Positivism And The On The Development Of Nursing Knowledge Is Still Dominated By The Positivistic Perspective

For centuries the development of nursing knowledge has been influenced by numerous theorists and their respective theories. These theories have influenced, and continue to influence, nursing education, practice and research. (Johnson & Webber, 2005)

“Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations” (American Nurses Association, n.d.). The purpose of this paper is to expand my nursing philosophy as I transition into an Advanced Practice Nurse.

I define my philosophy of nursing within the three nursing domains of person, health, and environment. My goal is to communicate the importance of nursing as a knowledge-based career, depending not only on the nurse fulfilling her role but also on the patient’s compliance. A patient must learn to provide self-care at home in the same capacity as the nurse would provide care in the clinical setting. I discuss various subjects within nursing. I explain why I want to be a nurse, what I believe a nurse’s role is, the different domains of nursing, and where I believe nursing will be in the future. My philosophy demonstrates the interdependence of the nursing domains. You cannot fully evaluate a person without evaluating their health,

There are different types of knowledge and different ways of knowing. Four fundamental concepts of knowing in nursing highlighted by Caper (1978) are empirical, personal, ethical and aesthetic. He divided knowledge into two forms which are tacit and explicit. Tacit is insights and based on experience and not easily visible and expressible, difficult to share and communicate with others which is highly personal. Empirical sources of knowledge depend upon an individual’s manner of observing and responding to events in the outside world (Higgs et al, 2004). Whereas explicit is formal and based on rationality and easily can be expressed, shared, communicate which are highly universal principles. Rationalism comes from within the individual and

“Philosophies of nursing are statements of beliefs about nursing and expressions of values in nursing that are used as bases for thinking and acting. Most philosophies are built on a foundation of beliefs about people, environment, health, and nursing” (Chitty & Black, p. 298). By using person, environment, health, and nursing as a guideline to achieve the ultimate goals of nursing; I will discuss my personal philosophy and how these factors are used in nursing.

The development of a philosophy related to the profession of nursing is important in that it provides a framework for the nurse to base his/her work on. Philosophy is defined by Merriam-Webster as “a search for a general understanding of values and reality by chiefly speculative rather than observational means”. In other words, philosophies are based on beliefs and assumptions with an overall goal of obtaining an objective which states the nurse’s purpose in the profession. In my undergraduate nursing program I was exposed to multiple nursing concepts that guided my practice. Coupled with my ten years of experience in the nursing field, I was enabled to formulate my own framework or guide to nursing. The paradigm which resonates with me the most is the interactive-integrative perspective as it views practice “as having multiple, interrelated parts in relation to a specific context.” (Newman, Sime, & Corcoran-Perry, 1991, p.38). My framework includes three main components: the client, the professional nurse, and the nurse-client relationship.

Equally, the received view is the label for experiential positivism, which combines the objectives of empiricism with logic in the scientific theories’ development. The received view denotes a set of notions that have not yet been challenged (McEwen & Wills, 2014). On the other hand, the received view has various weaknesses when analyzing nursing as a science. According to the received view, science is seen as a value free where ethical considerations and traditional metaphysics are regarded as relatively insignificant. As such, nursing’s growth in theoretical advancement which has depended on the received view has made the progress to be slow. The received view ignores the underlying problems, and their causes by treating the symptoms. This has made nurses to struggle in creating meaningful theories as well as achieve its objectives of becoming a scientific

A nursing philosophy coincides with self-awareness. Nursing philosophies are developed by each individual nurse regarding the nursing practice and are important in understanding what is fundamentally important to each nurse, along with their values and beliefs. Self-awareness, in short, is knowledge of one 's self, feelings, motives, and desires. In order for nurses to develop their own nursing philosophy they must first have a good sense of self-awareness. As a future nurse it is important that I recognize my own self-awareness so I can continue to build onto my beliefs and values of the nursing profession and gain a better understanding of what is fundamentally important to me as a nurse. In this paper I will discuss why I chose the nursing profession, my beliefs and values, and what I feel is fundamentally important in the nursing profession.

With the postmodern turn of nursing a focus on science as a process instead of a product has emerged (Rodgers, B.L., 2015). Postmodernism rejects the idea of a single truth and instead interprets knowledge as more contextual and relative. The discipline of nursing includes components other than just a knowledge base. Emerging within the 21st century, nurses especially involve the human component. Judgments are made about what is acceptable science and current priorities (Rogers, 2015). Previously in nursing, procedures such as medications and dressing changes were priorities. Today, medication and health care is expensive. Consideration must be taken to follow the whole patient, spiritually, emotionally, physically, and

Personal theory and philosophies are important for Advanced Practice Registered Nurses (APRN) to help care for patients and their career. According to the American Nurses Association (ANA, 2010) an “APRNs are registered nurses (RN) who have acquired advanced specialized clinical knowledge and skills to provide health care” (p. 112). APRN is a general term used to describe certified registered nurse anesthetist, certified nurse midwife, clinical nurse specialist, and nurse practitioners (NP) (ANA, 2010). For the purpose of this paper and my personal theory and philosophy, I will focus on the NP as the APRN. NPs are able to perform comprehensive assessments and promote health and prevention of illness and injuries (ANA, 2010). The ANA’s concepts of health promotion and disease prevention have helped shape my personal theory and aided in identifying a theory for my future practice as a Family Nurse Practitioner (FNP). The best theory to guide my practice will be Nola J. Pender’s health promotion model (HPM). By using Pender’s HPM, it will allow me to identify each patient as an individual with different needs for health promotion and disease management.

Nursing was, for my sixteen year old self, taking care of the sick. Little did I know the complexities of that definition. Still, taking care of the sick was interesting enough to make nursing my major. I started practicing nursing years ago. However, I still struggle defining and explaining my profession to others. I usually start by differentiating nursing from medicine. Nurses see patients as humans rather than a disease that needs treatment (Zaccagnini & White, 2014, p. 15). However, as I advance my career, I must actively incorporate nursing theory into my practice. Nursing theory gives a foundation to understand patients and their health problems better. The use of nursing theory provides a framework to evaluate nurses’ interventions on a higher standard (Zaccagnini & White, 2014). Kenney described five steps to follow once the decision to include nursing theory has being made. This paper will explore the process of applying the Kenney’s five steps into my practice.

The two theories that have helped to form my personal perspective on nursing are Erickson; and Rogers. Helen Erickson’s model is based on caring for an individual patient based on their own unique needs and perspective (Nursing Theories and Models, 2017). Erickson’s model took concepts from several other theorists such as Maslow, Padget, Seyle, and Lazarus and combined them to create a nursing model that takes care of each individual patient based on their needs ( Reed, 2017). This theory helps me to be more cognizant of the individual needs of my patient, not all patients regardless of disease process are the same. Each patient may have different underlying factors or circumstances that affect their health and current situation. Rogers’ theory is broader, viewing nursing as both an art and science, promoting health and wellbeing to patients regardless of where they are (Nursing Theories and Models, 2017). The science of nursing involves the knowledge and research of nursing, and the art is applying that science for the betterment of the patient. This theory views an individual as part

Historically, the nursing discipline has borrowed its basis for knowledge and practice from other disciplines (Weaver & Olson, 2006). Today, inquiry specific to nursing is continually changing and growing, as nurses are increasingly interested in developing their own unique body of knowledge. This interest results partially from the emergence of nursing paradigms in recent years. According to Weaver & Olson (2006), paradigms are practices and beliefs that manage our knowledge by proving a framework with which to utilize within our profession, and to guide nursing research. A paradigm shapes our quest for epistemological awareness (Weaver & Olson, 2006). Examples of paradigms common within nursing are empirical, interpretive, and critical paradigms. While each paradigm is unique with sometimes competing focuses, each contributes greatly to nursing knowledge, practice, and research.

This theory explains, describes, guides, and supports nursing practice. It gives language to the unspoken beliefs and perspectives of the nursing profession. This allows the nursing professionals to better envision, realize, and articulate their unique role in healthcare (Green & Robichaux, 2009). Human caring is the basis of therapeutic relationships between human beings (Wade & Kasper, 2006)

A philosophy is created to find truth and meaning. It requires evaluation and use of critical thinking as to why one’s nursing practice matters. The history of philosophy and theories allows me to evaluate my personal nursing philosophy. I believe that each person is their own individual. My way of practicing nursing is by using compassion, listening to my patients and trying to understand them. It is not just the body or the disease but rather the holistic nature of the patient. I believe that nursing deals with promotion of health and prevention of disease. Lifelong education, research and evidence based practice are all utilized in my profession of nursing and are all concepts important to my nursing care.