Question

What historical trends shaped the development of nursing knowledge?

Answer 1

Ans) The diversity of the settings within which nurses in these cases practice is indeed a foundation of our strength, and illustrates our main argument about the importance of perspective.

- We take our evidence from a wide variety of sources; develop our arguments based on the data we find; and demonstrate that nurses' power comes not only from their work at the bedside but also as actors in larger social and political arenas. We each have our own historical lens.

- From our perspective, nurses are indeed powerful and resourceful, and the illustration of their power stems less from the source of their training program than their ability to work within locations to shape their own practices.

- Their education is important, but what most stands out is nurses' ability to capture opportunities to creatively apply their skills, knowledge, and a keen sense of the possibilities.

- In each of our cases, a nurse or nurses generated opportunities for themselves and other nurses and, often in the case of substantive resistance within and outside the profession, leveraged them to some level of social and political advantage.

- Of course, our cases do not cover the universe of nurses' experiences, and other data may show how various forces such as physician obstruction, lack of resources, among other things did indeed keep nurses from higher status and practice opportunities.

- But what these histories also show are the variability in nurses' ability to chart their destiny, and that nurses' inability to advance in one area is not necessarily true in the larger sense.

- The data for generating a coherent explanation of nurses' place in modern society can be found in many places and can be constructed into multiple narratives.

- One need only consider the relatively new places for nurses within our health care system as nurse-midwives, nurse anesthetists, and in other advanced practice roles and the new kinds of power they wield within certain contexts.

- Caution must be used then to prevent the danger that comes when one particular history told from one particular perspective becomes reified as the only history.

- For example, concluding that nursing failed because it did not or could not follow recommendations for a baccalaureate standard for entry into practice lacks a broader historical perspective that embeds particular reports that urge such a standard firmly within a circumscribed set of political, social, and economic realities that may or may not reflect the prerogatives and the possibilities of nursing practice. As these cases show, nurses were powerful across other kinds of places: in the clinical spaces where they interacted with patients; across institutions as they provided leadership and strategic thinking about their own welfare and the patients they served; and in political arenas where they negotiated the difficult path between the ideal and the real. In our analyses, data becomes valuable evidence only when their contextual underpinnings are acknowledged and integrated into the analysis.

- Nursing's history should do as much. Its importance to our current health care debate rests in its ability to remind us that practice and education are political entities. We structure our practice based on overt and covert power structures, and our consciousness of the power of education is certainly never absent. But ultimately, how we use history to understand a broader range of concepts and events in practice and in politics is our challenge and our opportunity. Resisting its call is our loss.