In the future, professional nursing practice will continue to respond to the changing needs of society in new and unique ways. Allegiance to the medical profession and health delivery systems is diminishing as nurses struggle for increasing autonomy.
Professional nurses` autonomy will grow with the development of a body knowledge and nursing science. As nurses acquire the necessary education, apply nursing models creatively in practice, conduct research to test theories, and expand their personal knowledge nursing science will mature.
The professional nurse will want to be knowledgeable about current nursing research and to crreatively apply valid findings in practice. To accomplish this task, practitioners must visualize possibilities beyond the common clinical constraints. They must recognize the impact and application of changing word views, scientific discoveries, and shifts in nursing models and theories.
Example : The shift from a mechanistic empirical view of knowledge to a holistic and humanistic view may inspire the professional nurse to study the meaning of “quality of life” for a specific target population. This type of study would likely incorporate phenomenological and qualitative research methods. Initially, such a study may be viewed as unscientific by one`s peers. However, there is a growing acceptance of esthetic, ethical, and personal knowledge in the profession. Professional nurses will take risk and seek creative challenges.
Having internalized the nursing process, professional nurses will see the client`s situation as a gestalt and creatively apply appropriate nursing models. With experience, professional nurses will identify common patterns in client situations, raising new questions. Some of these questions, such as, Would this nursing action or another action be more effective in assisting the client? Are worthy of further pursuit. The nurse may discuss these questions with peers, search the literature for answers, initiate a research study, or develop clinical impressions for publication. The professional nurse always looks for new meanings in nursing phenomena. The ability to see new relationships in human behaviors or new patterns of response leads to more questions about nursing actions. Rather than revert to lock-step thinking, where if X happens, then Y is the appropriate nursing action, the professional nurse critically analyzes multiple factors and examines all feasible possibilities. Experience in practice, a broad knowledge base, and continuous updating of research and theory stimulates the professional nurse to raise new questions about practice and seek greater knowledge. It is in the practice arena that theories are generated and tested. New questions and problems lead to continuing refinement of theory and development of new theories. Like other disciplines, nursing knowledge and science will never be static. As trends and shifts occur in technology, economics, politics, and culture the professional nurse seeks an understanding of these changes by raising questions and searching for answers in theory, research, and practice. The continuous search for answers to new questions is what stimulates the development of new knowledge and contributes to the growing body of nursing science.
The evolution of nursing science has made great strides in the last 40 years. During the scientific age, the emphasis on empirical knowledge stimulated the prrofession to develop and refine the nursing process. By the 1980s, the five components of the nursing process were legitimized in the Standards of Nursing practice and the National Council Licensure Examination.
Effort to achieve professional status were augmented by nurses who sought doctoral degrees in other disciplines. Nurses then developed doctoral programs in nursing. Some of the nurses described their conceptual models for practice and initiated research studies to test their models and theories. The profession reached consensus on four major concepts in the nursing domain. Although a dichotomy continues to exist between nursing practice and nursing theorists and researchers, there is a growing commitment toward integration of theories, research and practice. Nursing science and research are moving toward acceptance of other ways of knowing, such as ethical, esthetic, and personal knowledge.
New approaches in practice, theory development, and research will be developed to expand nurses` understanding of humans and their health care needs. The future will bring stronger collaboration between practitioners, scholar-theorists, and researchers to improve nursing science. In this way, the nursing profession can best respond to the ever changing social forces of our time and to the impact that these major social forces have on the health care needs of individuals, groups, and society.
(Grace L. Deloughery, 1991, Issues and Trends in Nursing, Mosby Year Book, St. Louis, Missouri).
