A review of Chapter 4 Nursing Knowledge: Science, Practice, and Philosophy by Mark Risjord Shane Cantrell Practice values and the disciplinary knowledge base

First Thoughts

Testing the knowledge that was implicit in practice Three levels of theory in the natural and social sciences* Nursing needed more** Dickoff and James’ practice theory

Values and theory testing The goal is what the nurse ought to strive for Therefore this is a value-judgment We need to test nursing interventions for value, but how?? Study about Postoperative vomiting* But was it truly good (palatable)**

Testing palatability* How do we go about doing this? Orlando—meet the patient’s needs and relieving distress** Dumas and Leonard protocol (ADPIE) ** Relieving distress through Assessment, Diagnosis, Planning, Intervention, and Evaluation (the beginnings of ADPIE) rough draft Challenges to Dickoff and James’ criteria

Kuhn Paradigm Shift

Practice theory was not possible* Nursing was more of a moral value decision making that should go with ethical theories instead of scientific ones Beckstrand’s critique

Battle between is this intervention truly good? Value-laden theory Instrumental vs Intrinsic** Beckstrand’s critique

Strict separation of scientific and ethical knowledge in nursing Four domains of knowing Empirics, esthetics, personal knowledge, and ethics Keep empirics and ethics separate……domains or patterns Carper’s fact-value distinction

The obfuscation* of evaluative commitments Yeo argues they should be blended** Moral influences on research (biases and assumptions) Ethical reflection is a necessary component of empirical inquiry The disintegration of nursing knowledge Carper is wishy washy ☺, separate but interrelated and interdepend ent (How can this be?) Problems with patterns

The role of theory in ethical knowledge* Yeo basically said we are in trouble if we rely on ethical theory to make nursing decisions Seedhouse said that ethical theories will tell us how to act is an “ethics myth” Plugging topics into a mathematical formula will not help A + B = C, where A is a situation, B is an ethical theory, and C equals the outcome or goal** Problems with patterns

We need a blended ethical and empirical pattern, but how? Egg yolks Problems with patterns

Sociopolitical knowing Additional pattern Nurses should be engaged in social issues, e.g. poverty, unemployment, and drug addiction Commitment to political causes, advocacy, and engagement in political debate* Problems with patterns