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Foreword

Nurses are searching for what characterizes the nursing discipline or the nursing sciences. Publications as well as conferences have been held around the world with the aim of specifying the purpose of the discipline. However, there is no consensus on the subject. What is nursing knowledge made of? What are the foundations of the discipline, what is its purpose and what is its scientific identity?

This book by Michel Nadot provides concrete answers to the questions raised. Nadot proposes an epistemological analysis of the three phases of nursing knowledge in a unique way by following a historical chronology. Drawing on his long experience as a writer, he is keen to present the traditions of our languages and their influences on knowledge and, consequently, on the nursing discipline. Through his research as a philosopher and nurse, he proposes an innovative schematization of nursing knowledge and takes up his conceptual model in nursing sciences (health mediology) conceived through his empirical research as an alternative to the name “nursing sciences”.

This book entitled The Discipline of Nursing – Three-time Knowledge is Michel Nadot’s masterpiece, which is composed of three main parts. This volume focuses on the foundations of the discipline, a subject little discussed in Europe and the Middle East. His style of writing, the structure of the text and the illustrations provided, followed by proposals for the development of the discipline, add to the maturity of this book, which is reflected in the pleasure of an enjoyable reading, reinforced by the “image feedback” and a summary of the key ideas at the end of each part.

Nadot’s involvement in his work is that of a nurse who is both a historian and a philosopher at the same time, who tries to demonstrate in his book that the nursing discipline was built up chronologically in three stages: lay knowledge, which was documented as early as the 14th Century, protodisciplinary knowledge as early as the middle of the 19th Century, and finally scientific knowledge as early as the last third of the 20th Century.

In the first chapter of his book, Nadot argues that caring or caregiving is a three-dimensional field that gives rise to the first languages from traditions and by extracting experience and nursing practice. The basic triptych of the nursing discipline has its origins in lay knowledge: Domus (care environment)–Familia (family)–Hominem (person), and is at the center of a three-dimensional field of competences “Domus–Familia–Hominem”, which, according to Nadot, constitutes the foundation of the nursing discipline on which new knowledge and new roles will be superimposed.

Then, in the second part of his work, appears protodisciplinary knowledge. During this period, two distinct training models proposed by two great women marked the formalization of nursing knowledge. The first model was developed in Switzerland thanks to Valérie de Gasparin, discovered by Michel Nadot, who created the “school-hospital¹” training model, and the second in England with Florence Nightingale, known throughout the world and who in turn created the “hospital-school²” training model. These two training models have influenced many schools around the world.

In the third chapter of his book, Nadot shows through his multiple publications that the nursing discipline was born implicitly with reference to the medical sciences; however, it is, in fact, situated in the humanities. He insists by saying that in the game of science, scientists are the only people to produce knowledge in order to obtain recognition, including recognition of the discipline in question. In this scientific part of knowledge, Nadot situates himself as an epistemologist, who aims to understand the origin of nursing sciences and the world in which the knowledge of the nursing discipline and its problematic identity develops.

According to Nadot, it seems that clinical research is more developed at the expense of basic nursing research. This is due, according to him, to the valorization of the practical side of the profession at the expense of nursing theory and research.

However, Nadot adds that nurses’ access to university has provided access to scientific language and methods, as well as to research and epistemological thinking, which constitute a pillar of recognition for the nursing discipline. It is therefore incumbent on nurses, researchers and university professors to take responsibility for the direction of our discipline, because the profession is in crisis and does not seem to be able to rely on legislation or its theorists to get out of it. According to Nadot, only basic research, which has long been absent from nursing faculties, will be able to do a conceptual and historical clean-up, revise our linguistic codes and produce knowledge specific to our discipline. This will create a paradigm shift that will allow disciplinary identity to be enhanced.

Several factors will contribute to this conceptual clean-up. According to Nadot, the fact of being part of a reflexive science, or rather I would say a “reflexive practitioner” attitude, of taking a distance, having a critical look to examine the existing knowledge, not only at the individual level but also at the collective level, from experience, from the historical roots of our profession, as well as through the destructuring and restructuring of our traditions, allows us to better propagate and value nursing knowledge. Hence, the role of universities to train nursing students who are not only called upon to acquire specific knowledge and know-how, but also who must prepare themselves to have a reflexive attitude and research, analysis and questioning skills in order to bring about the emergence of a disciplinary “green knowledge”. This “green knowledge” is demonstrated in this book.

Nadot’s book proposes a very original schematization of the aggregation of knowledge where disciplinary “green knowledge” forms the core of practical knowledge and is immersed in a cultural environment represented by institutional culture, healthcare culture and medical culture. According to Nadot, it should not be denied that the knowledge emanating from these three cultures is developing in such a way that it gradually comes to the moor, and masks the “green ball” at the origin of fundamental knowledge. Hence, the problem of disciplinary visibility that only basic research on the elements of the discipline, namely the environment (Domus), care, health and the individual/family (Familia/Hominem), enriches nursing knowledge. It is a matter of proving that nursing is not only a collection of knowledge borrowed from other disciplines, particularly medicine and humanities, but also that it has a distinct identity. Thus, the schematization would be more harmonious by constructing a knowledge that places the human being at the center and in continuous interaction with a changing healthcare environment.

In this book, Nadot sheds light on several factors, highlighting that our nursing science has not reached the same level compared to other existing sciences. According to him, it is a question of the female status of the profession, and the evolution of this status in our societies at different rates of development of scientific research. However, for a discipline to develop, it must be neutral, exclusive of gender, consistent and must reflect the world it came from. For Karl Popper [POP 85], for example, a discipline can only claim the status of a scientific discipline if it produces falsifiable statements, that is, statements that are capable, in the form of testable hypotheses, of being subjected to the test of experimentation.

Nadot’s book is one of the European reference works that calls on the reflexivity of nursing researchers, teachers, managers and theorists from North America, Europe, Africa and the Middle East to formulate, based on their theories and scientific statements, hypotheses that are supposed to be subjected to experimentation with the aim of attaining a consensual construction of a scientific status for the nursing discipline in the 21st Century. Let us thus take advantage of the globalization of nursing knowledge to develop a disciplinary identity that takes into account the influence of the demographic, political, economic, scientific, social, regulatory, cultural and technological environment of a constantly changing healthcare environment.

This is what makes this book innovative, a true disciplinary revolution, a call for a major paradigmatic change or better, a real conceptual clean-up to come. It calls for the construction of a clear status for the discipline, a distinct professional identity and a scientific discipline that only increases the credibility of the nursing profession, as well as the confidence of other healthcare professionals and, above all, of all the beneficiaries of the services provided by nurses in response to ever-increasing healthcare needs.

Finally, I conclude with Bachelard [BAC 83] who said that nothing is selfevident. Nothing is given, everything is built. This is the case with this book. So let us demystify and overcome the nursing myth that we currently know and build together the nursing sciences of the 21st Century!

Rima SASSINE KAZAN

Dean of the Faculty of Nursing

Saint-Joseph University of Beirut, Lebanon

August 2020

1 1 Where the hospital depends on the school on a geographical, administrative and financial basis.

2 2 An opposing model to the previous, where the school depends on the hospital on a geographical, administrative and financial basis.