What is Nursing Science?

Recently, I was attending a leadership meeting at Washington DC. There were intense discussions about recent development across the nation such as changes at the National Institute of Health (NIH), shifts in state policies, and other significant updates. Within the current sociopolitical contexts, one of the important questions that the leaders discussed was "what is nursing science?" In 1960s, 1970s, and 1980s, there were great discussions on ontological and epistemological questions on nursing.1 Then, over time, we have taken the existence of nursing science for granted, and unlike in the past, we rarely discuss foundational questions on nursing science – except occasionally in PhD classes. With the upcoming possible changes at National Institute of Nursing Research (NINR), nursing leaders began to worry about the existence of nursing science. Our early generation of researchers challenged and advanced nursing research and established NINR within NIH,2 and celebrated the victory of nursing science as the fruition of our own efforts to advance nursing science. The official reason for the establishment of NINR within the NIH shows a little bit different story though. According to the NINR website,2 NINR was established because of two landmarking reports: (a) a 1983 report by the Institute of Medicine (the former National Academy of Medicine) that strongly proposed to include nursing research in biomedical and behavioral science, and (b) a 1984 report by the National Institute of Health (NIH) Task Force on nursing research activities that are relevant to the NIH mission. Subsequently in 1986, the National Center for Nursing Research (NCNR; a former NINR) was established first within NIH according to Public Law 99-158, the Health Research Extension Act of 1985. Then, in 1993, NINR was established based on NCNR and elevated to an NIH institute with the signing of the NIH Revitalization Act. As I understand, the establishment was based on strong acceptance and understanding of what nursing science is and why nursing research needs to be supported. However, with the current wave of both expected and unexpected changes sweeping across the national research enterprise, the question that we need to ask at this time is not if we need NINR, but rather, what nursing science is. As I previously mentioned in a previous editorial,3 in a PhD theory and philosophy class that I taught for the first year PhD students, one of the PhD students posed a thought-provoking question: what is nursing perspective and what is nursing science within the current contexts of interdisciplinary collaborative research environments. The student was a student with a bachelor degree in a different field but sought to be a nurse with a PhD. I invited her to co-author a literature review paper exploring "what a nursing perspective is." Although she eventually withdrew from the work, it was interesting experience to me because I had never expected encountering such a fundamental question about the existence of nursing perspective and nursing science in a nursing PhD class. At that time, since they were PhD students in nursing science, I just assumed that they would not have a question on the existence of nursing perspective and nursing science. Dr. Peggy Chinn also shared similar experience related to nursing theory, in the Nursology blog at https://nursology.net/2019/07/09/what-makes-a-theory-or-model-nursing/. The reality is harsh though. Not only in the classrooms, but also in local, national, and international interdisciplinary conferences, grant review meetings, and university meetings, I frequently met the same question over and over again. Especially with increasingly blurred boundaries among different health disciplines, this question has frequently been raised not only by outsiders, but also by insiders. Even within Schools of Nursing, I frequently face this question while collaborating with non-nurse faculty. Even at national and international meetings of professional nursing organizations, the same question has been asked. Are we able to answer this question with clarity and confidence or are we even questioning to ourselves? Our research landscape continues to evolve, and the uniqueness of nursing science may be complicated by all interdisciplinary works that involve interprofessional teams of researchers. Amid shifting healthcare environments and sociopolitical dynamics, it may be the time for nursing scholars to re-raise ontological and epistemological questions on nursing. Maybe, the re-visit would help clarify what nursing science is in this changing landscape of interdisciplinary healthcare and sociopolitical environments. We may need to go back to our old fundamental ontological and epistemological questions and critically re-define what we have long taken for granted. How is nursing science different from other health sciences? What is nursing science in this ever-changing interdisciplinary environment? —Eun-Ok Im, PhD, MPH, RN, CNS, FAAN Editor