Sunday, January 12, 2014

Nurses: Slaves immersed in a liberal ideology

 2012 Jan;13(1):69-77. doi: 10.1111/j.1466-769X.2011.00527.x.

Slaves immersed in a liberal ideology.

Author information

  • School of Nursing, University of British Columbia, Vancouver, BC, Canada. kese@shaw.ca

Abstract

Paradigm debates have been featured in the nursing literature for over four decades. There are at least two opposing paradigms specific to nursing that have remained central in these debates. Advocates of the unitary perspective (or simultaneity paradigm) consider their theories to be more philosophically advanced and contemporary alternatives when compared to the older more traditional ideas characteristic of models they describe as originating from the totality paradigm. In the context of these debates, I focus on some theoretical positions embedded in the unitary perspective, noting their limitations with respect to integrating the individual and social mandates of nursing; nurses are responsible not only for individual health-related needs, but also for the health of the collective. I explore two hypotheses that may explain the powers of endurance of the unitary perspective. Paley, who outlines the origins of nurses' 'slave morality', inspires the first hypothesis. The second hypothesis speaks to the location of nursing knowledge development in the context of liberal ideology. In this work, I outline key conceptualizations of the unitary perspective in order to clearly illustrate the limitations of the unitary perspective for nurses' social mandate. Then, I explore how slave morality and liberal ideological assumptions might both work to sustain the unitary perspective. A paradigm for nursing must have utility in addressing both the health-related needs of individuals, and for addressing the health of the collective. To this end, I advance suggestions in three areas: first, to transform nurses' slave morality to more honest and noble aspirations; second, to examine liberal ideological premises; and third, to end paradigm debate by resituating elements of the unitary perspective to the level of mid-range theory, where it could be most effective for research and practice with specific populations.

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