Nursing

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What is nursing? What exactly does it mean to nurse a patient, and how has this definition changed over the past centuries? What does the discipline of nursing consist of? In this essay, I aim to attempt to answer these questions, along with the help of a myriad of nursing researchers whose studies have helped to broaden my perspective on what exactly it is that I now do for a living. I will be discussing the different types of nursing knowledge that assists us as nurses to care for patients and why it is that our discipline has, almost since it started, been seen as second to medicine. I will also be comparing the public’s views of nurses and nursing and our status in society from the early 1980s to now, with help from some of my own personal experiences.

Ever since Nightingale’s statement, “I will endeavour to assist the physician in his work,” (cited in Hilton, P.A., 1997) it seems that the discipline of nursing has followed as such, simply existing as a profession to aid doctors in their work. Indeed, I myself sense the dominance of the bio-medical field in my practice, sometimes believing that nurses would be redundant if doctors were to cease to exist in the hospital. Attempting to distinguish nursing as a line of work separate from medicine has been a tough task for many owing to Nightingale’s comment, labelling nurses as the ‘doctor’s handmaiden’ (Hilton, P.A., 1997). What I have observed in healthcare organisations in the past few years is exactly that, majority of the tasks nurses are assigned to have been set by doctors, which reduces the time we have to actually nurse the patient.

In that sense, we are not only viewed as serving patients, but serving other healthcare professionals as well. Tayray, J. (2009) explained that in the early years of nursing, nurses blindly did as they were told by doctors. She says that nursing was “primarily a profession of giving”, and nurses did not make use of any particular scientific approach in practice. As ‘giving’ without expecting anything in return is generally seen as being satisfying for the giver, during Nightingale’s time “there was no imperative to pay nurses a fair and just salary” as simply caring for someone “was seen as the reward in and of itself” (Cutcliffe, 2008). However, as nursing is now deemed a profession, there is the separate reward of income.

Currently, however, we have enhanced our status by broadening our knowledge and including not just objective and methodological knowledge preferred by medical professionals but also relying on subjective and practical knowledge of our own in day to day work. Be that as it may, one researcher has commented that as the “dominance of physicians in healthcare” still exists, objective knowledge is still privileged over subjective knowledge. Objective knowledge refers to that which is concrete evidence, tangible, definite, e.g. you can see the patient sweating. Whereas subjective refers to knowledge that exists in the mind, that is different in every individual e.g. the severity of pain a patient is feeling. As such, this makes it hard on nurses to boost our current rank as we feel our knowledge is invalid when it is not accepted by physicians (Canam, C. J., 2008). The key here would be to have confidence and belief that our knowledge is important in its own way to our practice. In this way, as Rafferty (1996), Maslin-Prothero & Masterson (2002) phrased it, we can be “freed from historical oppression of the male-dominated medical profession” (Cutcliffe, 2008). However, we still have a long way to go, as not only do we need healthcare professionals to approve of and acknowledge our opinions, we also need our patients to have confidence in our decisions. Nightingale has somehow actualised an arrangement where our nursing process “is directed by doctors, who predominantly operated from an emerging scientific medical paradigm” (Brennan, D., 2005).

Litchfield (2008) sets forth the view that nursing is still seen...
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