to Mary G.
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The Evolution of Nursing Science and Practice: Historical Opportunities and Challenges Many historical challenges have influenced the evolution of nursing science and practice related to society, academic legitimacy and professional boundaries. One of the most significant challenges was establishing nursing as its own science, rather than simply an extension of medicine. Doubt about the independence as an academic and scientific field presided in the nursing field until recently, given that the knowledge of this professional discipline was historically considered to have been borrowed from other disciplines and fields, specifically from the biomedical and social sciences. The positivist influence was prevalent in the mid-20th century, where the emphasis on theory development and empirical validation bred a rigid “hard science” perspective along a continuum of the optimization of society through the provision of services, where humanistic and social aspects of nursing practice were diminished (Da Silva & Wynn, 2025). This caused a tension between the desirable standardization of scientific method used to deliver care and the holistic, individualized care which is the essence of nursing.
Furthermore, highlighting the relevance of feminist theory to nursing science is crucial, since it matched the core values of nursing science which consisted of advocacy, care, and social justice. But, feminist-driven changes encountered political and gender biases and were resisted, which further delayed the full recognition of nursing as a legitimate science (Mendívil, Choperena, & Salas, 2025). This was further compounded by the postmodern turn in nursing theory that criticized traditional paradigms and encouraged qualitative research and patient-centered narratives, which some scholars and critics believed lacked the scientific basis. This has long been one of the major divides in nursing between those favoring the production of objective knowledge and those calling for a more subjective epistemology and continues to be a key challenge to the discipline.
The other fundamental problem towards transform of nursing practice has been the restriction of independency and acknowledgement of nurse practitioners in the healthcare setups. Nursing used to be considered a step down from medicine, with nurses as caretakers under the orders of physicians, not independent practitioners. This limited their participation in the formation of healthcare policy and evidence-based practices specific to concerns important in nursing. The emergence of advanced practice nursing and higher education for nurses, especially the DNP, has improved the role of nurses as innovators in healthcare, but we still have a significant pathway to go when it comes to fully realize this potential. According to Finnegan et al. (2025, p.), it’s hard to align nursing competencies, education standards, and degrees, varied across institutions, and resisted by traditional medical hierarchies.
Evidence-based practice (Essential III) and healthcare policy and advocacy (Essential V), identified as critical areas within DNP Essentials, are key requirements in overcoming previous obstacles that have historically limited the independence of the nursing profession and the development of nursing practice. Nevertheless, integrating these competencies holistically still mandates advocacy, legislation, and cross-disciplinary efforts to disrupt systemic obstacles. The future must distill this social science knowledge and marry it with nursing science and practice while contextualizing both from a philosophical view while reinforcing the methodology of research and redefining the nurse as both scientist and practitioner.
References:
Da Silva, T. H. R., & Wynn, M. (2025). Introduction to digital nursing and nursing theory. King’s College London Publications. Retrieved from https://kclpure.kcl.ac.uk/portal/en/publications/introduction-to-digital-nursing-and-nursing-theory
Finnegan, L., Kelly-Weeder, S., Akintade, B. F., & Hooks, J. D. (2025). Harmonizing excellence: Crafting the nexus of competencies, standards, and degree demands in nurse practitioner education. Nursing Outlook. Elsevier. https://www.sciencedirect.com/science/article/pii/S0029655425000016
Mendívil, M., Choperena, A., & Salas, V. (2025). Interventions to develop clinical judgment among nurses: A systematic review with narrative synthesis. Nurse Education in Practice. https://www.sciencedirect.com/science/article/pii/S1471595325000563