Discipline of Nursing. Michel Nadot
term, to take care of the life of the estate, the Domus, the house, the hospital, that is, of the living environment of care, of the languages required and of the first spaces of speech. Apart from this kind of representative alienation of women from domestic and free work, which is very present at the beginning of institutional care, it already requires some spatio-temporal skills to understand the organization required for a collective household to function.
History is the mother of all human sciences, Michel Foucault told us [FOU 66]. This is an important statement for the nursing discipline. Nursing is concerned with the human being, and therefore belongs to the human sciences. Are today’s doctors of the nursing sciences aware of this? Now, the history of our language traditions is part of the first research to be carried out in order to imagine an identity for our discipline. “It is indeed more important for a discipline to determine the identity of its knowledge than to question the identity of the people who refer to it” [NAD 12a]. One does not become a nurse before using knowledge of the same nature as the proclaimed identity. History clearly shows that the title “nurse” is a myth for lay people [NAD 12b]. It came into being before the conceptualization of knowledge took shape or before the “nursing metaparadigm” and its theories became known. At a time when charitable and welfare institutions are growing and common sense is mixing their values or ideologies at the end of the 18th Century, it is important to rediscover according to which values and in which space of origin the activity of those who today are seeking a scientific identity to give to their own discipline began. In the French-speaking tradition, in the first half of the 20th Century, people began to call themselves “nurses” after having been given an identity imposed by doctors. This was in reference to a Franco-Catholic model of care (nuns), but before having been able to give a name to the discipline and conceptualize theoretical conceptual models in nursing or care theories.
It is the weight of the past that makes the invention of the future possible, it is said. This statement by the French historian Fernand Braudel highlights the fact that history brings to individuals the substance of their consciousness. Without history, individuals are condemned to follow the system of the moment. Not always giving the right place to historical knowledge in a training program, especially for nurses, or not evaluating the knowledge acquired in the field, also allows leaders (in our case, in the health field) or other disciplines to better instrument the values and ideologies of a field. When nurses seen as cheaply trained labor are sometimes manipulated, for example solely on the basis of health costs or socio-economic needs, they cannot fail to assert themselves in the name of their language traditions, convince politicians of their actions, form a scientific identity or participate in the critique of reason. If we are not careful, one day, for economic reasons, we will end up replacing nurses with their assistants. “The concept of identity thus refers both to the permanence of the social means of recognition and to the capacity of the subject to give lasting meaning to his or her experience” [SAI 85].
History also avoids the alienation of future generations and avoids the production of “efficient consumer workers and beings without memory, without identity, without roots” [BUG 04]. History participates in the construction of professional identity. But since we have been talking about it, what can it be used for? As Rocher points out, “professional identity is this essential condition for the maturity of the personality, it allows the harmonious social functioning of a person in his environment, as well as the cohesion of groups” [ROC 68]. It is nevertheless preferable for the harmonious social functioning of interdisciplinary work4, for example, to know the origins, contents and logic of action of the discipline we represent!
“The teaching of history also gives, whether premeditated or not, nourishment to what is and will be the work of the memory of those who follow us” [MON 93]. The function of memory represented by the saying to know where we are going, is to know (and accept) where we come from “is not to celebrate the office of the past, but to help us imagine the future” [MON 93]. It is therefore incumbent on nursing educators to update the collective memory of their own discipline. It is also the role of universities, particularly nursing faculties, to promote basic nursing research. While it is interesting to discover what the language traditions of caring are made of ethnographically, we must also accept a past that was not necessarily glorious or spectacular in the secular era or in the Ancien Régime according to the representations in use.
Initial nursing training today is increasingly being given in academic settings, particularly in English-speaking countries. This is why the term “discipline” appears. In the French-speaking community, there are also nursing faculties (Canada, Lebanon) and high schools (Switzerland, Belgium). As SIDIIEF (Secrétariat international des infirmières et infirmiers de l’espace francophone) stated in 2011: “The pursuit of graduate studies in nursing is fundamental to ensure the training of competent teachers capable of guaranteeing quality initial training as well as the training of clinical nurse specialists and the training of researchers. The development of nursing research remains an essential condition for the renewal of care practices and the evolution of knowledge” [SID 11]. But how can nursing faculty researchers produce new knowledge to develop their discipline if they ignore the language traditions inherited from the past and the ancient knowledge on which it is based?
NOTE.– Nursing researchers rarely refer to their language traditions, which, according to the philosophy, “represent the most important source of knowledge, both qualitative and quantitative” [POP 85]. New knowledge is often knowledge that modifies or enriches previous knowledge.
While language traditions thus play a primordial role in the constitution of knowledge, it is normal that this tradition be rediscovered (history of knowledge), maintained and updated to serve as a basis for subsequent knowledge produced by scientific research. These language traditions, whose importance Popper emphasized, are precisely those statements and those units of discourse that allow specific phenomena related to the action of caregiving in the field of discourse to emerge in the long term. These traditions, which, as we have seen [NAD 12a], are passed on by caregivers from generation to generation, are also mainly units that should be considered:
By what right they can claim a domain that specifies them in space and a continuity that individualizes them in time; according to what laws they are formed; on the basis of what discursive events they are divided; and if finally they are not, in their accepted and quasi-institutional indivisibility of duality, the surface effect of more consistent units. [FOU 69]
It is from this questioning that the history of the discipline known as “nursing” can access its statements. It is in fact a matter of finding the original statements:
How far and how often they are repeated, through what channels they are disseminated, in what groups they circulate; what general horizon they draw for men’s thinking, what limits they impose on it; and how, in characterizing an epoch, they make it possible to distinguish it from others. [FOU 69]
Certainly, historical research for the nursing discipline has little influence on day-to-day nursing practice, as noted above. However, it remains a necessity if only to teach students about the history of their own discipline. This has long been a seemingly normal procedure at university where, depending on the discipline taught, we can find the history of psychology, the history of medicine, the history of sociology or the history of education sciences, to name but a few. This logic is much less obvious within the nursing discipline where history when taught (!) often takes on hybrid, redundant, stereotyped, laudatory and even hagiographic aspects. But why should we be surprised? Moreover, what place do history courses have in the training programs? On a purely informative basis and without claiming to draw any comparison whatsoever, we find that between 1980 and 2009, for example, “the history of nursing” represented between 6 and 16 hours of teaching in the nursing course at the Fribourg University of Health (Switzerland). It also represented about 24 hours of teaching (foundations of the nursing discipline) and 4 credits in the master’s degree program in nursing research in 2016 at the Faculty of Nursing of the Saint-Joseph University in Beirut (Lebanon). It is also 15 hours of “history of the profession” courses that were registered in the curriculum of the schools of nursing run by Quebec hospitals in 1960 [COH 00] and between 2 hours (!) and 8 hours