The professions of nursing and nurse education are currently experiencing a crisis of confidence, particularly in the UK, where the Francis Report and other recent reviews have highlighted a number of cases of nurses who no longer appear willing or able to ‘care’. The popular press, along with some elements of the nursing profession, has placed the blame for these failures firmly on the academy and particularly on the relatively recent move to all‐graduate status in England for pre‐registration student nurses. (...) This has come to be known in the UK as the ‘too‐posh‐to‐wash’ argument, that there is an incommensurability between being educated to degree level and performing basic nursing tasks. I will argue in this paper that the diagnosis of the problem is substantively correct, but the formulation and the prescription are misguided and dangerous. I will suggest that the growing emphasis on research‐based and evidence‐based practice is the logical conclusion of an inappropriate scientific paradigm for nursing which is underpinned by the social sciences, by technical rationality, and by a focus on people. In contrast, I will suggest that a more fruitful way of thinking about and practising nursing and nurse education is to consider it as a human science with a focus on persons in which evidence for practice derives largely from practice itself. The history of the idea of a human science is traced from its roots in nineteenth century hermeneutics to the work of Gadamer and R.D. Laing in the 1960s, and I attempt to imagine a paradigm for nursing practice, scholarship, and education based on Laing's ‘existential–phenomenological’ approach with a focus on the endeavour to understand and relate to individual persons rather than to make broad prescriptions for practice based on statistical and other generalizations. (shrink)

The past decade has seen the gradual emergence of what might be called a postmodern perspective on nursing research. However, the development of a coherent postmodern critique of the modernist position has been hampered by some misunderstandings and misrepresentations of postmodern epistemology by a number of writers, leading to a fractured and distorted view of postmodern nursing research. This paper seeks to distinguish between judgemental relativist and epistemic relativist or ironist positions, and regards the latter as offering the most coherent (...) critique of modernist/(post)positivist nursing research. The writings of poststructuralist philosophers, including Barthes, Lyotard, Derrida, Foucault and Rorty are examined, and a number of criteria for a postmodern ironist concept of research validity or trustworthiness are suggested. Whilst these writers reject the idea of Method as a guarantee of valid research, they nevertheless believe that value judgements can and must be made, and turn to notions of ironism, différance, and the differend. Ultimately, the postmodern ironist reader of the research report must make a judgement without criteria, based on her own practical wisdom or ‘prudence’. (shrink)

It is widely acknowledged that the modern university can be traced back to the inauguration of the University of Berlin in 1810. In the subsequent two centuries, the idea of the university has taken on many forms, largely driven by the political concerns of the day and often in response to demands from the electorate for greater state regulation and accountability for public spending. Until recently, the responsibility for academic and social legitimation had shifted between the church, the state and (...) the university itself. However, in opening up the higher education sector to the influence of the market economy, the state has surrendered much of its political influence over the academic governance of the university to the power of the consumer, which is to say, to students. In this essay, I trace the history of the modern university and examine the significance and implications for nurse education of the turn towards the market. Drawing on the work of Derrida, Lyotard and Readings, I suggest that the return to liberal education is no longer possible, and argue instead for a philosophical strategy of subversion. (shrink)

ROLFE G. Nursing Inquiry 2012; 19: 98–106 [Epub ahead of print]Cardinal John Henry Newman and ‘the ideal state and purpose of a university’: nurse education, research and practice development for the twenty‐first centuryCardinal John Henry Newman’s book, The Idea of a University, first published in the mid nineteenth century, is often invoked as the epitome of the liberal Enlightenment University in discussions and debates about the role and purpose of nurse education. In this article I will examine Newman’s book in (...) greater detail and with a more critical eye than is generally the case in the writing of nurse academics. In particular, I will focus on the claims that Newman was a champion of the Enlightenment University of the nineteenth century, that he promoted the idea of ‘disinterested’ universal knowledge for its own sake, that he was an early advocate of the pursuit of knowledge through scientific research, and the supposition that he would have welcomed the discipline of nursing into the University. In each case, I will suggest that these claims are based on an extremely selective reading of Newman’s work. I will conclude by employing the example of practice development to propose an alternative way for nursing to find its place in the modern University that does not involve a retreat into what I will argue is an outdated and nostalgic view of the aims and purpose of higher education. (shrink)

The deconstructing angel: nursing, reflection and evidence‐based practice This paper explores Jacques Derrida's strategy of deconstruction as a way of understanding and critiquing nursing theory and practice. Deconstruction has its origins in philosophy, but I argue that it is useful and relevant as a way of challenging the dominant paradigm of any discipline, including nursing. Because deconstruction is notoriously difficult to define, I offer a number of examples of deconstruction in action. In particular, I focus on three critiques of reflective (...) practice by the meta‐narrative of evidence‐based practice (EBP) and attempt to show how those critiques can be directed back at EBP itself. I conclude with the observation that EBP is open to many of the criticisms that it directs at other discourses, including problems of a lack of empirical evidence, of distortions due to memory, and of falsification of the ‘facts’. (shrink)

The academy is in a mess. The cultural theorist Bill Readings claimed that it is in ruins, while the political scientist Michael Oakeshott suggested that it has all but ceased to exist. At the very least, we might argue that the current financial squeeze has distorted the University into a shape that would be all but unrecognizable to Oakeshott and others writing in the 1950s and 1960s. I will begin this paper by tracing the development of the modern Enlightenment University (...) over the past 200 years from its roots in late 18th century Berlin to its current predicament. I will then turn my attention to the introduction during the 1990s of nursing education into the University, and examine the particular difficulties and tensions encountered at the interface between a professional practice and an academic discipline. Finally, I will propose philosophy as a way of dwelling in the ruins of the Enlightenment University and of reconciling the corporate demands of the University with the obligations of the nursing profession. (shrink)

Kant (Grounding for the Metaphysics of Morals. Hackett, Indianapolis, 1797) described honesty as ‘a sacred command of reason’ which should be obeyed at all times and at any cost. This study inquires into the practice of dishonesty, deception, and deceit by universities in the UK in the pursuit of quality indicators such as league table positions, Research Excellence Framework (REF) scores, and student satisfaction survey results. Deception occurs when the metrics which inform these tables and surveys are manipulated to suggest (...) an improvement in quality when, in fact, the raised scores are merely the result of clever strategic planning. Deceit occurs when these manipulated scores are deliberately and knowingly presented as real improvements in research and educational quality. It might be argued that, within the context of the artificial ivory tower world of academe, this is a game played by almost every academic in every higher education institution with no real losers and little wider consequence. However, this study suggests that some of the strategies employed by institutions to improve their scores without directly addressing the issue of quality can, in certain practice‐based disciplines such as nursing, result in dire consequences for practitioners and service users. It concludes with a number of suggestions taken from personal experience to resolve the tension between the contractual demands placed on nurse academics by their employers and the moral and practical obligations of their professional body, most notably the use of subversion. The conclusion, contra Kant, is that the most effective strategy against dishonesty and deception is often more dishonesty and deception. (shrink)