nursing theones (eg self-care defiats, complementanty,
theory of the person as an adaptive system, and theory of
goal attainment)
Fawcett (1983) suggests that this evidence of nursmg
theory provides further support for nursmg as a discipline,
'for these theones, denved from conceptual models of nurs-
mg and thus clearly identifying nursmg's metaparadigm
phenomena, are truly unique nursmg theones' A particu-
larly relevant question to ask at this pomt was posed by
Fawcett (1983) 'Must all of the knowledge be unique?' This
wnter believes that a case can be made for the value of
theory borrowed from, or shared with other disaplmes for
it allows for added and expanded opportunities m which
nursmg can mterpret and utilize other strengths and per-
spectives that might be relevant to a given situation What
IS needed, however, is further development and research in
these areas of all theones m order to validate them m
nursing situations
'Nurses have come from an era of "domg tasks" and in
this era they are "domg thinking" Neither promotes cnti-
cal thinking' (Hardy 1986) Nurses of the future need to
develop reflective and cntical thinkmg skills They must
understand that their disaplme will always be searching for
clanty and stnving for answers, for what body of knowl-
edge ever has found all the answers? As queshons are
answered (or left unanswered), more hypotheses and
queshons are generated Meleis & Pnce (1988) concur that
cnhcal and reflective thinkmg skills are central mgredients
m developmg nurses who are committed to usmg and
developmg theones that will provide direction for nursmg
practice, education and research
THE FUTURE
As nursmg looks to the future, there is an exatement and
antiapation about nursmg that is being addressed not
only on a nationai level but an mtemational level as evi-
denced m some of the kejmote addresses presented at the
International Counal of Nurses Congress held m Seoul,
1989 — Nursmg A New Tomorrow, Forgmg Nursmg's
Future Beyond the Boundanes of Nursing Provmaal,
nationai and mtemational world leaders are recognizing
the need for health promotion m the ccvnmg century

(Carlyle 1988, Epp 1986, Smith 1988) Nurses will contmue
to take a pnmary role in this area
Important nursmg questions at a world level are bemg
asked This is reflective of a profession that is looking at
ways to 'proact' rather than react to meet the changing
needs of nursmg in vanous cultures throughout the world
Rogers (1983) suggests that new visions and new con-
cerns engage the nurses of tomorrow Nursmg is woriang
towards addressmg some of these A timely example of
this IS the collaborative planrung initiative that is occumng
to address the educational preparation of the nurse for the
year 2000 by the three nursmg schools in Calgary, Alberta,
Canada
CONCLUSION
This paper has suggested that nursing is an evolving disci-
pline that IS dynamic rather than static As nursmg forges
into the 21st century, educational cumcula in nursmg must
address the issues inherent m a growing and matunng
disapline All nurses must be able to utilize nursmg
theoretical frameworks for direction in their respective Chinn P & Jacobs M (1987) Theory and Nursmg A Systematic
areas of practice
No one model can stand alone as a framework for the
disapline Theoretical pluralism is advocated as it allows
nurses to select a model which suits a particular situation
the best The challenge we must face is how to create an
environment that nurtures the use of theory and at the
same time the openness needed to construct and develop
new relationships' (Meleis & Pnce 1988) Nursmg is in
the process of setting pnonhes and grappling with hard
questions
A quotation by Meleis (1983) seems fitting m summary
'out of all that has gone before, and the current state of Fawcett J (1983) Hallmarks of success in nursing theory develop-
nursing knowledge, the age of wisdom will occur
We will accept limitations in the disapline of nursing as
limitations of time rather than shortcomings of the
disaphne'
Further reading
BaumgartA &LarsenJ (196S) Canadian Nursmg Faces the Future 13(9), 8-9
Development and Change C V Mosby, Toronto
Beck C K, Rawlins R P & Williams S R (1988) Mental Health —
Psychiatnc Nursmg A Holtstic Life-Cycle Approach C V Mosby,
Missouri
Evans D (1980) Everynurse as researcher An argumentative
cntique of pnnaples and practice of nursing Nursing Forum Jennmgs B M (1987) Nursmg theory development Successes
XIX(4), 335-349
Jarvis P (1986) Nurse education and adult educaticm A question Johnson D (1968) Theory m nursmg Borrowed and unique
of the person Journal of Advanced Nursmg 1 1 , 4 6 5 - 4 6 9
DisapUne of nursing
Mitchell G & Santopmto M (1988) An alternative to nursing
diagnosis &nbraang a dynanuc view of humans and health
Canadian Nurse, November, 25-28
Wells T (1987) Nursing model and research compatibility
Concerns and possibilities Journal of Gerontologtcal Nursmg
13(9), 20-23
References
AARN (1985) Position paper on nursmg Alberta Association of
Registered Nurses, Edmonton
AdamE (1983) Frontiers ofnursmg in the 21st century develop-
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Adam E (1985) Toward more danty in terminology Frame-
works, theones and models Journal of Nursing Education 24(4),
151-155
Carlyle M (1988) Premier's commission on future health care of
Albertans Govemment of Alberta, Edmonton
Chinn P L (1983) Nursing theory development Where we have
been and where we are going In The Nursmg Profession A
Time to Speak (Chaska N L ed), McGraw-Hill, New York, pp
394-405
Approach 2nd edn C V Mosby, St Louis
Chnstman L P (1983) The future of nursing is predicted by the
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Donaldson SK & Crowley D M (1978) The disapline of
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Engstrom J (1984) Problems in the development, use and
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Epp J (1986) Achieving Health for All A Framework for Health
Promotion Minister of Supply and Services Canada, Ottawa
ment In Advances in Nursmg Theory Development (Chmn P L
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HoonE (1986) Game playing a way to look at nursmg models
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and challenges Journal of Advanced Nursmg 12,63—69
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827
S Moore

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