This is the group of fabulous students Professor White and I worked with at the Shanghai JiaoTong University. They are all Post graduate students undertaking research projects of various kinds. They are motivated, keen and a joy to work with. We have taken two workshops in addition to our undergraduate cancer nursing sessions. The latter has taught me the skill of brevity. I have found it difficult to tailor the content to undergrad levels and quantity and fear that i have lost the students for much of my lectures. Although – I have used a critical population of about 6 students around the room to watch carefully for nods of agreement and/or understanding. I have two sessions today, two tomorrow and then home. Much as I love travel, it has been a long 9 days. Shanghai is a vibrant cosmopolitan mix of ancient and modern and I also wish I had more time to explore.
I hope that this programme is able to continue and that the links we have developed grow strong – but it these are very difficult to assess here.
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.