Like Roger (as he outlined last week) I grew up in the 1960’s UK and was entranced by the promise of science to improve our world and the human condition. My interest was sparked after I was confronted with the response of “there are some things you should not ask, and just need to accept” to my questions at my local Church of England primary school. I soon found that science and textbooks could explain a lot of those questions I wanted answers to, and even if they couldn’t answer everything, they proposed a way we could at least try and find out. A childhood of an interest in anything scientific followed. It was really the age of popular science with moon landings,  supersonic passenger flight, new anti-malarial drugs  and transplant surgery all suggesting a brave new world awaited.

Unfortunately, as with many children who enter secondary education, the disinterested science teachers at my secondary school (high school) soon dented my earlier zeal. That and growing up in the violent 1970’s Bristol suburbs of Margaret Thatcher’s England made me reappraise my hopes for science and technology to change the world for the better. As the social problems, riots and unemployment  became local experiences, it looked like a dystopian future was on the cards. It seemed to me that the social sciences offered new approaches to explaining social phenomena and more likely to yield a brighter future. Therefore,  I choose to follow an art’s degree in Human Geography and after that entered the world of professional healthcare with a career in nursing.

At this point you make ask, why on earth are they writing about their childhood experiences and careers, who cares? Well the purpose of these apparently self-indulgent ramblings is that in setting up this new blog we felt it was important to put our cards on the table, and be open about our origins in the age of popular science, and acknowledge that indeed our own positions are as value laden as anyone else’s.

Anyhow, it wasn’t until fifteen years later that my interest in science and technology was really fired up again, as I became enthralled with the potential of computers to help act as a catalyst for social and educational change. This led to my undertaking a PhD in Information Science which further renewed my interest in science as a practical way of understanding and improving the world. At the end of this I was faced with a decision, whether to stay in the field of nursing, or move into information science. I thought long and hard about this, and decided that I could probably do more useful work in nursing and particularly in the application of information and communications technologies in nursing education. In any case in my nursing experience in the UK there had always been a good balance between scientific approaches to challenge some of the more extreme forms of new age postmodernism.

So when I moved to Canada in 2003 to take up a faculty position here at the University of British Columbia, I was surprised to find that postmodern epistemologies were the mainstay of nursing academia, and work that didn’t fit within a relativist ideological stance was definitely in the minority. You can probably judge that by the popularity of this blog; we probably have ultimate “science nerd” status as last time I checked we had three followers, and one of those was my daughter, and I suspect another may be my cat.

Postmodernism appears to have made much more significant inroads into nursing in North America. A couple of leading exponents of this in my field are Rosemary Rizzo Parse and Jean Watson, who have achieved almost cult like status in their followings with their mystical approaches to health and nursing.

For example if we look at Parse’s work with her “human becoming” school of thought outlined in the book Man-living-health (Parse, 1981) and later developed in her more influential work Illuminations: the human becoming theory in practice and research (Parse, 1995), they espouse a radical postmodern interpretation of nursing and human health which although presented as “human science” do not incorporate any form of empirical scientific methodology.

Parse’s theory of human-becoming is very difficult to interpret, but fundamentally rests on mystical notions of human beings becoming at one “with the universe” and nursing practice “illuminating meaning though, explication, synchronizing rhythms through dwelling with mobilizing transcendence through moving beyond.” The three areas identified as central to the human-becoming approach are meaning, rhythmicity, and cotranscendence. Meaning refers to individualized and personal meanings (as experienced by the individual), rhythmicity refers to patterns of relating (i.e. communicating and establishing relationships with other people), and co-transcendance is a recursive term (i.e. is self-referring), symbolizing reaching out beyond oneself. It is said to refer to, “cotranscending multidimensionality with unfolding possibilities” (Parse, 1992). The actual meaning here is open to a wide variety of interpretation, but Parse’s work is certainly consistent with postmodern pluralism, and reflects Nicklas Luhmann’s  (1927-1998) predilection for recursive statements.

Combining opposites to reference mutually exclusive forms in one is actually the ancient Zen principle of Satori, the Zen Buddhist idea of disclosing a new understanding hitherto unperceived in the confusion of the dualistically trained mind (Suzuki, 1996).  Lucidly stated, the means opposites and contradictions are united and harmonized into a consistent organic whole that must be experienced to be understood (i.e. cannot be understood through analysis alone). Strangely any reference to these origins in Parse’s work, seems absent, although to be fair I am not familiar with all of it.

I could go on with other examples from Jean Watson, and Martha Rogers work (amongst others) but clearly the focus of these works is ontological, representing  mystical relativist epistemologies of the divine, and bearing absolutely no relationship to empirical science. In fact to be frank, to claim so is rather disingenuous, and using complex etymological  forms to obfuscate, turning nouns into verbs (a curiously American pastime) and fabricating words does not actually make for a new science, but certainly represents an alternative to it.

In short these frameworks are pseudo-science as they claim to have a scientific heritage, and yet demonstrate none of the characteristics of scientific enquiry. E.g. hypothetico-deductive methods, theory generation through inductive and abductive reasoning, falsifiable hypotheses (even within a general group of falsifiable theoretical beliefs), repeatability and generalizability. Even an openness to peer review and challenge seems absent, as by their very nature relativist philosophical positions are unassailable in their terms (as everything is possible).

Interestingly I note both Parse and Watson have also developed their own publishing media (Watson’s Caring Science Library (under Springer) and Parse’s Nursing Science Quarterly, (under Sage), and websites that promote almost guru like personality status. One could certainly claim others in the science gliteratti are also doing this (such as Richard Dawkins), and I wouldn’t disagree, but at least they are more widely engaged in scientific literature, and open debate. But where are the challenges to postmodern nursing? Apart from a few brave souls who have put their heads above the parapit, there is an alarming absence of argument against these positions in the literature. If they are true to their form shouldn’t we also see Derridian deconstructions of postmodern nursing theories, after all there is plenty of scope to explore post-colonial, northern global, feminist-theological, Christian right, new age mystical and complimentary and alternative medicine agendas as underlying these perspectives.

Like Roger, I found myself in a position of debating whether I should jump in and join the postmodern posse or should I re-engage in the scientific community and join the evidence based practice camp. I did seriously consider the former. I thought of an intriguing postmodern position on how the nature of reality and health can be found in the songs of Elvis Presley, and if we adopt a Blue Suede Sciencing approach and accept the “stepping-non-stepping-on” nature of the human condition we will revolutionize nursing and health care. Ludicrous as this seems it actually represents a valid alternative postmodern narrative interpretation of health and nursing. But then the madness subsided, and I thought where are the outcomes, where is the academic discrimination, where are the negative studies? Everything in the postmodern garden is rosy it seems, but as Tom Hank’s once noted that we learn a lot more from getting our butt kicked than from having it kissed! Attempting a study, failing and refining our ideas is an important part of science, but it requires taking a fundamental position to start with.

Roger is right, and this new age holistic nonsense is not for me either. We need a science that questions itself and its own foundations, takes a position (accepting it may be flawed) and where publishing both positive and negative results are a part of the process. Nursing is about practical care, and how we can minimize human suffering. For example, a new mother wants advice from health care professionals to help her know what are the requirements for infant sleep, best practices for getting her baby to sleep and getting some sleep herself. If she wanted advice on the meaning of sleep and nature of her being she would likely  join a philosophy class.

My seven year old self had enough sense to figure that out, and I should listen to him.

And so, there you have it, the raison d’etre for this blog.

Onwards,

Bernie

P.S. Actually since the close of the last century it seems postmodernism is old hat. We are now witnessing a new epoch of post-postmodern thought arising, with the advent of mass communications and social media, globalization and a rejection of victimary thinking. Nursing needs to catch up, but more on that later…

References

Parse, R. R. (1981). Man-living-health: A theory of nursing. New York, NY: Wiley.

Parse, R. R. (1992). Human becoming: Parse’s theory of nursing Rosemarie Rizzo Parse. Nursing Science Quarterly, 5(35)

Parse, R. R. (1995). Illuminations: The human becoming theory in practice and research. Sudbury, Mass.: Jones and Bartlett Publishers.

Suzuki, D. T., & Barrett, W. E. (1996). Zen Buddhism: Selected writings of D. T. Suzuki. New York: Image Books, Doubleday.

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