Discipline of Nursing: Three–time Knowledge

294 Pages·2021·8.493 MB·English

by  Michel Nadot

Discipline of Nursing
Series Editor
Bruno Salgues
Discipline of Nursing

Three-time Knowledge

Michel Nadot
First published 2020 in Great Britain and the United States by ISTE Ltd and John Wiley & Sons, Inc.
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Library of Congress Control Number: 2020942263

British Library Cataloguing-in-Publication Data
A CIP record for this book is available from the British Library
ISBN 978-1-78630-429-2
Contents
Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvii
Part 1. Lay Knowledge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Chapter 1. Role of History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
1.1. Lay knowledge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
1.2. A difficult history for an ordinary experience . . . . . . . . . . . . . . . . . . . 4
Chapter 2. The Hospital as a Place to Talk . . . . . . . . . . . . . . . . . . . . . 11
2.1. The origin of the hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
2.2. The care environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Chapter 3. Care Before 1850 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
3.1. Maison staff . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
3.2. Sacred values in the period of lay knowledge . . . . . . . . . . . . . . . . . . . 28
3.3. Nurses (enfermières) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
3.4. Nurses and gardes-malades . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
3.5. City physicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
vi Discipline of Nursing
Chapter 4. Practices and Knowledge . . . . . . . . . . . . . . . . . . . . . . . . . 65
4.1. Domus or looking after property life . . . . . . . . . . . . . . . . . . . . . . . . 66
4.2. Hominem or looking after human life . . . . . . . . . . . . . . . . . . . . . . . 69
4.3. Familia or looking after group life . . . . . . . . . . . . . . . . . . . . . . . . . 82
4.4. Never enough time to do everything . . . . . . . . . . . . . . . . . . . . . . . . 86
Chapter 5. A Return to Image: Minion Syndrome . . . . . . . . . . . . . . . . . 91
5.1. Even more knowledge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
5.2. The economically unnecessary provision of services . . . . . . . . . . . . . . . 96
Part 2. Protodisciplinary Knowledge . . . . . . . . . . . . . . . . . . . . . . . . . 99
Chapter 6. From Hospital-School to School-Hospital . . . . . . . . . . . . . . 101
6.1. A non-religious form of training . . . . . . . . . . . . . . . . . . . . . . . . . . 103
6.1.1. Valérie de Gasparin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
6.2. Valérie de Gasparin and Florence Nightingale . . . . . . . . . . . . . . . . . . 110
Chapter 7. The Advent of Medical Writing . . . . . . . . . . . . . . . . . . . . . 127
7.1. The ERR process for practical knowledge . . . . . . . . . . . . . . . . . . . . . 136
7.2. Nursing students and writing . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Chapter 8. Towards Higher Education . . . . . . . . . . . . . . . . . . . . . . . . 143
8.1. Women’s groups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
8.2. Non-university higher education structures . . . . . . . . . . . . . . . . . . . . 152
8.3. Towards university schools and scientific research . . . . . . . . . . . . . . . . 160
8.4. Europe and the Hautes écoles spécialisées (HES) . . . . . . . . . . . . . . . . 164
Chapter 9. A Return to Image: The Shaping of Knowledge . . . . . . . . . . 167
9.1. Duplication of reduced knowledge . . . . . . . . . . . . . . . . . . . . . . . . . 168
9.2. The problematic identity of knowledge . . . . . . . . . . . . . . . . . . . . . . 171
Part 3. Scientific Knowledge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175
Chapter 10. Nursing Sciences? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177
10.1. Profession first, discipline and science second! . . . . . . . . . . . . . . . . . 178
10.2. Historical constants of the discipline . . . . . . . . . . . . . . . . . . . . . . . 192
10.2.1. Domus–familia–(ad)hominem . . . . . . . . . . . . . . . . . . . . . . . . 196
10.2.2. Three cultural and linguistic systems . . . . . . . . . . . . . . . . . . . . 198
Contents vii
10.2.3. Medium, mediation, cultural intermediary . . . . . . . . . . . . . . . . . 202
10.2.4. Concepts of the nursing disciplinary metaparadigm . . . . . . . . . . . . 206
10.2.5. Fourteen groups of practices . . . . . . . . . . . . . . . . . . . . . . . . . 207
Chapter 11. The Construction of the Discipline . . . . . . . . . . . . . . . . . . 219
11.1. The green knowledge theory . . . . . . . . . . . . . . . . . . . . . . . . . . . 226
11.2. Compulsory basic knowledge . . . . . . . . . . . . . . . . . . . . . . . . . . . 228
Chapter 12. Identity and Discipline . . . . . . . . . . . . . . . . . . . . . . . . . . 237
12.1. Why health mediology? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240
12.2. The identity of our knowledge and health mediology . . . . . . . . . . . . . . 243
Chapter 13. A Return to Image: “Where Do We Go Now”? . . . . . . . . . . . 249
13.1. An intergenerational continuity of knowledge . . . . . . . . . . . . . . . . . . 250
13.2. Ordinary practices before advanced practices . . . . . . . . . . . . . . . . . . 252
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277
Foreword
Nurses are searching for what characterizes the nursing discipline or the nursing
sciences. Publications as well as conferences have been held around the world with
the aim of specifying the purpose of the discipline. However, there is no consensus
on the subject. What is nursing knowledge made of? What are the foundations of the
discipline, what is its purpose and what is its scientific identity?
This book by Michel Nadot provides concrete answers to the questions raised.
Nadot proposes an epistemological analysis of the three phases of nursing
knowledge in a unique way by following a historical chronology. Drawing on his
long experience as a writer, he is keen to present the traditions of our languages and
their influences on knowledge and, consequently, on the nursing discipline. Through
his research as a philosopher and nurse, he proposes an innovative schematization of
nursing knowledge and takes up his conceptual model in nursing sciences (health
mediology) conceived through his empirical research as an alternative to the name
“nursing sciences”.
This book entitled The Discipline of Nursing – Three-time Knowledge is Michel
Nadot’s masterpiece, which is composed of three main parts. This volume focuses
on the foundations of the discipline, a subject little discussed in Europe and the
Middle East. His style of writing, the structure of the text and the illustrations
provided, followed by proposals for the development of the discipline, add to the
maturity of this book, which is reflected in the pleasure of an enjoyable reading,
reinforced by the “image feedback” and a summary of the key ideas at the end of
each part.
Nadot’s involvement in his work is that of a nurse who is both a historian and a
philosopher at the same time, who tries to demonstrate in his book that the nursing
discipline was built up chronologically in three stages: lay knowledge, which was
documented as early as the 14th Century, protodisciplinary knowledge as early as
x Discipline of Nursing
the middle of the 19th Century, and finally scientific knowledge as early as the last
third of the 20th Century.
In the first chapter of his book, Nadot argues that caring or caregiving is a three-
dimensional field that gives rise to the first languages from traditions and by
extracting experience and nursing practice. The basic triptych of the nursing
discipline has its origins in lay knowledge: Domus (care environment)–Familia
(family)–Hominem (person), and is at the center of a three-dimensional field of
competences “Domus–Familia–Hominem”, which, according to Nadot, constitutes the
foundation of the nursing discipline on which new knowledge and new roles will be
superimposed.
Then, in the second part of his work, appears protodisciplinary knowledge.
During this period, two distinct training models proposed by two great women
marked the formalization of nursing knowledge. The first model was developed in
Switzerland thanks to Valérie de Gasparin, discovered by Michel Nadot, who
created the “school-hospital1” training model, and the second in England with
Florence Nightingale, known throughout the world and who in turn created the
“hospital-school2” training model. These two training models have influenced many
schools around the world.
In the third chapter of his book, Nadot shows through his multiple publications
that the nursing discipline was born implicitly with reference to the medical
sciences; however, it is, in fact, situated in the humanities. He insists by saying that
in the game of science, scientists are the only people to produce knowledge in order
to obtain recognition, including recognition of the discipline in question. In this
scientific part of knowledge, Nadot situates himself as an epistemologist, who aims to
understand the origin of nursing sciences and the world in which the knowledge of the
nursing discipline and its problematic identity develops.
According to Nadot, it seems that clinical research is more developed at the
expense of basic nursing research. This is due, according to him, to the valorization
of the practical side of the profession at the expense of nursing theory and research.
However, Nadot adds that nurses’ access to university has provided access to
scientific language and methods, as well as to research and epistemological thinking,
which constitute a pillar of recognition for the nursing discipline. It is therefore
incumbent on nurses, researchers and university professors to take responsibility for

1 Where the hospital depends on the school on a geographical, administrative and financial
basis.
2 An opposing model to the previous, where the school depends on the hospital on a
geographical, administrative and financial basis.
Foreword xi
the direction of our discipline, because the profession is in crisis and does not seem
to be able to rely on legislation or its theorists to get out of it. According to Nadot,
only basic research, which has long been absent from nursing faculties, will be able
to do a conceptual and historical clean-up, revise our linguistic codes and produce
knowledge specific to our discipline. This will create a paradigm shift that will allow
disciplinary identity to be enhanced.
Several factors will contribute to this conceptual clean-up. According to Nadot,
the fact of being part of a reflexive science, or rather I would say a “reflexive
practitioner” attitude, of taking a distance, having a critical look to examine the existing
knowledge, not only at the individual level but also at the collective level, from
experience, from the historical roots of our profession, as well as through the
destructuring and restructuring of our traditions, allows us to better propagate and
value nursing knowledge. Hence, the role of universities to train nursing students
who are not only called upon to acquire specific knowledge and know-how, but also
who must prepare themselves to have a reflexive attitude and research, analysis and
questioning skills in order to bring about the emergence of a disciplinary “green
knowledge”. This “green knowledge” is demonstrated in this book.
Nadot’s book proposes a very original schematization of the aggregation of
knowledge where disciplinary “green knowledge” forms the core of practical
knowledge and is immersed in a cultural environment represented by institutional
culture, healthcare culture and medical culture. According to Nadot, it should not be
denied that the knowledge emanating from these three cultures is developing in such
a way that it gradually comes to the moor, and masks the “green ball” at the origin
of fundamental knowledge. Hence, the problem of disciplinary visibility that only
basic research on the elements of the discipline, namely the environment (Domus),
care, health and the individual/family (Familia/Hominem), enriches nursing
knowledge. It is a matter of proving that nursing is not only a collection of
knowledge borrowed from other disciplines, particularly medicine and humanities,
but also that it has a distinct identity. Thus, the schematization would be more
harmonious by constructing a knowledge that places the human being at the center
and in continuous interaction with a changing healthcare environment.
In this book, Nadot sheds light on several factors, highlighting that our nursing
science has not reached the same level compared to other existing sciences.
According to him, it is a question of the female status of the profession, and the
evolution of this status in our societies at different rates of development of scientific
research. However, for a discipline to develop, it must be neutral, exclusive of
gender, consistent and must reflect the world it came from. For Karl Popper [POP 85],
for example, a discipline can only claim the status of a scientific discipline if it
produces falsifiable statements, that is, statements that are capable, in the form of
testable hypotheses, of being subjected to the test of experimentation.