Nurse Education in Practice (2006) 6, 243–245

Nurse

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Educationin Practice

GUEST EDITORIAL

Why nursing does not exist[A response to Thompson D andWatson R, Editorial,Nurse Education in Practice 6 (3) (2006) 123–126]

The purpose of this paper is to respond to a recenteditorial by Thompson and Watson (2006) publishedin this journal (vol. 6, issue 3), essentially to dealwith the question they pose: Professors of nursing:What do they profess? I attempt to assume thesame burden as Thompson and Watson ‘‘to stimu-late the academy of nursing about the notion ofprofessors and their scholarly endeavours’’ (p.123) however, my position shall be somewhat crit-ical of theirs.

This certainly is not the first time that Thompsonand Watson (2006) have had something to say con-cerning nursing in the university (Thompson andWatson, 2005, 2004, 2003, 2001; Watson andThompson, 2005, 2004, 2003). However, it is thefirst time that they have been absurd about it. Ofcourse to say that they are absurd is not to say thatthey are wrong. To be sure the university is, asReadings (1996) put it, ‘‘in ruins’’. A consumer ori-ented corporate institution far more concernedwith accounting than accountability (Giroux andGiroux, 2004).

Moreover, ‘‘the nursing professoriate has a caseto answer to’’ (Thompson and Watson, 2006, p.125) and it is likely that the ruined university theycurrently inhabit, or perhaps mis-inhabit (if I maymis-use a word to make a point), is what allowsthem to avoid having to ‘‘answer to’’. The ‘‘ship’’is indeed sinking. Yet despite this inevitable fact, ahost of individuals calling themselves nursing pro-fessors will have made a decent living and lookback on careers in which they will claim to have at-tained, or come awfully close to, excellence. Yetfew will have even bothered to examine Readings(1996) critique of the university of excellence

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‘‘. . . excellence has the singular advantage of beingentirely meaningless. . .’’ (p. 22). ‘‘[It]. . . functionsto allow the University to understand itself solely interm of the structure of corporate administra-tion’’. (p. 29).

So where do Thompson and Watson get absurd.Quite frankly it is in their pipedream. What nursingscholarship does not need is some nostalgic returnto ‘‘Enlightenment’’. That ship sunk long ago andmoreover lamenting this is nothing more than anexercise in Habermasian pipedreams.

We have to recognize that the ‘‘University is aruined institution, while thinking what it meansto dwell in those ruins without recourse to roman-tic nostalgia. . . the task that faces us. . . [is] the taskof rethinking the categories that have governedintellectual life for over two hundred years’’.(Readings, 1996, p. 169).

Thompson and Watson (2006) are right to claimthat ‘‘we panicked and gave away tasks which wethought were beneath us and turned our attentionto bettering ourselves by being like other profes-sions’’. (p. 125). In particular the profession wewant to emulate is medicine, that problematiccrowning achievement of Western Weltanschau-ung, which has, as Porter (1998) claimed, ‘‘becomethe prisoner of its success’’ (p. 717). In ‘‘takingstock of what nursing is’’ then I shall attempt to ar-gue, all too briefly, the seemingly outrageous the-sis that nursing does not exist.

To say that nursing does not exist is not, ofcourse, to say that nurses do not exist. However tolabel a group of heterogeneous individuals engagedin a diversity of tasks with a significant variety ofagendas nurses and then claim that what they are

ed.

244 Guest editorial

all doing is nursing leads to a problematic conclu-sion, if not an aporia of sorts. Even Nightingale(1859) recognized this difficulty ‘‘I use the wordnursing for want of a better. It has been limited tosignify little more than the administration of medi-cines and the application of poultices’’. (p. 6).

This does not mean that we cannot define nurs-ing, rather it means that we, nurse intellectuals Isuppose, might not be comfortable with the defini-tion that is apparent. I submit that a rather simpleempirical study would settle the matter. Nurses arethose individuals who carry out the explicit or im-plicit will of physicians. This is to say that nursesare those individuals who realize through diverseactions, tasks, procedures, psycho-motor skillsthe directives, however removed, of bio-medicaldecision making. Again this is perhaps not the def-inition that most nurse scholars want, however – ifthe empirical shoe fits. . .

Yet if we eschew such an empirical fact, it isperfectly reasonable to suggest that nursing schol-arship, like postmodernism or critical theory, issimply not one thing at all, hence no-thing in-it-self. Moreover any attempt to examine or speakof nursing in a unified manner is finally incoherent.Certainly there are those who harbour the intellec-tual dream of unity, or perhaps at the very leastcoherent foundation ‘‘Contemporary healthcare is-sues demand that nurses know who they are andwhat they are about, how to identify and actualizetheir societal mission, and how to communicate itto others.’’ (Cody and Mitchell, 2002, p. 4).

A host of Human Becoming theorists would Ithink seriously object to the pipedream ofThompson and Watson. And though I cannot be cer-tain, I think that Thompson and Watson would justas seriously object to Simultaneity. Hence what wehave is a conflict and as an unavoidable result – wehave a relationship, a condition that Graff (1992)would see as productive, or perhaps constructive‘‘. . . culture itself is a debate, not a monologue’’.(p. 8). Or put more ontologically ‘‘the genesis ofthe human mind is. . . not ‘monological,’ not some-thing each accomplishes on his or her own, but dia-logical’’. (Taylor, 1991, p. 33).

Thorne (2005) recently claimed that ‘‘despitetwo or three generations of scholarship, the rela-tionship between the practice of nursing and theconceptual knowledge that is supposed to drive itremains ambiguous and confusing’’. (p. 107). Sheis of course quite correct regarding the ambiguousand confusing part. However, in implying that thisis a bad thing, she could not be more wrong. Thisassertion will no doubt appear rather ridiculous tomost, but this is only because we, of the latemodern era are deeply uncomfortable with ambi-

guity and confusion. After all how can we – Homoengineericus as it were – measure, manipulate andcontrol what is ambiguous and confusing to us? Thiscontemporary predicament is none other than thecrisis of modernity itself. Such a state human af-fairs is the direct result of the ambiguity andconfusion regarding the nature of truth and knowl-edge that has demarcated the postmodern era. It isperhaps characterized by a single word – Relativ-ism, a concept that no serious thinker is entirelycomfortable with yet at the same time one whichhas become increasing difficult to deny.

Latour is particularly germane to my purposehere. By turns both subtle and profound he man-ages to move philosophically from absolute relativ-ism to relationism:

Nothing is, by itself, either reducible or irreducibleto anything else. Never by itself, but alwaysthrough the mediation of another. . . If the questionof relativism is insoluble, relativist relativism – or,to put it more elegantly, relationism – presents nodifficulty in principle. . . Relationism will serve as anorganon for. . . negotiations over the relative uni-versals that we are groping to construct (Latour,1994, p. 114).

Such negotiations are the future of nursingscholarship. And certainly not a return to some lostenlightenment project or indeed some Star Treklike ‘‘mission. . . [of] ‘fundamental inquiry into theunknown’’. (Thompson and Watson, 2006, 125). Infact I confess that I have no idea just what ‘‘funda-mental’’ means here, though it does sound excit-ing, again in a Star Trek way. Concerning thefundament of inquiry into the unknown we simplyhave to ask – whose unknown? Columbus sailedinto the unknown and found a New World, whichdid not bode well for its Old Inhabitants.

With Caring, or perhaps Connolly’s (1999) criti-cal responsiveness ‘‘. . . where tolerance impliesbenevolence toward others amid stability of our-selves, critical responsiveness involves active workon our current identities in order to modify theterms of relation between us and them’’ (p. 62)as a founding principle and relatedness as an ontol-ogy of sorts, I propose then that we no longer usethe term nursing. Thus rather than being a profes-sor of nursing and finding it so hard to answer theimportant question that Thompson and Watsonhave put to us, we ought to claim that we are pro-fessors of Nursism. Although in many respects thelast thing the world needs is another ism, at leastthis way we can have both a tradition of thoughtand a multiplicity of interpretation within it. Atthe very least when I am asked what it is that Ido I shall have to argue, dialogism if you will, a

Guest editorial 245

point rather then simply offer up some terminolog-ical referent as a tidy and obvious explanation, analibi as Readings (1996) refers to it. Then, likethose who might call themselves postmodernistsor critical theorists we are no longer beholden toa notion of one thing yet can continue to do impor-tant, and yes intellectual, work. We can continueto do something without doing only one thing andindeed we do not have to pretend that what weknow, our legitimating principle, is some ‘‘credi-ble research base’’ that does not actually exist(at least with any kind of credible unity to it).

Perhaps I can now answer the question thatThompson and Watson have thoughtfully offeredup. I am a Professor of Nursism which is essentiallyno-thing itself, unlike medicine, psychology, soci-ology and what not, but as I do my work, thinking– or rethinking as it were – the nature of relation-ships and relatedness, I do tend to avail myselffrom time to time of the ‘‘credible research base’’that each discipline believes itself to have. More-over, I am certainly free to be critical of them, in-deed as an intellectual one might suggest that Ihave an obligation to be critical.

Acknowledgements

The author thanks to the Editor Karen Holland forgoing well beyond what one expects of an editor,as well as Professors Olive Wahoush and CharlotteNoesgaard of the McMaster University School ofNursing for helpful comments on an earlier draft.

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Connolly, W., 1999. Why I am not a Secularist. University ofMinnesota Press, Minneapolis.

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Clinton E. BettsSchool of Nursing, Faculty of Health Sciences,McMaster University, 1200 Main Street West,

Hamilton, Ont., Canada L8N 3Z5Tel.: +1 905 525 9140x22036

E-mail address: bettsc@mcmaster.ca