really not to displease in the end.
I also discovered that it is not through the history of language traditions that nursing research began. Aside from a few cleverly maintained myths, the results of research say little about the historical foundations of the knowledge that constitutes the discipline today. The nursing discipline, situated in the human order in terms of science, is struggling to go beyond its ordinary social representations and its own myths to construct its specific knowledge and give it a name.
Focusing on what is now known as “nursing knowledge”, “nursing discipline” or “nursing sciences”, this book deals with a subject little discussed in the literature, particularly in Europe. Each of the three parts ends with a short critical analysis of the knowledge presented (image feedback). This image feedback is a kind of selfreflexivity on the content and context of knowledge emergence.
Several excerpts from this book are based on the author’s doctoral thesis [NAD 93], especially the unpublished passages. Also included are the results and reports of scientific research financed by the Swiss National Science Foundation (SNF) and developed since 1999 by the Health Mediology Laboratory of the Fribourg University of Applied Sciences (HES-SO)3. First-hand documents from partially published empirical research [NAD 12b, NAD 13] are also used, supplemented by a series of reflections published since 1982 and numerous scientific conferences held on several continents between 2000 and 2016.
Drawing inspiration from a diagram of the development of fundamental knowledge with reference to the philosophy of science (Figures 11.2 and 11.7), I believe that I can verify, through a succession of questions, whether the increase in knowledge reveals a thought process that has “as a starting point and as a term, the formulation of problems that are ever more fundamental and whose fruitfulness continues to increase, giving rise to other problems that are as yet unpublished” [POP 85]. Not only is an understanding of the language tradition a necessary condition for innovation, but also the knowledge carried by several concepts worked on as needs and questions arise makes it possible to envisage a reality that goes from the macroscopic to the microscopic. These concepts serve to delimit the object of the study carried out within the researcher’s specific discipline and practice, and drive the dynamics of the research. They have analytical value while delimiting both the object of the research and the disciplinary field concerned. They allow the object of the study to be treated from authoritative sources of knowledge found in what Popper calls the “third world” or what he calls “objective knowledge” [POP 91].
This book is primarily intended for nursing students, their professors and researchers involved in the development of the discipline. Although indirectly concerned, nurses in healthcare settings are also likely to be interested in this book, if only out of curiosity. It is also intended to contribute to the nascent academic debate on nursing knowledge, its origins, the discipline, nursing science, its existence, its orientations, its identity or the reasons for the indifference it arouses. How is the term “discipline” represented in the healthcare environment and why do the advancement of nursing science and its theories remain inaudible in the scientific community, the media, politics and the economy despite the efforts invested in this endeavor?
Michel NADOT
August 2020
1 1 Women have always been predominantly represented in the care world. Today, they still represent the majority of professionals in practice. On average, between 7% and 11% of the profession’s members are men, depending on the source or country.
2 2 At a time when the first word-processing typewriters heralded the arrival of the first computers.
3 3 This will exist for about 10 years (1999–2009), directed by the author.
Introduction
At present, there are very few books on the foundations of the nursing discipline1 and the progressive construction of its knowledge. Most of those that do exist start from the nursing reform carried out by Florence Nightingale, who, presented at the time as a pioneer (the English aristocratic heroine), found herself projected onto the nursing scene as the one who brought about the knowledge of care through spontaneous generation of knowledge. Yet care has been provided for a long time and long before Florence Nightingale’s entry into the hospital scene. Nursing practices and their knowledge did not wait until the middle of the 19th Century to exist. However, there is not much in common between Florence Nightingale’s social status and that of the hospital maids and governesses of the 19th Century. A good example of this is the prominent image of the English heroine Florence Nightingale or a confessional past of “nuns” among the caretakers. The emergence and foundations of the discipline of care are much more complex than this, and the role played by French-speaking Switzerland in the emergence of the first schools for care workers should not be overlooked. Florence Nightingale did indeed exist, but we cannot understand her involvement in care if we do not place her thinking in the context of the time, and this in relation to Valérie de Gasparin-Boissier, the Swiss woman who founded the first school for care workers in the world and who, in terms of values, was both her forerunner and her rival. Just as it is difficult to understand the role of nuns and the Church in hospitals if we do not know why at one time the Catholic Church began to send its nuns to civilian hospitals to replace the lay personnel already in place or, as in Quebec, to develop healthcare institutions that were to be established in the wake of French colonization, so too is it difficult to understand the role of the sisters and the Church in hospitals.
Contrary to existing beliefs, the nursing profession does not have good nuns as forebearers and has no medical paternity from the outset. With practices sometimes almost similar to those of today, but in different contexts, the knowledge at work in lay hospitals in secular times cannot be called “nursing”. The term nurse, moreover, is an exclusively religious term, as will be seen later, and belongs to the Catholic Church according to values proper to the ancient Scriptures. Why do the lay people still use it today?
NOTE.– The terms “infirmière” (i.e. “nurse” in French) and “garde-malade” (i.e. sick nurse in French) are neither synonymous, nor interchangeable and are rather historically in competition to qualify (the real!) professional care. Each term has its own history, and the latter does not tolerate mix-ups. It is not by chance, as Canadian nursing researchers point out, that the name to be given to future faculties of care poses a problem for rectors to gallicize the term nursing and illustrates “the difficulty of adequately translating the word nursing” [COH 02]. The difficulty is of the same order when it is necessary to explain the nature of the nursing discipline and to find a name for it.
Some nursing students, who are traditionally familiar with biomedical books or manuals and data sheets during their studies, are rarely required to obtain books that address the fundamentals of their discipline as is often the case in other academic disciplines. Moreover, there are very few critical works on the development of the discipline and its early theories. As Debout points out, “the English-language preponderance for scientific activities makes English the primary language of dissemination of the discipline’s work. Nursing research often does not take into consideration existing disciplinary knowledge and theories, but prefers to borrow those of related disciplines”. This, of course, has paradoxical consequences. “The professional group claims to be recognized in its singularity, but rejects a disciplinary content that seeks to establish this specific nursing perspective” [DEB 08].
Books
