interactions related to health and health care.

Philosophies of the postmodern,

critical social theory, and feminist traditions continue to evolve and stimulate

new ideas for research methodology and criteria for evaluating the quality and

range of application for research results.

Work remains, however, to explore ideas of postmodernism and the methodologies

consistent with these ideas in a context of contemporary science.

Prevailing notions of quality and what constitutes science still tend to be consistent

with a positivist or logical positivist philosophy. To date, considerable

effort has been devoted to articulating standards for evaluating the quality of

inquiry in postmodern traditions (Guba & Lincoln, 1989; Hall & Stevens, 1991;

Rolfe, 2006), and the rules associated with such work represent a vast departure

from traditional notions of science. Reconciling these disparate viewpoints

is important so that the merit of each viewpoint is appreciated and the

potential usefulness understood. This is an area in which continuing work can

develop a cohesive body of nursing knowledge and have that knowledge valued

across an array of situations and contexts.

EMERGING TRENDS IN NURSING SCIENCE

The prior examination of developments and trends in the evolution of nursing

science provides a glimpse into the progress made in the discipline and

attempts to provide a solid foundation for nursing knowledge. Numerous

approaches to knowledge relevant to nursing practice have been entertained

within the discipline; some were taken as prescriptions for nursing thought,

whereas others offered what was considered to be a closer fit with nursing as

it currently exists. While the variety of philosophical approaches and methodologies

appears appealing simply because of the diversity of perspectives

offered, the plethora of philosophies also places some demands on the nurse

in an advanced practice role.

One option for dealing with the myriad approaches that can be appealing

to any nurse is to adopt a pluralistic view, or something similar to an anything

goes attitude. Each era in nursing history has contributed to the development

of the discipline of nursing through development of the knowledge base and,

concomitantly, a stronger identity for nursing. In addition, each viewpoint has

some merits, just as each has limitations. So why not selectively apply pieces of

these traditions, if not the whole tradition, when addressing a problem relevant

to nursing? Noted Austrian philosopher Feyerabend (1975) specifically supported

an approach allowing for maximum creativity and innovation in the process of

knowledge development. Numerous authors in nursing have taken such a position

as well, by suggesting that there should be a variety of methods and perspectives

from which nurses can choose whatever is appropriate to guide their research

or practice (Baker, Norton, Young, & Ward, 1998; Coward, 1990; Schultz, 1987). be addressed. The DNP-
prepared nurse also has sufficient knowledge of processes

of inquiry, as well as an understanding of the discipline of nursing, both

of which help to ensure that attempts to expand the knowledge base are properly

conducted and are relevant to the discipline.

Other developments in nursing have helped to bring some focus and direction

to knowledge development in the discipline. During the 1980s and 1990s,

a series of conferences was held in the northeastern United States, alternately

sponsored by schools of nursing at the University of Rhode Island and

at Boston College. These conferences served as a vital forum for discussion of

ideas about science and knowledge development relevant to the discipline of

nursing. After this period of sharing and development, it became apparent to

the conference organizers that the next appropriate step would be the development

of a consensus statement reflecting crucial areas of agreement about

nursing as a discipline. The purpose of the Knowledge Consensus Conference

in Boston in 1998 was for the 40 participants “to discuss and synthesize various

perspectives on knowledge development related to (1) the nature of the

human person, (2) the nature of nursing, (3) the role of nursing theory, and

(4) the links of each of these understandings to nursing practice” (Consensus

Statement on Emerging Nursing Knowledge, 1999, p. 1). The document that

resulted from this effort, the Consensus Statement on Emerging Nursing

Knowledge, serves as a reminder of an important event in the recent history

of nursing and reflects the values and knowledge that are embedded in the discipline,

as well as the practice, of nursing.

The consensus statement exemplifies the values and perspectives that

underlie the discipline of nursing. It is not necessary to have a specific document

that dictates what nursing is or should be, or what nurses in practice or

research should be doing relative to the developing knowledge base. What this

manifesto does provide, however, is a statement of important values and perspectives

that may provide some cohesiveness among nurses, a reminder of the

lens through which nurses see the world and the recipients of their care. A variety

of philosophical traditions, modes of inquiry, and research methods may be

used to solve epistemic problems in nursing. Keeping in mind the key assumptions

and values embedded in the discipline allows plurality in approaches to

knowledge development while still supporting a sense of unity in the discipline

and the knowledge that underlies the work of nurses.

THE FUTURE OF NURSING KNOWLEDGE DEVELOPMENT

Predicting the future is an onerous—if not absurd—task. Current trends do

lead to future developments, yet precisely how that occurs and which changes

may take place along the way are difficult, if not impossible, to predict with