- learn about the conceptual framework Hodges' model. A tool that can help integrate HEALTH and SOCIAL CARE, INFORMATICS and EDUCATION. The model is situated, facilitates person-centredness, integrated - holistic care and reflective practice. A new site using Drupal is an ongoing aim - the creation of a reflective workbench. Email: h2cmng @ yahoo.co.uk Welcome

Saturday, June 01, 2013

Review: Philosophical And Theoretical Perspectives For Advanced Nursing Practice

If you are a miner for insight, a pearl diver for knowledge or seeking blue sky wisdom this book can deliver and sign-post in plenty through its references. In summary: this book is a history book that nods at futurology.

I had high expectations for the text, also anticipating an exacting read. After all, as a 5th edition this is a well established text. The expectations were not wholly realized, however; many of the papers are quite dated being published originally in the 1990s.

The book is an important collection and can certainly be regarded as essential reading for advanced nursing practitioners and those pursuing post-graduate nursing studies. Several chapters hail from the same journal publisher and perhaps - as a positive - this contributes to the readable and accessible style throughout the book. The text format and size are also easy to read. I found one spelling mistake within the index entry for 'diagnosis' p.387. In addition to the historical development in part 1 the book's division into five parts - 31 chapters in total - acknowledges the reliance on the past and from it appears from a previous edition the arrival of the 21st century. Apart from the current date of issue 2013 I cannot accurately place the most recent additions to the volume. The contents listing and preface are limited in this respect. Judging from the references they are not that recent. 2010 is one of the most recent references I could find, and this, the 75ed of Toby & Mariner.

Many of the papers are seminal and include an overview of particular aspects of nursing thought - analysis and synthesis. Unsurprisingly, there is philosophy and ethics in great abundance, together with ecocentricism, several forms of feminism, aboriginal peoples and their world views, evidence, health, beliefs, art, professionalism, research, patterns, advanced practice, theory and much more. The distinction between evidence based theory and evidence based practice is something of which all nurse students should be aware.

There is specific reference to Advanced Nursing Practitioners. There could obviously be some variation in how this professional group are considered as opposed to Advanced Nursing Practice. Having just returned from Belfast and the University of Ulster there is ongoing currency in McCormack's chapter 17 A Conceptual Framework for Person Centered Practice with Older People. While dated 2003 McCormack's work was emphasized at a recent conference in Ulster I was able to attend (and there are plans for another). I am sure other chapters may be enlivened by such reviewer found co-incidences as this.

I wonder if the scope of the book and acknowledgement of the passing of time seems to shout for a two-volumed approach. As suggested above, the previous acknowledgement of the future seems to have hailed from the 20th century and got lost. We are now after all more than a 1/10 of the way into the 21st century.

Having started my nursing career in the RN, chapter 22 on military metaphor in nursing and the need for another. A researcher contacted me several years ago about using Hodges' model (a conceptual framework) in a study on bullying in nursing. I've never heard anything since, but Hodges' can help in such research in two respects. The inclusion of a political domain and the organization of groups of people, emphasizes process, procedure, protocol, routine, and may proceed to regimentation, discipline, hierarchy so to a degree language games will follow. As this chapter notes, several professions, including nursing are said to eat their young. A commentary after the chapter provides a useful balance and makes this point. The chapter is nonetheless a reminder of the role of language and how professionalism arises and is sustained (disciplines too?). The proposal of frontier as a new metaphor is fitting as Hodges' model identifies five conceptual fronts - frontiers that must be integrated. 

As a frontier - Chapter 21 on rapture and suffering with technology in nursing holds many lessons and insights. Heidegger's "standing reserve", the human-technology interface, what it means to live like a human being and the distinction of being a human being. Mobile technology, m-health, e-health are making a huge contribution to global health and need a place here. I found Macurdy's four principles 326-327 on what patients need to assume power and control over their care very illuminating, especially in highlighting information access and the importance of health literacy.

In the text and the index I could not find specific reference to capacity, as in mental capacity, informatics, global health, information (access), justice, law, legal, management, human rights, literacy, mental, political, psych-, long-term medical conditions and recovery. While the book would become incoherent if a disease/diagnosis-based approach was adopted, we might ask: does dementia deserve specific inclusion? This is an interesting (and potentially vociferous) debate in itself - to what extent should such a book record change through several decades? Of course the book is not an encyclopedia and it is easy to critique according to omission. These are pressing times demographically, however; while there is a population focus: global communities and aboriginal communities in chapter 23 and 24, this merely scratches the surface of very large world.

This book is a valuable asset and has stimulated many ideas here (and potential blog posts). I am very pleased to have read it and would recommend it to students and practitioners alike. I am grateful to the publishers for the review copy.

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