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The Science of Nursing: Current Issues and Dilemmas

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The Science of Nursing: Current Issues and Dilemmas REVIEW THE SCIENCE OF NURSING: CURRENT ISSUES AND DILEMMAS H. Brink WIIAT IS SCIENCE? Abstract The question "What exactly is science?" is not The question regarding the nature and direction of nursing science, how it is derived easy to answer. Many and varied ideas, attitudes or why and whether nursing is a science is a much debated one. This article focuses and conceptualisations on the exact nature of on an examination of the literature with regard to conceptualisations of science in science and knowing can be found in the general and nursing in particular with special emphasis on the nature, purpose, literature, each reflecting a specific world view. methods and domain of science and nursing science. It looks at the various positions Science has been defined as a product, a process or both. As a product, science represents the taken, examines the consequences of holding any special position and makes evergrowing, everchanging accumulated knowledge of a particular discipline (Abdellah Opsomming 1969; Downs 1979; Einstein 1950; Hinshaw 1989; Moody 1990). Hinshaw (1989: 162) Die aard van wetenskapsbeoefening in die verpleegkunde, die rigting wat ditbehoort states: "The sciences are defined as bodies of human knowledge based on general principles te volg, diemetodes van kennisversameling en die bestaansreg van die verpleegkunde about a delimited range of phenomena derived ofhoekom dit well as wetenskap kwalifiseer, is almal omstrede vraagstukke in die from empirical observation". The product or verpleegliteratuur. Die literatuur met betrekking tot bogenoemde aspekte is verken body of knowledge is the outcome or result of en aspekte ten opsigte van die konseptualisering van die wetenskap in die algemeen scientific inquiry (Parse 1987; Silva an^ en meer speisfiek die verpleegkunde as 'n wetenskap, word bespreek. Daar word Rothbart 1984) and includes scientifi^ veral aandag gegee aan die aard, doel, metodes en domein van die wetenskap en terminology, definitions, propositions, verpleging as ’n wetenskap. Verskillende standpunte rakende hierdie aspekte word hypotheses, theories and laws (Rudner 1966). onder die loep geneem. Aandag word ook gegee aan gevolge, indien 'n sekere As defined by Moody (1990:19) it is a body of standpunt gehuldig word. Voorstelle hoedate uitmuntendheid in verpleegkunde knowledge which includes facts and theories bereik kan word, word gemaak. generated by the use of systematic, controlled and precise methods within a defined area of concern. As a process science refers to a method of INTRODUCTION on the nature and direction of nursing science or inquiry or the means by which a body of how it is derived, or why nursing is a science. knowledge evolves and progresses (Beckwith Nursing has long been considered as an art, For close on thirty years this has been a subject and Miller 1976; Bronowski 1965; Harrison whereas nursing as a science is a relatively of debate among nurse scholars, and contrary 1984). Bronowski (1965:16) describes science positions still are being explicated. recent development. Other than Nightingale as an intellectual activity and states "Science is who in 1860 identified nursing as both an art and nothing else than the search to discover unity in science not valuing one more than the other, In order to be able to participate meaningfully the wild variety of nature, o r... in the variety of (Nightingale reprinted 1969) it was not until the in such debates or defend their views when our experience". late 1950’s that serious attention was given to challenged, it is essential for nurses to have an nursing as a science. Since that time nursing understanding of the nature of nursing science WIIAT IS THE NATURE OF increasingly has become concerned about its and how it relates to the larger body of science, SCIENCE? knowledge base for practice. Today the term to be exposed to different viewpoints and to be nursing science is familiar to nurses. able to judge the relative merits of arguments The nature of science is a controversial issue. Contemporary literature abounds with related to nursing as a science. Conceptualisations vary according to the world strategies for building a nursing science (Chinn view or philosophical orientation of the & Jacobs 1987; Jacox 1974; Watson 1985). scientist. Two dominant world views of science There are Departments of Nursing Science and This article seeks to examine conceptualisations are reflected in the literature, namely the the South African Nursing Council (SANC) of science in general and nursing science in "received view" and the "perceived view" of describes nursing as a human clinical health particular, as presented in the literature, with science. For decades the received view, also science. regard to its nature, purpose, methods and known as logical empiricism or positivism, was domain. It will also look at the various positions the predominantly accepted world view of There are, however, critics who challenge the taken, exami ne the consequences of holding any science. In the literature it is frequently referred view that nursing is a science, and nurses are not special position, make suggestions for to as traditional science or pure science. always able to present convincing arguments achieving excellence in nursing science and that nursing in fact is a science. Even among thereby try to clarify the issues relating to Proponents of the traditional view or logical nurses themselves there isnot always agreement nursing as a science. positivism operate on strict rules of logic, truth, 12 Curationis, Vol. 15, No. 2, 1992 laws, axioms, predictions and reductionism. Despite the differences in the conceptualisation represents a shared belief among its members They believe that all human behaviour is of science by proponents of the received and regarding its reason for being. For example, the objective, purposeful and measurable. Only perceived view of science, common threads in domain of enquiry for physiology is the study what can be seen, sensed and measured is the characteristics, criteria and norms of science of the function of living systems, and for worthy of pursuing. Predictive statements that can be identified. Gortncr and Schultz (1988) sociology it is the study of principles and have no sensory data corroboration are not provide a list of well-accepted criteria for processes governing human society. The focus scientific. They hold the position that "truth" is judging excellence in science which include for law is injustice and grievance and the focus absolute and there is a single reality. True significance, theory-observation, congruency, for architecture is the form and function of statements are based on experience and known gcneralisability, reproducibility, precision and buildings. All research in these disciplines is from experience. In order to find truth one must intcrsubjectivity. These criteria are applicable directed towards addressing this focus in some be completely objective, which means that regardless of the methodological or small part. Each discipline thus has a central values, feelings and personal perceptionscannot philosophical approach used in developing the focus which influences the perspective of that enter into the measurement of reality. knowledge. A number of criteria which arc field, the way i t conceptualises the world and the Accordi ng to logical positivists there is only one interdisciplinary across the social sciences are question it poses for investigation. Donaldson method for science. This method is detached often used as norms to judge the merit of the and Crowley (1978:418) draw attention to the observation, controlled experiment and enquiry process and resultant knowledge base fact that even though each discipline is unique, mathematical or quantitative measurement (Merton 1979; Barber 1952; Storer 1966). they are not totally independent of each other. (Van Manen, 1990:4) and incorporates logistic These criteria include universalism, The quality of theories, research designs and and deductive reasoning. commonality, disinterestness and organised validity of conclusions drawn within one scepticism. Hinshaw (1989) suggests that two discipline are dependent upon their congruence Facts from research are systematically linked to additional criteria need to be used in judging with all of knowledge. Therefore knowledge in each other in a way that seems best to explain excellence in science - the development or one discipline may constrain or enhance the our empirical world; such linkages are called existence of substantiated bodies of knowledge process of enquiry in another and no discipline laws, principles or axioms depending on the specific to areas of critical concern in the should function in isolation. Donaldson and certainty of the facts and relationship within the profession, and the evolving information base Crowley (1978:418) further distinguish linkage. The emphasis of logical positivists is on the "cutting edge" of science - are both between academic and professional disciplines. one of theory validation, not theory discovery characteristics crucial to developinga creditable A professional discipline in addition to its area (Rudner 1966). and usable science base. of study is defined by social relevance and value orientations. The focus is derived from a belief Logical positivists do not address the These criteria may be useful in exploring and value system about the profession’s social application of science and therefore are accused whether or not and to what extent a science of commitment,
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