KNOWING AND DOING
“Copper Woman warned Hai Nai Yu that the world would change and times might come when Knowing would not be the same as Doing. And she told her that Trying would always be very important.”1(p53)
We are all familiar with persistent voices decrying the various and sundry gaps that exist between the realms of theory and practice (also called, for us, the education v practice gap). Indeed, those of us who have walked in both the worlds of academia and service have experienced very real and distressing senses of “other worldness” as we pass back and forth from one world to the other. Yet we continue to hear pleas for someone to bridge these gaps, and wish for some magic formula that might make it possible for one world to better inform the other.
As nurses we are particularly vulnerable to an unrelenting sense of disparity between what we know and what we do. We know we would be stronger as a profession if we were unified with each other and with other health care providers, but we are not unified. We know we would be able to provide a high quality of care if we were free to practice nursing as we envision it to be, but we do not and cannot practice in these ways. We know we would better serve society if we focused our practice on health and developed greater knowledge about health, but we practice in an illness care system, not a health care system.
When we attempt to sort out the underlying issues and dynamics of these disparities, we experience clouded vision. We are confronted with circumstances and factors we would rather not see, that do not fit with our experience of ourselves and the world. We find contradictions, extremely complex situations, and a multitude of internal and external voices screaming dilemmas we already know too well. In the face of what seems to be an impossible challenge, I believe that there are brave steps that we can all take toward healing the perceived gaps. There is no single path, and some of the paths that we attempt may turn in a direction we would not intend. But it is vitally important that we begin to take the steps, as the authors in this issue of ANS demonstrate.
One step is to no longer accept the notion that we are doomed to experience fundamental gaps between what we know and what we do, and to begin to act and think in a way that reflects our desire to more fully express unity between our theory and our practice. We can begin to act in accord with our ideas about the way nursing should be, with firm conviction that what we think and what we do are vitally important. We can increase our conviction that what we think and what we experience are related, by thinking systematically about what we experience and consciously forming our experiences in light of our fundamental ideas about the world. We can give voice to our doubts and our questions about the ways that things are and listen attentively to the voices of others, especially those who are doubting, questioning, angry, or aggrieved. We can begin to discuss, with nurses from all walks of life, all areas of work, all levels of preparation, how we might move beyond our doubts and questions and anger, to create something that will make a difference. We can begin to believe, and act on the belief, that what we think and what we do can, indeed, make some difference in the structures that exert control over our lives.
Another step is to recognize that as we express unity in our knowing and doing, we will begin to enter dimensions of experience that have been previously unfamiliar. We will recognize paradoxes in our own thinking and in the thinking of other nurses that we wish did not exist. With recognition will emerge vision of how to move beyond the paradoxes. Bunch2 has named one of these the “too hard/too easy” paradox. Some nurses assume that theory must be esoteric and far removed from daily life, if it is to be properly called theory. It must be too hard for most people to understand if it is to be taken seriously in the academic community. On the flip side, as Bunch notes, some of us want all theory to be easy—to have words that do not require a dictionary, to be able to be read rapidly and easily, if it is to be of any use. Both of these attitudes represent barriers to serious consideration of ways to move beyond the disparities between what we know and what we do. If we recognize that reading and writing theory is not easy but can be done, and theory can be comprehensible to all nurses, then we will begin to experience both theory and practice in ways that we cannot imagine in advance.
Healing what we experience as the theory-practice split in nursing cannot be left to someone else to do. As each of us, regardless of our work orientation, begins to heal the splits within our own thinking and in our own actions, we will begin to see movements toward unity that we all yearn for.
Peggy L. Chinn PhD, FAAN
1. Cameron A: Daughters of Copper Woman.
Vancouver, British Columbia, Press Gang Publishers, 1981. Told from the stories of the native women of Vancouver Island.
2. Bunch C: Passionate Politics: Feminist Theory in Action.
New York, St. Martin's Press, 1987.