The answer to the question "what is the focus of the discipline of nursing?" depends on who is being asked and their perceptions, values and assessment. I surveyed a patient, a practicing nurse, and a private citizen to glean their perceptions and compare them with my own thoughts in light of recently learning about a host of theoretical models in the nursing literature. Further, I have attempted to reflect upon how theory contributes to the discipline of nursing in light of my personal and professional experiences and recent course readings.

As an associate degree prepared nurse educated in the mid 1970's, I was exposed to very little theory in my nursing school courses. I did learn a lot of concepts, and integrated concepts about how best to assess, plan, and deliver care as part of the core courses. In essence, class time was spent reviewing body systems, disease processes, nursing interventions, assessments, how to communicate findings, both in written and verbal form. It seemed as if everyone in the class had an intuitive kernel of nursing knowledge and a caring heart in their temperament to begin with, almost as if those characteristics were part of the admission requirements!

That inherent nursing sense, knowledge and intuition we collectively brought to our nursing school needed to be polished and organized in a formal way through the nursing curriculum to differentiate us from the basic role of "attendant," and acquire the credentials needed to perform "higher" nursing functions such as medication, administration, charting, delegation, and a host of organizational tasks. I can appreciate that nurses today, working without a strong theoretical or spiritual framework- or the ability to articulate just what value nurses bring to the clinical setting- are almost an endangered species.

The focus of the nursing discipline as perceived by a patient is this: A strong theoretical framework is an immunization for practicing nurses to protect their domain, their careers and continue to provide stellar care for patients and families. I feel very strongly about this, and in hindsight believe that had I had a stronger command of the theoretical framework for the profession of nursing, I would have been a stronger advocate during a recent "re-engineering" effort at my workplace.

Essentially, an engineering firm with a Taylorian style approach was brought in to cut costs. The unskilled, two dimensional observers of nursing care report what they can perceive about nursing "care," namely that nursing is a series of tasks. Those "tasks" can be performed by lesser skilled, lower paid persons, and save the "system" money. The flaw with this thinking is that much of what professional nurses do occurs on multiple levels: to the inexperienced eye, a nurse may appear to be "giving a bath" or "making a bed" or "walking a patient." But in reality, that nurse is processing multiple layers of information, performing the "task" while also doing therapeutic interventions such as listening, observing skin tone, muscle tone, physiological response to medications, assessing mentation, observing the relationship between the patient and their family, counting respirations, or comforting by one's mere presence.

The discipline of nursing is broad and diverse, with a myriad of activities, functions, roles and outcomes. The focus of the discipline of nursing essentially is to help people.

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