Essay Sample on The Importance of Nursing Research
Nursing evolved from a healer’s helpmate performing basic housekeeping duties to a skilled profession that functions semi autonomously, with its own perspective and objectives that exist outside of a hospital and independent from those of the physician. This progression began with a set of ideas and beliefs that form the grand nursing theories. As nursing developed into a discrete discipline, it required a unifying framework for research and study. The nursing metaparadigm by Jacqueline Fawcett (Bender, 2018) was created as a vehicle to understand the diverse elements necessary to address patient care and to provide an organization system for nursing theories. Fawcett’s model established four central domains. The first domain is the person, a patient who is ill and the recipient of care. The second domain, health, encompasses the state of living, healing, or dying. The third domain, the environment, is comprised of the patient’s immediate surroundings or the situation that led them into care. The final domain, nursing, incorporates research and study of pathology, wellness, and health. These elements constitute a broad outline under which all of nursing research can be structured. The specific concepts did not originate with Fawcett. Rather, she created an organizational template, borrowing from theorists such as Florence Nightingale who first proposed some of these ideas.
According to McEwen (McEwen, 2019), “Professions are valued by society because the services professionals provide are beneficial for members of the society” (p. 32). A significant element distinguishing a profession from a paid occupation involves the establishment of education, training, and expectations for success. Nurses existed prior to the establishment of a metaparadigm and grand nursing theories. They just weren’t professionals. The development of
a discrete discipline necessitated a vision as well as strategies that would delineate specific functions and establish parameters for their completion. Early nursing theories envisioned nursing largely from the theorist’s perspective. Florence Nightingale, who saw the practice of nursing as a spiritual calling, proposed such a “grand theory.” Nightingale theorized that nurses could enable patient healing by influencing the environment, in the provision of clean air, hygiene and warmth (Sher & Aktar, 2018). Nightingale’s theory outlined abstract concepts that were empirically unproven, but they offered a vision and included philosophical constructs that described the ethical and moral values that formed the underpinning of nursing beliefs. The Nightingale environmental theory of nursing was simplistic but profound, entailing several basic assumptions: nursing is a vocation, distinct from medicine, requiring specific education; nursing as a profession entails art and science; humans can and should aspire to perfection; nursing follows natural laws and facilitates healing through manipulation of the patient’s surroundings (Nightingale, 1969). Nightingale envisioned nurses as creating an environment in which necessities such as cleanliness, fresh air and sunlight, appropriate diet, and sanitation, together with empathy and compassion would assist patients to use their own strengths to heal. The Nightingale nurse saw herself as moving closer to God through her efforts, achieving a spiritual epiphany by working hard and bearing witness to suffering. In this sense, the Nightingale theory proposes a “patient care” view of the nursing profession, devoted to the provision of individualized patient care. What is notable and laudable about Nightingale’s theory is its conspicuous lack of jargon. Nightingale saw a need and attempted to meet it. She remains the quintessential nurse, devoid of affectation, seeking to facilitate healing in the most efficacious way possible and providing a spiritual pathway for the exhausted nurse to lean on when feeling unappreciated or marginalized.
It is easy to see how Nightingale’s theory is relevant to the Nursing metaparadigm. The Nightingale theory effectively address all the domains established by the nursing metaparadigm. Nightingale addressed patient care in the context of individual patient needs. She wrote about the nurse’s ability to affect the patient’s health through changing the environment. She also discussed the impact of nursing on the nurse herself as she believed that suffering and dedication could bring the nurse closer to God (Nightingale, 2021).
Florence Nightingale provided an early example of how nursing research can impact practice. Nightingale began with observation of the situation, followed with a hypothesis, and then proved or disproved it. This is the essence of research which is meant to establish scientific fact and to provide a rubric for improvement and discovery. Nightingale’s study and use of statistics offers a model for nursing research as it provided a way to legitimize her observations and support her methods.
Several studies have documented the challenges of nurses as they begin to transition from the bedside to advanced practice roles. It is easy to stumble when attempting to bridge the gap
between a bedside nurse and an advanced provider, given the various hierarchies present in modern hospitals. “Power struggles amongst nurses, both overt and covert, and the deliberate misuse of power were frequently encountered.” (Maclellan et.al., 2016). Nursing educators should take heed of Nightingale’s exhortation to provide specific education that will benefit the nurse’s role. Education should focus on the best ways to optimize health, rather than endlessly discussing the nursing profession. The advanced care nursing curricula is studded with courses bearing lofty titles that are virtually indistinguishable in their content. In place of a focus on health assessment, medicine or pharmacology, students are inundated with assignments directing them to manipulate the language and ponder the vicissitudes of abstract research studies that appear to merely replicate established information already present in other disciplines. The graduating nurse practitioner may be a novice at understanding why and how their prescriptions actually work in the human body, but they can prattle endlessly about theory in a language indistinguishable to anyone but other nurses. Is it any wonder that new ARNP’s experience a lack of self-confidence (Mannox,2020) when they are woefully undereducated in the skills that are integral to treating complex medical conditions? Unlike medical schools, that empower students, nursing schools have historically relied on coercion to establish structure, possibly due to their origins within the hospitals that employed them. How can a new advance practice nurse assert herself when she has been repeatedly threatened and bullied by an educational system that values compliance over internalization? In this scenario, nurses can graduate without knowing who they are within the reality of the health system.
The Nightingale Grand theory of nursing can be applied seamlessly to advanced nursing practice while encompassing the heart of the nursing role as expediter of optimal health. Like Nightingale, the advanced practice nurse has the role of “facilitator” of human healing, a significant distinction from the medical model that is predicated on reduction of pathology and symptoms. Whether writing a prescription to stimulate the nervous system, teaching effective coping skills or encouraging sunlight and exercise to improve mood, the basic task remains the same. The behavioral health nurse in an advanced role, manipulates the patient’s surroundings by creating a therapeutic milieu and addressing the various psychosocial stressors that impact the patient’s ability to reconstitute and recover. To address deficits in emotional expression or socialization the nurse practitioner may offer group and family therapy to assist the patient with establishing a supportive environment in which to learn and to take the risks necessary for growth. Providing patient centered, individualized psychotherapy and pharmacotherapy for patients and assisting them to develop coping skills to optimize healing facilitates the patient’s own abilities to tolerate adversity and to manage their responsibilities. The advanced practice nurse remains the vehicle of healing for the patient, albeit with a larger toolbox and increased understanding and influence. She utilizes the information gleaned from research and conducts her own independent study to address the scientific portion of her role while perfecting the art that is compassion, empathy, and patience. She motivates the patient to reach for their optimal potential while striving for her own perfection. The advance practice nurse, like the bedside nurse and her predecessors, advocates for her patients, comforts them and bears witness to their suffering. In doing so, if she is lucky, she too may reach closer to the heavens.
