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Nursing History: An Irrelevance for Nursing Practice?

Anne Borsay Professor of Healthcare and Medical Humanities College of Human and Health Sciences Swansea University. Nursing History: An Irrelevance for Nursing Practice?. Themes. Irrelevant history? The development of nursing history The origins of the medical model

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Nursing History: An Irrelevance for Nursing Practice?

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  1. Anne Borsay Professor of Healthcare and Medical Humanities College of Human and Health Sciences Swansea University Nursing History: An Irrelevance for Nursing Practice?

  2. Themes • Irrelevant history? • The development of nursing history • The origins of the medical model • Historical scholarship and • professional identity • patient perspectives • evidence-based decision-making

  3. The Development of Nursing History • Biography • Context • administrative histories e.g. Brian Abel-Smith (1960) • progressive histories e.g. Monica Baly (1973) • social science histories e.g. Celia Davies (1980) • postmodern influences • The relevance of the past

  4. The Medical Model of Healthcare • Disease-orientated approach • Growth of molecular medicine • Renaissance origins: man as machine • mind-body split • experimental methodology • Towards a medical monopoly • Medical knowledge: from holistic humoralism to localized pathology • Medical practice: from patient narratives to signs, symptoms and measurements

  5. Professional Identity • Florence Nightingale: nature not medicine cured • Mick Carpenter: three phases in the professionalization of British nurses • From professionalization to professional identity • A profession of white middle-class women? • Multi-disciplinary working • Social and technological changes • History and the construction of meaning for changing roles

  6. Patient Perspectives • Nursing theories e.g. • Roper, Logan and Tierney: activities of living • Neuman: systems model • Historical examples e.g. • Dr Richard Kay, Lancashire general practitioner (1749) • Joseph Wilde’s nurse, Devon and Exeter Hospital (1809) • History and the exploration of psychological distance

  7. Evidence-based Practice (1) • A language for evaluating nursing practice? • A strategy for personalizing the patient? • Prioritizing randomized control trials and epidemiological data • A mechanism for financial constraint • The loss of the patient to medical reductionism

  8. Evidence-based Practice (2) • History = a template for decision-making under conditions of uncertainty • Present practice = a temporary phenomenon in an evolving chronology • Evidence-based decision-making = combining research-based and experiental knowledge • History and the interpretation of the messy human condition

  9. Conclusion • Evolution of nursing history • Professionalization and the medical model • History as a challenge to reductionism • Nursing history as a resource for critical reflection • A copy of the article upon which this paper drew is available from: a.borsay@swan.ac.uk.

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