Importance of nursing and paramedical research
Bringing new knowledge into the nursing and other paramedical care fields will clearly be an advantage if this knowledge is put into practice. A certain amount of work in this respect is necessary (evidence-based nursing) to demonstrate that this is effective and profitability must also be measured.
Research into wider fields where nurses play a prominent role may contribute to improving health, the quality of life, women’s health, health in certain high risk communities, end of life, disease prevention, the quality of life at work, etc.
Nursing research is important, not only because it improves knowledge in the nursing practice field but also because it contributes to the improvement of health in society: it concerns patients and those around them as well as the various ethnic and cultural communities, whether small or large scale.
Research helps to improve the working conditions of the nurses themselves. Nursing research helps to shape the identity of the profession by drawing up specific knowledge. In this respect, only nurses can produce their own science, a science at the crossroads of living sciences and human sciences.
France lagging behind
A project for the nursing profession
The nursing profession has always felt the need to formalise its practical knowledge. With the transition from a charitable activity to a professional activity, the handing down of knowledge from generation to generation has been replaced by formal theoretical and practical teaching. This was not easy in a field where knowledge was in the form of an oral tradition. The knowledge had to be formalised before it could be taught. In 1900, A Hamilton put forward the concept that there was a nursing savoir-faire that was different from medical savoir-faire. It was nearly 50 years later that action was taken and the movement towards scientifically-based nursing began.
The special role of the nursing profession in the health field, therefore, needed to be formalised. The nursing code confirms that research can play a useful role in society. This features in the regulations governing nursing practices, in the initial and post diploma national training programmes as well as in the missions of the health establishments and training structures.
The creation, in 1965, of the École Internationale d’enseignement infirmier supérieur (EIEIS – Higher International nurses training college) in Lyon was part of this approach aiming to establish nursing as a discipline in the health field. Until it closed in 1995, the EIEIS developed specific nursing knowledge based on nursing sciences and drawing on associated disciplines (anthropology, sociology, etc).
The first research conference was organised in France in 1971.
From 1982 to 1988, nursing advisors within the Health Ministry attempted to develop nursing research. Work began on producing a glossary of French terms relating to nursing care, leading to the publication of a nursing care dictionary.
The Association de Recherche en Soins Infirmiers (ARSI – Nursing Care Research Association) was set up in 1985. This played an important role in promoting research in France. The work of the EIEIS also contributed to this development.
In 1991 the CNRS launched an initiative to describe and promote the development of nursing care research. This had no effect on funding and the position accorded to nursing care research in the academic field.
There have been individual initiatives regarding other paramedical professions that were laudable, even extraordinary, but often not visible.
Comment
Despite these efforts, the French scientific nursing community has difficulty in establishing its identity. It also lacks the essential characteristics to accomplish its missions.
French nurses have difficulty in defining clearly the purpose and limits of the discipline to which they belong. This situation does not make it easy to identify the social value of nursing research and the knowledge it produces in the health field.
The relative self-sufficiency of the French nursing community is another obstacle. The prevalence of English-speaking countries in the scientific community makes English the language usually used for research in the discipline. French nurses only have a compartmentalised view of the concepts, theories and research methodologies in the discipline. Their selection is random, often depending on whether a French translation is available. This is not without consequences. Works on nursing research do not take account of existing knowledge and theory on the subject and instead draw on associated disciplines.
Furthermore, nurses who carry out research as part of their training or professional activity only too often break off their research before publication. If results are not published, the scientific community cannot assess them or continue to perfect them. They cannot be used in practice.
The non university character of the nurses training does not make it easy to remove these obstacles. Nurses are kept too far away from the infrastructure, resources and acquisition of standard models that are essential for the development of a fruitful scientific community able to produce knowledge.
Nearly 650,000 paramedics, thousands of persons treated in hospitals or by general practitioners and millions of treatments are concerned by this research. Research therefore has an essential role to play.
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