THE TRUTH OF THE MATTER
When I was an undergraduate student at the University of Hawaii (UH) in the early 1960s, one of the lessons that were imprinted on us was the importance of believing the patient, of understanding that the patient's perceptions were that person's truth. Our curriculum was modeled after that of the University of California Los Angeles (UCLA)—a program led by the great Lulu Wolf Hassenplug. The UCLA faculty and students at the time included key figures who would become leaders in the development of nursing knowledge—Dorothy Johnson, Sister Callista Roy, and Betty Neuman.1 My senior medical-surgical instructor, Noreen Meinhart, had just completed her master's degree in nursing at the UCLA, along with her close friend and classmate Afaf Meleis. In the UH curriculum, consistent with the emerging ideas of the UCLA faculty, the principles of psychiatric/mental health nursing were integrated throughout each and every course—both didactic and clinical—and so the message of understanding, and believing, the patient's perspective was thoroughly engrained in our thinking. At the same time, we were taught, and expected to apply in practice, certain scientific facts and theories—those principles underlying the best of nursing practice as presented in our main text—the Principles and Practices of Nursing by Bertha Harmer and Virginia Henderson.2 We acquired the ability to balance a respect for the person's own perceptions and truth, while at the same time bringing to the situation our understanding and appreciation of scientific facts and theories. We learned, in essence, the distinction between “truth” and “fact,” and how to assess the validity of each.
Understanding the complex realm of truth was especially meaningful to me, having grown up in the midst of multiethnic children where perceptions of the world—what is right, good, proper, or acceptable—often differed vastly from the norms of my white, southern parents. From an early age, I observed the contradictions between the norms of my parents and those of the local people we were living among. I learned to “fit in” to at least 3 or 4 different worlds, realizing that some things were OK and “right” in some contexts, but not in others. I was not exactly confused about the differences, but it was only as a nursing student that I began to understand the critical “truth” that more than one truth can exist at the same time, arising from different contexts and circumstances—differences that are vitally important to health and well-being for individuals, and for the communities in which we live.
Much later, as I grappled with various philosophic perspectives on the nature of truth, these early “lessons” began to take on even more significance. I had learned early in life to appreciate and tolerate ambiguity and complexity, even welcome it. But I was always aware of even my own tendencies to seek certainty, for relatively simple models and constructions to help make sense of the world. These tensions are not yet fully understood, nor have we, as a society or a discipline, developed widely acknowledged and practiced approaches for constructive ways to integrate and appreciate the wide diversities of experience that are now acknowledged as never before.
In our current social context in which there is an unrelenting assault on “truth” and “science” and “facts,” I have thought a lot about these ideas that have formed a thread in my nursing career, and tensions involved in making sense of an increasingly complex world in which competing, divergent, even opposing ideas can and do coexist. It is no wonder that there are those who “blame” universities for confounding the ultimate claims on “truth.” I can appreciate those who are utterly frustrated with the world as it is now—the overwhelming challenge of figuring out what to trust and what not to trust in the overwhelming onslaught of information, the imperative to deal with technology in ways never before imagined, the desire for an imagined past that was simpler, more certain, more comprehensible.
For those of us who are engaged in the project of developing nursing knowledge, we must grapple with ways to heal the fractures that have created the challenges of our times if we are to make a lasting and significant contribution to health and healing. The articles in this issue of Advances in Nursing Science (ANS) make such contributions—addressing threats to health and well-being created by the complexities of the times in which we now live. We welcome your comments and insights. We feature each article on the ANS Journal blog (https://ansjournalblog.com/), and hope you will follow the blog and participate with your comments.
—Peggy L. Chinn, PhD, RN, FAAN
2. Harmer B, Henderson V. Textbook of the Principles and Practice of Nursing. New York, NY: The Macmillan Co; 1960.