ABSTRACT
In this chapter, Peter McDonnell critiques recent shifts in nursing practices, from a practical person-oriented form to an elitist academic form, currently accepted by nurse leaders as the only legitimate form of nursing. However, arguing that this form fails to meet the everyday hands-on needs of nurses and patients, he proposes a new model of nursing and nurse education called ‘total nursing’, premised on a close relationship between academic and practice-based knowledge. Drawing on evidence relating to external and internal influences, and from historical factors in nursing history, he argues that this practical form would support a new progressive nursing qualification, enabling nurses to develop frontline healing-oriented skills while simultaneously developing theoretical professional knowledge. Demonstrating the ability to nurse patients would become the basis of selection, while the responsibility of nurse educators would be to support nurses’ learning rather than offer a table d'hôte menu. Programmes dedicated to facilitating progression of nursing knowledge in more specialised and complex areas would ensure that the practice of nursing remains relevant to and focused on the needs of patients; supporting also the development of practical knowledge for less-experienced colleagues. This approach challenges the present system that sees nursing and care as separate entities. Nurses could develop themselves as specialists and academics, confident that they have met the essential life needs of the patient. This approach would attract people interested in fulfilling the role of nursing, while reaching a level at which they were happy to work, knowing they were always contributing meaningfully to patient wellbeing.
