Beyond today’s horizon, is there a future for nursing science? 15th European Doctoral Conference in Nursing Science Graz 19 th September 2015 Rona McCandlish Rona_McCandlish
Defining nursing science ‘The enigma of defining nursing science is preceded by defining nursing, science, research, and nursing theory-guided practice…’ Manhart Barrett EA (2002) Nursing Science Quarterly: 15 (1) 51-60
Nursing Science or…. Is It the Science of Nursing? Risso Parse R (2015) Nursing Science Quarterly 28(2): 101 – 102
…Nursing science… ‘…nursing science connotes and denotes the unique body of knowledge embedded in the extant nursing frameworks and theories that continue to be developed through research and creative conceptualization .’ Rizzo Parse 2015
…science of nursing ‘In discussing the expression science of nursing , the precision in defining it was less clear. It definitely did not seem to have the same meaning as nursing science… Risso Parse 2015
Science of nursing ‘…the construct science of nursing was related to research that focused on those projects funded by government or other agencies concerned with attributes and characteristics of disease- related situations in populations and with issues surrounding healthcare systems.’ Risso Parse 2015
Revisioning the Science of Nursing ….nurse scientists study health problems and generate “knowledge, interventions, and measurement models for important health issues, such as transitions of care, caregiving stress and stress management, improving quality of life in chronic illness, pain assessment and management, and normalization in families of individuals with chronic illness.” Broome ME (2014) Revisioning the science of nursing, Nursing Outlook 62 : 159-161.
Whose science is it? Where is the incentive to have doctoral students begin their scholarly work building on ideas that arise from their own curiosity and interest? Where are the new innovative ideas arising from the insights cocreated in the engagement of faculty scholars with budding scholars?
The aim of science… ‘...is not to open the door to infinite wisdom but to limit infinite errors.’ Bertolt Brecht The life of Galileo 1939
What a nurse requires It seems a commonly received idea among men, and even among women themselves, that it requires nothing but a loving heart … a general or incapacity for other things , to turn a woman into a good nurse…
What a nurse requires What cruel mistakes are sometimes made by benevolent men and women in matters of business about which they can know nothing , and thing they know a great deal… These matters [care of the sick] require learning by experience and careful inquiry …
No room for doubt … ‘No bibliographic references have been given because of the vast number of sources which have been tapped in compiling the text and because pupil midwives become confused when they study from more than one or two textbooks’ Myles M (1953) Myles Midwifery preface… re -published until 1982
…but certainty demands challenge
Hands on or Poised (HOOP) study RCT: two methods of perineal management used during spontaneous vaginal delivery on the prevalence of perineal pain reported at 10 days after birth. 5471 women who gave birth between December 1994 and December 1996 McCandlish et al (1998) A randomised controlled trial of care of the perineum during second stage of normal labour. Br J Obstet Gynaecol. 1998 Dec;105(12):1262-72
HOOP study results • At 10 days 910 (34.1%) women in the 'hands poised' group reported pain in previous 24 hours compared with 823 (31.1%) in the 'hands on' group (RR 1.10, 95% CI 1.01 to 1.18: absolute difference 3%, 0.5% to 5%, P = 0.02). • rate of episiotomy significantly lower in the 'hands poised' group (RR 0.79, 99% CI 0.65 to 0.96, P = 0.008) • rate of manual removal of placenta significantly higher (RR 1.69, 99% CI 1.02 to 2.78; P = 0.008).
Hands on or Poised (HOOP) study • reduction in pain observed in the 'hands on' group was statistically significant • results provide evidence to enable individual women and health professionals to decide which perineal management is preferable
…constant challenge!
Beyond today’s horizon, is there a future for nursing science?
Creating challenging, curious, capable workforce in England Growing the Nursing Midwifery and Allied Health Professional Clinical Research Workforce in England
Clinical academic careers in England
Nursing doubt with pleasure ‘Each time we learn something new and surprising , the astonishment comes with the realisation that we were wrong before…In truth, whenever we discover a new fact it involves the elimination of old ones. We are always, as it turns out, fundamentally in error’ Thomas L (1995) From our own correspondents. Paediatric and Perinatal Epidemiology, 9: 250 – 255
Past, present, future…
Beyond today’s horizon, is there a future for nursing science?
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