Tag Archives: ideology

Reconsidering the "art of nursing" through the lens of health promotion

Florrie (& you know who I mean), in 1893, proposed that there are two kinds of nursing. One  is “the art of nursing the sick. We shall call that art nursing proper” and the other kind, health nursing, was not so much a priority in her tented world at that time. I came across this idea as i was critiquing our notions of health promotion and it’s  basis in the 17th century liberal ideologies of individual responsibility, itself based upon the assumptions that individualism, rationalism and egoism are  good. The health promotion movement, built on  public health and health education work, really began in the USA in the 1940s and Maslow’s theory of ‘self actualisation’ (1943) really entrenched the notions of the individual responsibility as a member of society  and the demand to overcome lower level needs and achieve, achieve, achieve. Talcott Parson’s classic sick role theory in 1951 emphasised this individual responsibility by outline the rights and responsibilities of the sick person. Since then health promotion models have been built on these basic assumptions within a bio-medical paradigm. Health promotion tends to make claims; one that HP (as an entity) knows what constitutes health behaviour ;and two, HP knows the best way to go about it. This sits, as a separate practice to sick nursing. Health promotion is becoming/is a separate discipline.
However, if we reconsider the notion of health nursing as part and parcel of clinical practice – an approach rather than a discrete task, it may shift the idea that HP is something else and separate to being about the way that we practice not what we do. I think of  HP as being a component of every therapeutic interaction as it is related to how we practice not what we practice. I think that we do/can/maybe could do more practice through the lens of HP.
I guess what I am also saying is that the models of HP and the world, national and local programmes (macro, meso and micro levels of interventions) are only one part of the picture. Health nursing as a holsitic, relational, collaborative and situational approach to nursing where priorities, interventions and understandings are worked through together with the participant everyday rather than a more top down approach dominated by health care professionals, focused on disease and something seperate.