It’s Time For Nurses To Get In Front of the Parade, Where Society is Taking Healthcare

Here we are.

You are nurses providing your best care.

Healthcare is a beast.

Patients are finding their voices.

Society wants wellness.

And medical science has dominated healthcare for a century.

Alert!   Things are changing for nursing.

Let’s start by reminding ourselves that there are 4 components of nursing knowledge, derived from our history and practice patterns. These describe nurses’ patterns of knowing:

  • Empirics – The science of nursing
  • Personal – Personal knowledge that influences caring
  • Ethics – Moral knowledge that influences decision making
  • Aesthetics – The art of nursing; expressive discovery

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We all know that empirics, where science and technology live, have overcome our development of the personal and aesthetics, and sometimes the moral aspects of our nursing practice.

Empirics have become our way of thinking and our way of doing, but not our way of being.

And that’s the source of nursing’s inner struggle.

Here’s the Big change….

Society’s needs are shifting from all things science and technology, to….

Wellness awareness has entered healthcare.

What comes with wellness is the recognition that health is not just absence of disease and illness. The core of wellness is imbedded in the individual’s mind, body, heart and spirit. How well you, the nurse, connect and care for each individual on these levels defines their care experience.

Patient Satisfaction is one of the best things that could have happened to nursing. It provides public validation of nursing’s value and impact on patients.

Watson advised that healthcare change would happen when nursing and the people it serves are aligned (1999).

This is the good news, societal changes are changing healthcare, and in the direction of nursing’s domain.

The bad news is that although the healthcare industry is now recognizing nursing’s influence on patient satisfaction, science and technology still dominate the workload.

Beyond that, what this does bring forth is the need for widespread cultivation of nurses’ personal nursing knowledge development, which creates a new set of challenges.


Personal nursing knowledge is the most problematic to master and to teach (Carper, 1978), for the following reasons:

  1. It’s misleading – Personal knowing implies focusing on individual perceptions in a vacuum. It instead is deep inner reflection that is part of the whole of knowing that arises from within and through deep connections with others.
  2. Nurses’ choice – This area has been left to the individual nurse’s choice to develop.
  3. Unique & life-long – It requires ongoing inner processes that are unique and individually cultivated throughout one’s life.
  4. Dependent – Success depends on each nurse’s dedication to inner processes.
  5. Supportive environment – For these skills to flourish, it requires organizational support and skill-sensitive practice environments.
  6. Not in traditional education – These skills have not been comprehensively or consistently integrated into the curriculums of traditional education or organizational work settings.
  7. Requires group support – Requires both solitary inner work and group support.
  8. Resources – Resources specific to nursing’s interior pathways to personal mastery remain individualized and understudied.

We must achieve widespread personal nursing knowledge development and success to lead this parade! 


  • Carper, B. A. (1978) Fundamental patterns of knowing in nursing. ANS, 1(1), 13-24.
  • Chinn, P.L. & Kramer, M.K. (2004). Integrated knowledge development in nursing, 6th Philadelphia: Mosby.
  • Watson, J. (1999). Postmodern nursing and beyond. Edinburgh: Churchill Livingstone.

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