Maya Zumstein

Confusion remains about the concept “nursing science.” Definitions vary, depending on country, context and setting. Even among nurse scholars and scientists there is disagreement about the content and boundaries of nursing science. There is an urgent need for an acceptable definition that can guide nursing knowledge development, education, and practice. In this article, we highlight the problems for the profession of this sort of conceptual ambiguity, arguing that it is an ethical responsibility for the profession to gain clarity about the meaning and apt focus of our knowledge development initiatives. We parse out nursing and science as separate concepts and synthesize from this analysis a simple yet comprehensive definition of nursing science. We propose that this definition is capable of unifying ongoing nursing endeavors and should serve as the basis for evaluating nursing's knowledge development and educational initiatives.

To enhance patient care in the inevitable conditions of complexity that exist in contemporary healthcare, collaboration among healthcare professions is critical. While each profession necessarily has its own primary focus and perspective on the nature of human healthcare needs, these alone are insufficient for meeting the complex needs of patients (and potential patients). Persons are inevitably contextual entities, inseparable from their environments, and are subject to institutional and social barriers that can detract from good care or from accessing healthcare. These are some of the reasons behind current movements to develop competency frameworks that can enhance cross‐disciplinary communication and collaboration. No single profession can claim the big picture. Effective teamwork is essential and requires members of diverse professions to understand the nature of each other's knowledge, skills, roles, perspectives, and perceived responsibilities so that they are optimally utilized on behalf of patients and their families. Interdisciplinary approaches to care permit different aspects of a person's needs to be addressed seamlessly and facilitate the removal of obstacles by engaging the range of resources exemplified by the different professions. Additionally, collaborative efforts are needed to influence policy changes on behalf of individual and social good and to address root causes of poor health especially as these impact society's most vulnerable. Here, we explore both the benefits and the risks of an uncritical acceptance of competency frameworks as a way to enhance interdisciplinary communication. We highlight the importance of anchoring proposed competency domains in the reason for being of a given profession and exemplify one way this has been accomplished for advanced practice nursing. Additionally, we argue that having this mooring, permits integration of the various competencies that both enhances professional moral agency and facilitates interdisciplinary collaboration to further the mutual goals of the healthcare professions on behalf of quality patient care.

In 2016, Bowen and Prentice published a dialogue on Benner's model ‘From Novice to Expert’. Their main concern was to explore the development of expertise in nursing and the evolution of this expertise when domains of practice change. In this contribution, this dialogue by Bowen and Prentice (2016) is the starting point to consider Advanced Practice Nurses (APN). The argument will propose that Benner's model can help perceive APN skill (and knowledge) acquisition. For this purpose, Benner's original works, the philosophical bases on knowing that and knowing how, as well as the concept of APN, which was developed by Ann Hamric (2014; Tracy et al. 2023), are consulted. Eventually, it will be demonstrated that Benner's model can be employed in conjunction with APN and can provide valuable insight into skill and knowledge acquisition and career development. Therefore, APN can reinvigorate Benner's model and render it again very valid for today. This contribution will conclude with suggestions for supporting APNs' skill and knowledge development and indications for the evolvement of Benner's model.

In the last few decades, nursing scholars have drawn on philosophy to establish the scientific status of nursing. However, well‐known philosophical accounts of science, such as those by Popper and Kuhn, are primarily targeted at the pure natural sciences. Accordingly, the application of such accounts to nursing has led to dubious results. In this paper, we propose a fresh start and apply Hoyningen‐Huene's recent account of science to nursing. According to Hoyningen‐Huene, knowledge about a given topic such as nursing is scientific if, and only if, it is more systematic than other knowledge about this topic. Here, systematicity manifests in various dimensions such as description, explanation, and defense of knowledge claims. In our application of Hoyningen‐Huene's account of science to nursing, we focus on current nursing practice and compare it with the state of nursing before the so‐called Consensus Statement on Emerging Nursing Knowledge. Upon examining the dimensions considered by Hoyningen‐Huene, we find that the knowledge currently used and gained by nurses is more systematic than it was before the Consensus Statement. For instance, in the dimension of prediction, knowledge has become more systematic through the use of classification systems. In the dimension of defending knowledge claims, systematicity has increased due to the use of measurement devices. According to our analysis, the scientific status of current nursing knowledge is partly due to the fact that nurses draw on knowledge from nursing science, a discipline that is organized like other scientific disciplines. Still, it is also the case that knowledge‐gaining practices in nursing are more systematic than they were before the Consensus Statement.

Certain moral beliefs and/or values about what is good or harmful can cause nurses and other healthcare professionals to object to participating in some clinical actions. Such objections are also called conscientious objections. Invocation of a conscientious objection (CO) can produce complexities in patient care and health care delivery and must be mindfully evaluated for its soundness. In this manuscript, a recently developed framework, The Ethical Evaluation of a Nurse’s Conscientious Objection (EENCO), is applied to expose hidden elements and nuances in a proposed or actual CO by nurses or other healthcare professionals, thereby illuminating strategies that can lessen associated harms. The EENCO is utilized to explore two types of situations where a nurse makes a CO claim. Scenario 1 involves a nurse’s reluctance to follow provider medication orders intended to relieve pain and suffering at the end-of-life. In scenario 2, nurses object to a visitation policy during the COVID-19 pandemic. Additionally, we provide a summary of the necessary elements of institutional policy to address claims of CO using the EENCO. Drawing on the EENCO, the two scenarios were analyzed for their ethical implications. This framework contributes to the exposure, scrutiny, and clarification of potentially unappreciated aspects of CO claims. Steps for developing institutional policy are identified. Application of the EENCO guides the analysis of the two scenarios. CO claims are explored more deeply, thereby revealing implications for those involved. Additionally, the EENCO provides guidance for the development of institutional CO policies.

To enhance patient care in the inevitable conditions of complexity that exist in contemporary healthcare, collaboration among healthcare professions is critical. While each profession necessarily has its own primary focus and perspective on the nature of human healthcare needs, these alone are insufficient for meeting the complex needs of patients (and potential patients). Persons are inevitably contextual entities, inseparable from their environments, and are subject to institutional and social barriers that can detract from good care or from accessing healthcare. These are some of the reasons behind current movements to develop competency frameworks that can enhance cross‐disciplinary communication and collaboration. No single profession can claim the big picture. Effective teamwork is essential and requires members of diverse professions to understand the nature of each other's knowledge, skills, roles, perspectives, and perceived responsibilities so that they are optimally utilized on behalf of patients and their families. Interdisciplinary approaches to care permit different aspects of a person's needs to be addressed seamlessly and facilitate the removal of obstacles by engaging the range of resources exemplified by the different professions. Additionally, collaborative efforts are needed to influence policy changes on behalf of individual and social good and to address root causes of poor health especially as these impact society's most vulnerable. Here, we explore both the benefits and the risks of an uncritical acceptance of competency frameworks as a way to enhance interdisciplinary communication. We highlight the importance of anchoring proposed competency domains in the reason for being of a given profession and exemplify one way this has been accomplished for advanced practice nursing. Additionally, we argue that having this mooring, permits integration of the various competencies that both enhances professional moral agency and facilitates interdisciplinary collaboration to further the mutual goals of the healthcare professions on behalf of quality patient care.

Confusion remains about the concept “nursing science.” Definitions vary, depending on country, context and setting. Even among nurse scholars and scientists there is disagreement about the content and boundaries of nursing science. There is an urgent need for an acceptable definition that can guide nursing knowledge development, education, and practice. In this article, we highlight the problems for the profession of this sort of conceptual ambiguity, arguing that it is an ethical responsibility for the profession to gain clarity about the meaning and apt focus of our knowledge development initiatives. We parse out nursing and science as separate concepts and synthesize from this analysis a simple yet comprehensive definition of nursing science. We propose that this definition is capable of unifying ongoing nursing endeavors and should serve as the basis for evaluating nursing's knowledge development and educational initiatives.