Academic journal article Creative Nursing

Kaleidoscopes of Reality

Academic journal article Creative Nursing

Kaleidoscopes of Reality

Article excerpt

This article addresses the broad context of shifting definitions of how knowledge and reality can be described, including the transition from positivism to postpositivism in the 20th century. It provides an exploration of ways of knowing, from ancient Greek and yogic traditions to Barbara Carper's Fundamental Patterns of Knowing in Nursing (1978). It examines three reported components of modern care (intuition, cultural knowing, and spirituality) which are simultaneously present and absent in nursing. It concludes with an imaginative exploration of how nursing might be changed by transdisciplinary scholarship and education, new knowledge creation through interactive online communities, and the emergence of collective wisdom.

Keywords: ways of knowing; postpositivism; Carper; intuition; cultural knowing; spiritual care; transdisciplinary

One of Albert Einstein's famous thought experiments, the elevator experiment, demonstrates the complexities of understanding observable knowledge. A man inside an elevator that is not moving might assume that the force holding him to the floor is gravity. However, if the elevator were moving through space, the pull on his body would actually be caused by acceleration of an equal force. See the University of California, Los Angeles (UCLA) Physics and Astronomy Department's great video about this on YouTube (UCLA, 2013).

In another thought experiment, if two people in a box are observing a light (one observing from a static position and one moving), they may observe two different realities-one light or two lights (Bassett & Edney, 2002). Which observer's description of reality is correct? In this case, both people are right, within their frame of reference-their way of knowing. Both of these experiments demonstrate that a shift in perspective can m ake reality assume a new pattern, as in a kaleidoscope. This background is relevant to ways of knowing in nursing for two reasons.

First, nursing education and practice in the 20th century focused primarily on rational, logical, positivistic methods of diagnosis and care. The scientific method, itself a way of knowing, seeks consistent results-thus the emphasis on evidence-based care. However, in addition to Einstein's thought experiments, new theories and findings began to challenge positivism: The Observer Effect (Studying behavior can influence subjects to change their behavior, and measuring physical properties can change those properties), Heisenberg's Uncertainty Principle (Photons have both wave and particle properties depending on how they are being observed), and Chaos Theory (Predictability is rare, and occurs only when complexity is filtered out; Gamow, 1966).

These and other advances in thought contributed to the emergence of postpositivism, in which objective reality exists but can only be described in imperfect or probabilistic terms. This enlarged view of reality, along with the acceptance of phenomenological research, supported the development of integrative and holistic nursing and gave nurses permission to explore other ways of knowing. In this regard, nursing embodies a paradigm shift in science, a revolution in knowing (Kuhn, 1962).

Secondly, although nursing had been defined primarily by positivism, by mid-century, courageous nurses began public exploration of the nonrational knowledge found in nurses' intuition, care for culturally diverse patients, and spirituality: Leininger's work in transcultural nursing (Murphy, 2006), Benner's seminal research on the use of intuition by expert nurses (Benner & Tanner, 1987), and Rew and Barrow's (1987) review of intuition's use in nursing, as well as a resurgent interest in spiritual care (Burkhardt, 1989; Goldberg, 1998; Rew, 1989). In each case, interest in these topics was sustained by small groups of devoted nurses who published journal articles and conducted relevant research. Their leadership provided a foundation for applied postpositivism in 21st century nursing. …

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