The Future of Nursing

The current ANS featured article is titled “Nursing Knowledge in the 21st Century: Domain-Derived and Basic Science Practice-Shaped” authored by one of nursing’s best known scholars – Callista Roy, PhD, RN, FAAN. In this article Dr. Roy proposes a path forward for nursing that is clear, well-defined and vital to the future of nursing and healthcare. We invite you to download this article while it is featured and share your comments here – let us know your vision for the future!  Dr. Roy sent this message for ANS readers about her work:

Callista Roy

As I look back on the last 50 years of progress in nursing knowledge (Roy, 2018) I feel a great sense of pride in accomplishments of setting a firm foundation for the discipline of nursing and the practice of nursing as a profession.  Still, I feel challenged by a call to nurses to move forward in building on the advances in defining nursing to create a structure for knowledge for practice that accounts for our developments and those of all the sciences. This structure gives a central place to all levels of nursing theory. In this article, I present a full picture of nursing knowledge development as domain-derived and practice shaped. The figure (Figure 1 below) includes philosophical beliefs and values and has at the center, the goal of nursing. I really feel, as did Dorothy Johnson 50 years ago (Johnson, 1968) that a clear goal for nursing is the basis for developing knowledge. I selected the goals of facilitating humanization, meaning, choice, quality of Life, healing in living and dying from a publication on a central unifying focus for the discipline (Willis, et al. 2008) that has received attention in the literature in the years since. The right side of the figure proposes that nurses use all other scientific developments, including genomics by shaping them for practice. Nurses will contribute to this knowledge in other disciplines by asking practice relevant questions. However, the major efforts of nurse scholars will be to focus on domain-derived knowledge using all forms of inquiry.

In my view, the contribution of this article is the domain-nursing knowledge tree (see Figure 2 below). I am proposing that based on the over-all goals of nursing, each nursing grand theory has a way of contributing to these goals.  Each grand theory then is the basis for a number of model range theories that give rise to practice theories. This approach is open to controversy. I ask PhD students to consider the advantages of all theories aimed at common goals of nursing. Secondly, what do they think might be barriers to all theories aimed at common goals?  Every reader will have opinions on these and other questions. Still at this stage of my work, I feel called to put forth this possibility. I would love to see how this approach might turn out. I will also enjoy whatever happens by just putting the ideas forward.

References

Johnson, D. E. (1968). Theory in nursing: Borrowed and unique. Nursing Research, 17, 206-209.

Roy, S. C. (2018). Key issues in nursing theory: Historical developments and future directions. Nursing Research. Special Focus Issue on Theory and theorizing in nursing science. 67 (2). 81-92.

Willis, D., Grace, P., & Roy, C. (2008). A Central Unifying Focus for the Discipline: Facilitating Humanization, Meaning, Choice, Quality of Life and Healing in Living and Dying. Advances in Nursing Science. 31(1).  available online only: http://www.advancesinnursingscience.com