ii Seeds in 'architecture'

There is something seductive in architecture, the imagination of ideas on paper, the promise of the cornerstone, the reality of the construction, the space it grasps and the space it bestows.

Arriving at Younés paper, the history and reference to Valéry's Eupalinos ou l'architecte, Socrates and Phaedrus had me captured. 

Healthcare is dialogue. Spoken and unspoken. Discourse. Dialectic. Perspective: One : Shared : (the) Many.

What is said, gestured, and unsaid. Valéry's dialogue sounds worthy of follow-up, appreciating Plato and this form of theatre and learning. There is a latent architect in us all. Patiency too - but not yet - let us build first. Every day and night we construct (hopefully). When necessary we know when to disassemble, de-construct, to initiate change.

Reading Younés I can readily relate the paper to nursing, Hodges' model, and healthcare generally. The paper's three main questions concern (of course) architectural theory:

1. the causal relation between building and theory;
2. the necessary mental conditions that precede theory;
3. a definition of theory in its scope, discourse, and nature.
   

There are many points of note (reading my yellow highlighter) here. 

'Reflection precedes realization, but theory does not necessarily precede practice'. p.234.

'Theory however, is a systemic elaboration that operates based on definitions and concepts, in the sense that definitions build concepts, and concepts in turn build a theory, but not the reverse of the sequence.'

'Theory, then, comes 'late', only because it is the synthesis of a content that was already present'. It is constructed after a prolonged reflection over many experiences, based on common, comparative, or contrasting sets of criteria.

Younés focus is specific the development of theory in architecture, but as he writes: 'there is some element of reflection which can be termed the building's efficient cause' p.234. I wonder about Nursing Theory and the nurse's theory based on the person - in-person: reflection of care, assessed, planned, delivered, evaluated and recorded. There are nurses still preoccupied with Q.1, even if the (primary) focus is within academia(?).

Q.2 seems an invitation for philosophy (as per the journal's title!). Being non-judgemental, if not starting to build nursing Theory, then especially for the nurse co-constructing, co-designing a theory of care with the patient/family. Hodges' model is not just a series of set squares, facilitating design; it is an empty set. Never completely empty, due to the structure. A structure that contradicts. A structure paradoxical as it constrains and releases, records and forgets.

Q.3? Did someone call - continuity? Yes, (and how!) we can carry on from Q.2. Scope - yes. See the space? Listen to all the dimensions. Reduced to those that count, in discourse and nature, by nature.

Person-centred? New patient. RESET. Re-build - but remember humanistically.

See also:

Seeds in 'architecture' i

Seeds in 'architecture' iii

Younés, Samir. “Constructing Architectural Theory.” Philosophy 78, no. 304 (2003): 233–53. http://www.jstor.org/stable/3752046.

 

What Hodges' model is not - prescriptive

Even though models of nursing (health and social care?) are not exactly flavour of the month at present, if they were then Hodges' model could avoid getting involved in the interminable debates that often surrounds this or that model. As per a previous post therapies, models and computing languages can have much in common with legions of supporters - champions who may have a great deal invested professionally and personally.

Hodges' model is neutral in this respect: it is not prescriptive. It does not dictate the particular approach (problem-based, solution focused, person-centred, family partnership, psychosocial, developmental, educational, recovery, self-care, citizen-centred...), but obviously wherever Hodges' model is used the values expected of the professional must follow. Hodges' model provides a very high level, generic arena with potential applications across home, all clinical, social care and pastoral settings, other work places, communities, businesses, governments, high schools, colleges, prisons and for the more adventurous the space station and beyond. This may suggest that Hodges' model is in some way 'above' other models, looking down as they fight it out in their disciplinary enclosures below; but this is far from it. All the tools we use must to subjected to debate, research and critique.

So wherever you are physically and wherever the (care) situation leads you cognitively (within and between one or more care domains) Hodges' model can be utilised. This freedom, this diversity of application does not come free. Allied with our values using Hodges' model requires work and effort. We can obtain an appreciation of the task and the work involved when we consider Hodges' model in terms of user interface design and progressive disclosure - to follow.

Original image source: http://www.medicinescomplete.com/mc/bnf/current/images/diamorphine_prescription.gif