Knowledge Development In Nursing

Knowledge development in nursing has been somewhat of a hot topic in the more scholastic endeavors of the profession for quite some time. As the profession grew from a focus centered on treating physical symptoms and conditions to a more well-rounded approach that considered psychological, social, and spiritual needs in addition to physical illness, the need to break down the process of knowledge development arose.
By utilizing nursing theories, which support the use of evidenced based practice in most cases, it seems as though the profession of nursing gained more credibility in the scientific community as far as the value of the knowledge produced; I feel that utilizing processes akin to those already accepted as prudent by more ‘established’ scientific fields helped achieve that credibility.
In order to get to nursing theories, however, the process had to begin with a philosophical component that can allow for a separation from concrete/ scientific knowledge, among other things, in order to promote more abstract concepts and different methods to look at how we come to that knowledge. McCurry (2009) touches on this premise as she describes how a common theme, in this case the common good of society, can be looked at from many different perspectives, as it creates an arena in which those perspectives can be arranged to determine how to go about investigating the perspectives further.

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Although it wasn’t the center piece of the article, one highlight was a breakdown of how more abstract thoughts can be linked to the application of intentional actions through the use of theories, which stems from philosophical questions. Philosophy lays the ground work for knowledge production to be built upon. In a way, Kim (1999) echoed these sentiments as she discusses critical reflective inquiry and its applications in relation to pain management in a South Korean hospital setting.
She admits that nursing has situations in which our therapeutic actions can be supported by one theory and conflicted by another. What it seemed to re-enforce was how our drive to answer the philosophical questions created by the issues we wish to address can use various forms to achieve that common goal, however, those that are centered around the evaluation of how our therapeutic actions actually pan out versus how we think they pan out will help us gain the most useful knowledge as long as we are able to recognize the need for, and benefit of, changes that help our patients out the most.
We wouldn’t be able to gain the ‘knowledge’ that specific actions and changes are therapeutically beneficial without understanding why we wanted to make changes in the first place, and generating multiple attempts at making those changes to see which ones actually accomplished the goal would seemingly allow us to have the best chance at achieving what we set out to.
Evaluating the nursing interventions we utilize to affect our patients for the better is important, we all know that. Abbott (1988) pointed out that although nursing is capable of evaluating our interventions in practice, we do not tend to emphasize the importance of breaking down specific practical interventions in an abstract way that allows for our ability to link the interventions we utilize to the thought processes behind it while we are out practicing our craft.
This I can personally relate to, when considering how the first couple years of my personal practice was spent learning how to simply accomplish the tasks I was presented with in the time frame I was to accomplish them in (assessment, documenting, intervening, documenting, evaluating, intervening, documenting, documenting, documenting…ugh). I knew that there was good reason behind the things I was doing; however, I was not keenly aware of the concepts and philosophies that comprised that reasoning, I was simply focused on completing my tasks in a timely, safe fashion.
Reed (2006) promotes the idea that nurses tend not to have a full understanding of the ‘why’ we do the things we do, and went so far as to say that there might be a level of mysticism when it comes to the healing processes we are engaged in. That mysticism was essentially summed up by purporting that when we can’t put our finger on the ‘why’ we do what we do, we fall back on concepts like intuition and gut feelings. It’s not to say that we are incorrect in our intuitions, however, we don’t have a strong link to the rationale behind it all the time.
This is where the concept of breaking down the ‘why’ we do what we do into more abstract, philosophical components can really benefit us, as we can extrapolate on the intuitions and gut feelings into philosophical questions and building blocks that theories can be generated from. When we utilize practice centered theories that arise from abstract, philosophical questions, the whole process of ‘nursing’ can be explained and evaluated with more ease, and the knowledge we generate could be seen as more credible.
Just saying something is true because it is doesn’t have a whole lot of weight behind it; showing how the knowledge we reference as truth comes to be and having evidence that supports it with results that highlight it is, by and large, the best way that nursing knowledge can be produced in a fashion that holds credibility with those that aren’t of our discipline. We know how awesome we are, but it’s hard to prove it to others without a process that everyone can relate to; that all starts with philosophy.

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