Personal knowing in cancer nursing

A lived experience of dualism between the natural and human science paradigms in nursing

AIM

To describe the use of narrative as both phenomenon and method to illuminate college nurse educators' nursing knowledge development through their day-to-day stories on the institutional landscape, which shape and are shaped by health-care and nursing education changes.

BACKGROUND

The Ontario health-care reform in Canada and a shift in nursing curriculum have brought to light a different dimension of a theory-practice issue. The traditional predominant natural science approach in nursing is now no longer considered responsive to the unique characteristics of patients' health-care needs. Emerging from current nursing education is an emphasis on a human science paradigm. However, as many college nurse educators moved back and forth between their classrooms to clinical settings, they experienced tremendous tensions in living between the new caring paradigm and the old culture of biomedical science ideology. Compounding this challenge is a lack of understanding by the policymakers and administrators of the importance of nurses' contribution vis-à-vis an ailing health-care system. This growing complexity demands that nursing, as a practice discipline, should articulate its unique body of knowledge for advancing contributions in health care.

METHODS

My stories of experience and those of my participants were analysed narratively to determine the knowledge and understanding developed from living the complex and interwoven changes in nursing education and practice.

FINDINGS

Through living, telling, retelling and reliving our stories, my participants and I recognized a false dualism between the seemingly polarized biomedical and human science paradigms.

CONCLUSION

The meaning of certainty-uncertainty inherent in nursing teaching and practice demands that nurse educators rethink how stories of experience play out in their understanding of teaching future graduates the interrelationships between these two approaches.

Starry night: using story to inform aesthetic knowing in women's health nursing

AIM OF THE PAPER

This paper describes the use of story as a vehicle to inform aesthetic knowing in nursing. Because health care demands that nurses know two distinct languages, the language of nursing science with its quantifiable outcomes as well as the experiential observations of health and illness, it is critical that nurses be fluent in each discourse.

BACKGROUND

Nursing scholars have long voiced a commitment to two epistemological domains: scientifically derived knowledge (empirics) as well as the expressive, creative, intuitive application of knowledge (aesthetics). In recognition of the need for these interpretive paradigms for practice, nursing scholars have sought to identify the kinds of knowing which provide the nursing discipline with its unique perspective.

DISCUSSION

Stories mould every human encounter and telling one's story in the context of a trusting relationship allows women and nurses to journey together to uncover and discover the meanings inherent in the story. Through this mutual process of unfolding the story, nurses engage the women in deep reflection and focus on what 'might be' so that possibilities for the future are illuminated. This is important in all nursing, but particularly in women's health nursing because the emergence of story suggests that contextual, phenomena-centred knowledge has found its voice in the nursing care of women as a way of knowing that focuses on personal experience and relies on methods in which woman-to-woman caring facilitates the disclosure of the human health-illness experience.

CONCLUSIONS

Storytelling is a useful strategy to inform aesthetic knowing in nursing. Stories supply a foundation for nursing scholarship because truly to hear women's stories require nurses analyse information, formulate hypotheses, and seek to understand the causal relationships as expressed by women. Through this analysis and attention to detail, nurses are able to glimpse possibilities for the future, thus transforming the experience.