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Why nursing research?

Anniversary Feature: Each 2008 issue of the Journal of Neuroscience Nursing includes an anniversary feature in which we celebrate the vision, determination, and challenges that have marked 4 decades of neuroscience nursing practice and publishing excellence. We will highlight our past and begin to envision our future as we examine the changes we have witnessed.

In the first course of my master's degree program, my professor started the class with a question: "What is the value of nursing research?" Students answered slowly, because they had not given much thought to such a question. The overall thoughts they expressed included the idea that although research is useful and relevant at the university level, students need practical advice regarding clinical practice. Also, most students stated that they did not have much time to read research journals. The consensus was that most nursing research took place in an "ivory tower" and was not at the top of the list when practicing nurses met to discuss their daily practices. If we took a poll of the entire nursing profession today, would the answer to that question be different in any way? Why did these nurses seeking a graduate degree find such little value in nursing research? What about research had "turned them off"? Perhaps more to the point, what had not been done to "turn them on" to it?

Nursing is a profession, and as in other professions, we set standards based on shared knowledge and understandings. One basic understanding involves what a nurse does. In a seminal article in the American Journal of Nursing, Virginia Henderson (1964) defined the function of a nurse. She said that the role of a nurse "is to assist the individual, sick or well, in the performance of those activities contributing to health or the recovery of health" (Henderson, 1964, p. 63). In the more than 40 years since this definition was written, it has been elaborated and refined, yet it remains valid today. But as they work with a growing and changing patient population in today's rapidly changing environment, how do nurses identify "those activities contributing to health or the recovery of health"? Also, as the patient population and environments change, how will nurses know what activities will be conducive to health care in the future when new challenges, unknown today, will arise? The answer to these two questions is "research."

Research leads to the discovery of knowledge. Random House Webster's Unabridged Dictionary (Random House, 2001) defines research as "a diligent and systematic inquiry or investigation into a subject in order to discover or revise facts, theories, applications, etc." Nursing research has been practiced for many years. Florence Nightingale was one of the earliest nurse researchers. Through systematic investigation and compilation of statistical evidence, she came to the conclusion that nursing actions dramatically reduced the death rate among wounded British soldiers during the Crimean War in the mid-1800s. Her painstaking observation, recording of results, and analysis were necessary in the male-dominated wartime milieu, when skeptics discounted the effect of nursing (a mostly female activity). These individuals could not argue with the demonstrated results that nursing was the reason that death rates declined (Kopf, 1977).

Research is necessary to inform practice. Nightingale found solid reasons for what her nurses did, and nurses today need the same. Consider the following examples of current nursing research found in the Journal of Neuroscience Nursing (JNN). Nursing researchers are changing practice regarding the effects of nursing care on fever management and the effect of oral care upon ventilator-associated pneumonia. Other research has demonstrated the problems that stroke caregivers face and the challenges caused by epilepsy, along with possible nursing interventions. Nurses have led the way regarding self-management for most chronic illnesses, including epilepsy, multiple sclerosis, and Parkinson disease. Our colleagues are performing bench research to discover better pain management. Also, our neuroscience nurse researchers are working to find new knowledge and test interventions based on what they have found. These are just a few examples of the many innovative nursing questions that are being answered by research.

However, the work does not end with research; that is only where it starts. If we as a profession have no method of identifying and using the results of research that apply to our specialties, then research really does remain in an ivory tower. Nursing research must be translated and applied to nursing practice. Whose responsibility is it to perform this work? Nurses who engage in research must keep its relevance in mind. They should take some responsibility for translating their results into a form that is applicable to practice and disseminating results in venues such as JNN. Performing research and sharing the results, though, must not be a top-down process. This research model leads to the perception of a disconnect between researcher and practitioner, and the ivory tower starts to appear on the horizon.

Practicing nurses must be sure that the interventions they use are based on solid evidence. Through continuing education, practicing nurses can become aware of the research on which their activities are based. Not all nursing research is performed in academia. Nurses can collect and share evidence of methods of practical, effective, and efficient care and measure outcomes of their activities. The definition of research is broad enough to include not only the researcher and the narrow focus of investigation but also individuals who will be likely to use the results. It is the responsibility of all nurses to be researchers; this is the hallmark of a profession.

References

Henderson, V. (1964). The nature of nursing. American Journal of Nursing, 64(8), 62-68.

Kopf, E. W. (1977). Florence Nightingale as statistician. In E. W. Kopf (Ed.), Studies in the history of statistics and probability. New York: Macmillan.

Random House (Ed.). (2001). Random House Webster's unabridged dictionary (2nd ed.). New York: Author.

Questions or comments about this article may be directed to Janice Buelow, PhD RN, at jbuelow@iupui.edu. She is an associate professor at the Indiana University School of Nursing, Indianapolis, IN. She also is a member of the Journal of Neuroscience Nursing Editorial Board.
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Title Annotation:Then & Now
Author:Buelow, Janice
Publication:Journal of Neuroscience Nursing
Geographic Code:1USA
Date:Aug 1, 2008
Words:1015
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