Oxygen therapy and patient management

NURSING

TEACHING as if the FUTURE MATTERS"

NANCY JOHNSTON, ET AL.

In this article, Nancy Johnston, Martha Rogers, Nadine Cross and Anne Sochan, all part of the faculty in the School of Nursing at York University in Toronto, Canada, pose a rather interesting question, one which at first does not seem to have anything to do with the profession of nursing -- "Is the human race making progress or (are) we simply hastening our demise?" The authors then follow this up by asking "Can we as citizens afford to avoid this question?" A reference to some people who believe asking such a thing is unhelpful "as it may lead to pessimistic conclusions" concerning the future of the human race upon planet Earth (2005, pg. 152). Obviously, being concerned about the future of humans on this planet is not a pessimistic topic, especially when we consider the role that professional nurses and other health officials will inevitably play in the long run. Thus, the authors of this article offer a very comprehensive plan related to teaching future nurses about national and international health policies and the global and planetary dimensions of health via a new teaching course called Nursing in the Global Context (2005, pg. 152-53).

This proposed teaching course, instead of focusing upon epistemological issues (questions of knowing), will devote itself to ontological questions "that speak to our understanding of reality, meaning and being" and will be based on the following five main premises. First, the overall health of an individual "cannot be understood apart from the environment" that sustains him/her, nor can it be understood without considering "the social and political structures that act to either promote it or undermine it." Second, a nurse must come to realize that poverty, disease, war and environmental destruction "know no national boundaries," due to the rapid expansion of global trade, travel, the Internet and other forms of electronic communication between peoples from diverse backgrounds and cultures (2005, pg. 153).

Third, every choice which a person makes in the present will somehow affect future generations; thus, "ethical decision-making requires responding to present needs" so as not to diminish the quality of life for future generations. Fourth, in order for all nursing students to possess personal concerns about the future of the human race on this planet, they must be shown that learning "must engage not only the mind, but also the heart and soul," and lastly, all nursing students and especially those who currently work in various health professions must come to understand "the meaning of health in a global context" (2005, pg. 153).

The authors then proceed to discuss in-depth a number of topics related to the above premises. First of all, they pose another question -- "What is most important of all?" In reference to suggesting that this question is "fundamental to any exploration of human existence" and to our planetary survival. As one might suspect, the answer is very simple and straightforward -- "it is the continued existence and flourishing of human civilization" which is of the greatest importance, along with global stability, freedom from war and violence, gender equality and the sustainability of the global environment (2005, pg. 153).

Secondly, the authors ask "How well are we doing?" when it comes to considering "whether the on-going existence of human civilization can be assumed," meaning that one would automatically assume that man's existence on this planet will not come to an abrupt end as a result of nuclear war or some type of devastating communicable disease. From a nursing standpoint, the authors point out that such a continued existence cannot be assumed any longer, due to "the effects of population growth, environmental degradation and social inequality" related to obtaining health care. In essence, the authors are forcing all nursing students and those who practice nursing today to understand that because of overblown "materialistic values, environmental sustainability, technology, clashes between societies" and global conflicts, the role of nurses has changed drastically, thus requiring some type of instruction on these and other topics (2005, pg. 153).

In addition, the authors maintain that nursing students of today and in the near future must extend their empathy "from a relatively passive, cognitive level to one of active, affective engagement" which in the end will result in engendered caring and move "the consideration of global conflict and war into a personal, relational context" (2005, pg. 154). One important way to accomplish this goal in relation to a classroom setting would be to compose a personal narrative on the events of September 11, 2001, when the World Trade Center was destroyed by an alleged terrorist organization, being Al Queda. Hopefully, as a result of writing this narrative, nursing students will come to realize "the fragility of life, the precarious nature of world peace and the desire to resolve conflicts" in ways never considered before (2005, pg. 154).

Thus, by creating a personal, empathic view of the world, nursing students will be able to "deepen their appreciation for the interconnectedness of all life on the planet and for the nature of health as a complex phenomenon," one made increasingly complicated by advances in technology and the continuing destruction of natural habitats in which people are forced to live on a daily basis, often without nutritional food, clean water and access to professional health care (2005, pg. 154).

The authors then sum up quite effectively their arguments pertaining to creating a new type of classroom experience for all present and future nurses. When this article was published in 2005, the authors had apparently already made some evaluations about their proposed course, for they include a number of comments from potential students. For example, one of the potential students remarks that she was "encouraged to go beyond in nursing, to see further, care deeper" as a result of participating in a group that evaluated the overall course curriculum and its teaching methodologies. Another student responded that "I found myself questioning world events and how they affect global health" which gave her "a broader perspective on the world and the issues" that affect health care, both in today's world and in the future (2005, pgs. 155-56).