The discipline of nursing has long maintained that is has a unique contribution to make within the health care arena. This assertion of uniqueness lies in great part in the discipline's claim to a distinct body of knowledge. Nursing knowledge is characterized by diverse and multiple forms of knowing and underpins the work of all nurses, regardless of field of practice. Unfortunately, it has been challenging for the discipline to take full ownership of its epistemological diversity, largely due to factors (...) such as competing worldviews, and ideological and binary positioning. A philosophical middle ground stance is proposed as a way for the discipline to contemplate, discuss and develop nursing knowledge; a middle space that provides the freedom to consider competing worldviews while still allowing for the discipline to fully express itself in all of its epistemological diversity. In being able to enact its multiple forms of knowledge in a creative and open space that is open to different ideas and worldviews, not only can nursing take full ownership of its practice and its unique knowledge, it can also demonstrate how best to navigate an increasingly polarized world. In a world that is increasingly fixated on binary solutions and dualistic points of view, it is time for nursing to celebrate its epistemological diversity. (shrink)

Canadian and international nursing educators are increasingly concerned with the quality of university nursing education. Contemporary nursing education is fraught by a growing anti‐intellectualism coupled with the dominance of neoliberalism and corporate university business culture. Amid these challenges, nursing schools must prepare nurses to provide care in an era compounded by social and health inequities. The purpose of this paper was to explore the philosophical and contextual factors influencing anti‐intellectualism in nursing education. We use John Henry Newman's view of the (...) purpose of a university education as a heuristic perspective to examine anti‐intellectualism in nursing. We contend that the ideological worship of technological advances, a culture of consumerism, quality improvement and risk management, the primacy of doing over thinking, competency‐based curricula and business models rooted in neoliberal financial policies reinforce anti‐intellectualism in nursing. Anti‐intellectualism is a complex issue to address within the corporate university culture. We propose multiple strategies at the disciplinary, university and sociopolitical levels to decrease anti‐intellectualism. Counteracting anti‐intellectualism requires critical thinking, praxis and emancipation. Nurses should critically examine this anti‐intellectual trend as it limits the advancement of the discipline and marginalizes its contributions within the academy. If nurses do not address this challenge, the survival of nursing as an academic discipline may be jeopardized. (shrink)

Nursing work centers around attending to a person's health during many of life's most vulnerable moments, from birth to death. Given the high‐stakes nature of this work, it is essential for nurses to critically reflect on their individual and collective impact, which can range from healing to harmful. The purpose of this paper is to use a philosophical inquiry approach and a critical lens to explore the potential influence of critical pedagogy (how we learn what we learn) on nursing praxis (...) (why we do what we do) with the aim of disrupting stigma and discrimination within the profession. This paper draws on the works of Paulo Freire, Henry Giroux, and bell hooks to alert readers to particular windows of opportunity where an intentional adoption of critical pedagogy in nursing praxis may help the profession think differently about two important and related topics: relational violence and peer‐led knowledge mobilization. As a practice‐based and theoretically grounded profession, nurses often strive to bridge the theoretical with the practical and the individual with the systemic. Thus, developing a robust and philosophically rooted disciplinary body of knowledge is particularly important to help us defensibly grapple with the notions of truth and ethics that shape our work's very essence and impact. (shrink)

The use of correlational probability values (p‐values) as a means of evaluating evidence in nursing and health care has largely been accepted uncritically. There are reasons to be concerned about an uncritical adherence to the use of significance testing, which has been located in the natural science paradigm. p‐values have served in hypothesis and statistical testing, such as in randomized controlled trials and meta‐analyses to support what has been portrayed as the highest levels of evidence in the framework of evidence‐based (...) practice. Nursing has been minimally involved in the rich debate about the controversies of treating significance testing as evidentiary in the health and social sciences. In this paper, we join the dialogue by examining how and why this statistical mechanism has become entrenched as the gold standard for determining what constitutes legitimate scientific knowledge in the postpositivistic paradigm. We argue that nursing needs to critically reflect on the limitations associated with this tool of the evidence‐based movement, given the complexities and contextual factors that are inherent to nursing epistemology. Such reflection will inform our thinking about what constitutes substantive knowledge for the nursing discipline. (shrink)

In spite of the growing public awareness of those who would identify as transgender, very little has changed in attitudes that would accord such people full approbation. The author takes the reader on a 40‐year journey of discovery that has led her to an abiding interest in and dedication to the issues faced by people who do not fit within the gender binary of Western society. As well as describing a personal experience with someone who identifies as transsexual, the author (...) relates two troubling experiences from her nursing career. Included in the discussion are linguistics, sexuality, and vocabulary. A personal epistemology is explored that incorporates unknowing, intuition, and embodiment, and the difference this view can make to the care of those who identify as gender‐diverse. (shrink)

The profession of nursing has recognized the need for contextual and relational frameworks to inform knowledge development. Two‐Eyed Seeing is a framework developed by Mi'kmaw Elders to respectfully engage with Indigenous and non‐Indigenous knowledges. Some scholars and practitioners, however, are concerned that Two‐Eyed Seeing re‐instantiates dichotomized notions regarding Western and Indigenous knowledges. As dichotomies and binaries are often viewed as polarizing devices for nursing knowledge development, this paper explores the local worldviews in which Two‐Eyed Seeing emerged, proposing that the onto‐epistemological (...) and axiological ‘roots’ of the framework are antithetical to divisiveness, paradoxically asserting space for the dichotomy to stand. Two‐Eyed Seeing, if understood as a relational, decolonial praxis, could fundamentally change the way nursing scholarship and practice operate by facilitating space for diverse knowledges, ways of being, doing and relating. In this paper, considerations for nursing scholarship and practice, as well as recommendations to support the uptake of Two‐Eyed Seeing are explored. The authors assert that conceptual divisiveness, dichotomization and exclusion can be mitigated if nursing is informed by contextual knowledge, seeks to enact accountable partnerships with Indigenous knowledge holders, and holds the Mi'kmaq worldview upon which the concept developed in positive regard. (shrink)

Epistemological pluralism is a recognized feature of nursing knowledge, which embraces both objective, scientific knowledge and situated knowledge that include subjective experience, values and affect, and is encountered in relationship. While there is a lively literature about describing and validating the need for pluralism in nursing's knowledge base, there has been less discussion of how to work with and across different kinds of knowing that are used in practice. In this paper, I describe Kasulis’ heuristic framework for understanding more clearly (...) what is entailed in different kinds of knowledge, and what some of their advantages and disadvantages might be. The framework was created by Thomas Kasulis, an American scholar of Japanese philosophy who identified broad orientations in Asian and Western philosophies that he characterized as ‘intimacy’ and ‘integrity’, respectively. Kasulis emphasized that his framework is a heuristic, a tool for making distinctions more clearly between different styles of thinking, that can manifest not only between cultural traditions from different parts of the world, but also between subcultures within one of the dominant orientations. He breaks his two orientations down by five distinguishing categories of objectivity, relating, affect, embodiment and transparency. In this paper, each category is described and discussed in relation to aspects of nursing knowledge. Looking at different epistemological viewpoints in this way helps to clarify their differences, and to explain the difficulty of reading across them, when they entail basic assumptions that are not commensurable with each other. Kasulis’ framework offers a new way of reading across viewpoints commonly seen in the epistemological pluralism of nursing. It is a tool that can sharpen critical discernment about what is at stake, what can be gained, and what might get missed while operating in either the intimacy or integrity orientation. (shrink)

Recently, a concern has been raised about a particular kind of behaviour that is adversely affecting the quality of nursing theoretical discourse. With the behaviour being attributed to nurses’ tendency to think in binary terms, it has been proposed that nurses replace their binary way of thinking with thinking that is inclusive and expansive and is based on an epistemology of contradiction. While agreeing that the behaviour of concern is indeed unscholarly, I disagree that the culprit is the binary. In (...) this commentary, I argue that the culprit is sophistical argumentation involving a binary (real or not) and that, by not making room for legitimate binaries, we run the danger of ‘throwing out the baby with the bathwater’. Further, I argue that the proffered solution is illusory. Its epistemological basis prohibits the deliverance of that which is promised. (shrink)

In this paper, we explore the concept of bearing witness in nursing practice. We examine the description of bearing witness in the nursing literature, particularly that offered by William Cody who suggests that bearing witness results in the limited moral obligation of “true presence.” We then turn to Lorraine Code's work on testimony, drawing parallels between the concepts of testimony and bearing witness. Code suggests that receiving testimony results in a responsibility to respond, and that this is an ethico‐political obligation. (...) We discuss these ideas in relation to a Canadian exemplar of witnessing the Truth and Reconciliation Commission of Canada's work to understand and address the historical injustices done to Indigenous peoples in Canada. Here, we focus on the Commission's definition of witnessing and highlight the experience of Shelagh Rogers who served as an honorary witness. As an outcome of our analysis, we suggest that bearing witness in nursing practice is most usefully conceptualized as both a moral and a political obligation. Implications for nursing practice are suggested, including first, the need to critically examine our own understandings of power and privilege in order to authentically bear witness and avoid being complicit in injustice, and second, the concomitant responsibility to take action to challenge injustice once we have borne witness to it. (shrink)

There is an enduring debate in nursing regarding the art–science dualism, involving an articulation of two distinct ‘kinds’ of disciplinary knowledge: objective/scientific and subjective/artistic. Nursing identifies both as necessary, yet unbridgeable, which creates problems in constructing a coherent disciplinary knowledge base. We describe how this problem arises based on an ontological assumption of two different kinds of ‘stuff’ in the world: that with essential determinate properties and that without essential properties. We experiment with a solution by ontologically understanding the world (...) as made from a single kind: That the most irreducible element of the world is process, in that reality is a continuous construction whereby subject and object are products, not independent constituents, of reality. Process philosophy overcomes nursing's ontological bifurcation and enables nursing's art–science dualism to be re‐conceptualized as a cohesive logic of skilled reality production. An unavoidable implication of a process turn in nursing philosophy is that the disciplinary goal no longer becomes a privileged ‘body of knowledge’ that authorizes, which has always been a defining challenge in nursing. Rather, and more productively perhaps, the aim is for greater sophistication and plurality in its ongoing commitment to attuning to reality in ways that shape disciplinary attainment. (shrink)