Postmodernism Raises Issues
I have always enjoyed JCN. The summer 2004 edition was no exception and evoked a reaction that made me look again at what I believe and how it relates to my career. However, I think that Dr. O'Mathuna sells nursing short. Nursing is growing as a discipline that embraces both the art and the science of nursing.
O'Mathuna wrote, "The old questions sought facts, objectivity, reproducibility, logic and theory. New questions look inside, to feelings, to the individual and to the present." He further stated that nursing has relinquished its ties to empirical research and taken up the mantle of qualitative methods because it is trying to define itself as a profession independent of medicine and because postmodernism has baited them with alternative methods of research. I probably can't speak for all of nursing, but I do know that many nurses turned to qualitative methods such as narrative inquiry because empirical results do not show the total picture-not because they were trying to overthrow medicine.
Narrative inquiry is a type of qualitative research that allows people to tell their experiences. The texts of these interviews are then interpreted to find common themes and patterns. O'Mathuna stated that the qualitative methods of research often use interpretation methods that are not empirical or accepted methods of analyzing texts. Narrative inquiry uses hermeneutics to find themes and patterns, which is how many people are taught to study the Bible. Are we not opening ourselves to the possibility that God has something to reveal to us in Scripture? We do the same in research.
The most recent trend in nursing is to blend quantitative and qualitative methods to obtain a fuller picture of the whole person's experiences. This possibility was never discussed by O'Mathuna, yet it is not completely new. Do we have to accept one research method over another, or can both methods help in the quest of caring for the whole person? I do agree, however, that nurses must understand the underlying philosophies/theories that guide their actions and beliefs. But will we end up with a list of research methods that we can and cannot use for that research to be accepted within Christian circles?
O'Mathuna wrote that we may be changing what nursing is. Is that so wrong, if change is needed? Nursing's goal remains the same. My goal of nursing within a Christian framework remains. But how I approach my practice may change as a result of research and experience.
I think I was most surprised with Dr. O'Mathuna's last statements that allow for believing some post-modernist ideas, and invite debate. To me, the article spoke against that debate. He offered a lot of material about philosophy that is unfamiliar and overwhelming to many nurses. Instead of truly inviting debate, I believe that the article was negative toward postmodernism and qualitative research. Many nurses will conclude that both are inherently evil. Instead of pronouncing these ideas as wrong, why not ask questions and invite dialogue?
Cheryl A. Webb, PhD, RN
Pittsburgh, PA
The author responds: I'm grateful to Dr. Webb for her comments and the opportunity to clarify some of the points made in my article. She expressed surprise that my conclusion accepted some aspects of postmodernism and invited debate. Yet I began the article saying precisely this (p. 5), and on a number of occasions, pointed out where I agreed with postmodern critiques, for example, of aspects of medicine and science. In agreement with Dr. Webb, I noted that qualitative research methods "clearly have an important role in answering certain questions" (p. 8). My aim was not to critique qualitative research methods but to point out problems with postmodernism, in particular its rejection of modernity and its quantitative methods. I would defend the appropriateness of different research methods in appropriate contexts-including hermeneutics for studying the Bible and other texts. As in many situations, it's an issue of distinguishing babies from bath water. Postmodernism makes some valid points, but as a worldview, it can be dangerous. It seeks to undermine all attempts to evaluate everything, especially ideologies. However, the fact that we are debating what I said and what I didn't shows that we don't accept postmodernism, and that we believe we can work our way closer to the truth.
Donal O'Mathuna, PhD
Parish Nurses Document
I read with interest the Spring 2004 articles regarding documentation of parish nurse practice. It was disappointing to read that William Parker observed "little tracking and documentation of nursing activities and observations" by parish nurses (p. 13). I have been a member of the St. Joseph Mercy of Macomb Parish Nursing Network (SJMM-PNN), Clinton Twp., Michigan, since 1995. This Network has had documentation as a requirement of practice from the beginning, even before the Scope and Standards of Practice for Parish Nurses was published by the ANA. We began with paper and pencil documentation, which included demographics, disease and wellness conditions, interventions, referrals and outcomes for individual contacts and group interventions. The documentation is the primary aid in helping the parish nurses formulate goals and be accountable to God, their church and the professional practice of nursing. It has also justified cost-savings to the hospital system that gives us support.
In 2001, the SJMM-PNN documentation system was computerized on a website so that data can be entered on a computer or a hand-held PDA. As of 2002, the documentation system is being offered to other parish nursing networks and individuals as a subscription. Parish nurses from California, Maryland, Indiana, Louisiana and Iowa are now using the system. I hope that with the example of the SJMM-PNN, another article in the future will be able to comment on the positive impact of documentation in parish nurse practice.
E-mail or http://www.pnhmnetwork.com to learn more about subscribing to the website.
Catherine Lick, MSN, RN
Troy, MI
Oasis Reading
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Grace Clarke, RN
Comox, BC, Canada
Stories of Healing
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Testing 1-2-3
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