Interestingly it was Nightingale who held out against state registration on the grounds
that it would reduce nursing practice to the lowest acceptable standards4. During the
1980s and early parts of the 1990s there was a penchant for models, theories, meta-
theories, and conceptual analyses of nursing or aspects of nursing in the search for a
theory that might once and for all articulate the true nature of nursing and might also
establish nursing as a legitimate and scientific discipline in the academy. These
activities drew variously (and one might say arbitrarily) from a range of established
disciplines (sociology, psychology, biology, physiology, philosophy and so on) in the
attempt to provide a systematic approach to nursing knowledge and theory. Often these
attempts arrived at similar sorts of conclusions, for example, about the need to regard
patients as bio-psycho-socio-beings who require holistic nursing.
This activity might well be characterised as a nascent academic discipline struggling to
develop a knowledge base that it might claim as its own. There seemed to be a
prevailing belief that if enough of this theorising activity (particularly of the rigorous
and scientific sort) was undertaken then there would emerge the sort of theory of
nursing that many believed to be out there waiting to be discovered. The struggle seems
to have resulted in competing and, perhaps in some instances, incompatible theoretical
perspectives which, together with often unarticulated, perhaps even unarticulable,
knowledge claims leaves nursing unsure of its place in the academy. This reductionist
approach has recently been tempered by an apparent general acceptance that a grand
theory of nursing might not emerge and might not be necessary.
The question of what sort of thing nursing is, is not a trivial matter for any predominant
vision of nursing will have effects not only on how others perceive it but also on the
basis on which nursing practice is predicated. The question may have more immediate
importance for academics than it does for practitioners but in time any prevailing view
of the nature of nursing (whether this is articulated or not) will influence many aspects
of both nursing practice and the way in which nursing practice is organised. It will also
have considerable influence on the educational philosophy of those in whose hands the
education of students and practitioners of nursing rests.
4 for a detailed account of the ‘state registration battle’ see Abel-Smith (1960).
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