by Pat Heyman | Jun 30, 2010 | Uncategorized
The Six-Lesson Schoolteacher
by John Taylor Gatto
Call me Mr. Gatto, please. Twenty-six years ago, having nothing better to do, I tried my hand at schoolteaching. My license certifies me as an instructor of English language and literature, but that isn’t what I do at all. What I teach is school, and I win awards doing it.
Teaching means many different things, but six lessons are common to schoolteaching from Harlem to Hollywood. You pay for these lessons in more ways than you can imagine, so you might as well know what they are:
The first lesson I teach is: “Stay in the class where you belong.” I don’t know who decides that my kids belong there but that’s not my business. The children are numbered so that if any get away they can be returned to the right class. Over the years the variety of ways children are numbered has increased dramatically, until it is hard to see the human being under the burden of the numbers each carries. Numbering children is a big and very profitable business, though what the business is designed to accomplish is elusive.
In any case, again, that’s not my business. My job is to make the kids like it – being locked in together, I mean – or at the minimum, endure it. If things go well, the kids can’t imagine themselves anywhere else; they envy and fear the better classes and have contempt for the dumber classes. So the class mostly keeps itself in good marching order. That’s the real lesson of any rigged competition like school. You come to know your place.
Nevertheless, in spite of the overall blueprint, I make an effort to urge children to higher levels of test success, promising eventual transfer from the lower-level class as a reward. I insinuate that the day will come when an employer will hire them on the basis of test scores, even though my own experience is that employers are (rightly) indifferent to such things. I never lie outright, but I’ve come to see that truth and [school]teaching are incompatible.
The lesson of numbered classes is that there is no way out of your class except by magic. Until that happens you must stay where you are put.
The second lesson I teach kids is to turn on and off like a light switch. I demand that they become totally involved in my lessons, jumping up and down in their seats with anticipation, competing vigorously with each other for my favor. But when the bell rings I insist that they drop the work at once and proceed quickly to the next work station. Nothing important is ever finished in my class, nor in any other class I know of.
The lesson of bells is that no work is worth finishing, so why care too deeply about anything? Bells are the secret logic of schooltime; their argument is inexorable; bells destroy past and future, converting every interval into a sameness, as an abstract map makes every living mountain and river the same even though they are not. Bells inoculate each undertaking with indifference.
The third lesson I teach you is to surrender your will to a predestined chain of command. Rights may be granted or withheld, by authority, without appeal. As a schoolteacher I intervene in many personal decisions, issuing a Pass for those I deem legitimate, or initiating a disciplinary confrontation for behavior that threatens my control. My judgments come thick and fast, because individuality is trying constantly to assert itself in my classroom. Individuality is a curse to all systems of classification, a contradiction of class theory.
Here are some common ways it shows up: children sneak away for a private moment in the toilet on the pretext of moving their bowels; they trick me out of a private instant in the hallway on the grounds that they need water. Sometimes free will appears right in front of me in children angry, depressed or exhilarated by things outside my ken. Rights in such things cannot exist for schoolteachers; only privileges, which can be withdrawn, exist.
The fourth lesson I teach is that only I determine what curriculum you will study. (Rather, I enforce decisions transmitted by the people who pay me.) This power lets me separate good kids from bad kids instantly. Good kids do the tasks I appoint with a minimum of conflict and a decent show of enthusiasm. Of the millions of things of value to learn, I decide what few we have time for. The choices are mine. Curiosity has no important place in my work, only conformity.
Bad kids fight against this, of course, trying openly or covertly to make decisions for themselves about what they will learn. How can we allow that and survive as schoolteachers? Fortunately there are procedures to break the will of those who resist.
This is another way I teach the lesson of dependency. Good people wait for a teacher to tell them what to do. This is the most important lesson of all, that we must wait for other people, better trained than ourselves, to make the meanings of our lives. It is no exaggeration to say that our entire economy depends upon this lesson being learned. Think of what would fall apart if kids weren’t trained in the dependency lesson: The social-service businesses could hardly survive, including the fast-growing counseling industry; commercial entertainment of all sorts, along with television, would wither if people remembered how to make their own fun; the food services, restaurants and prepared-food warehouses would shrink if people returned to making their own meals rather than depending on strangers to cook for them. Much of modern law, medicine, and engineering would go too – the clothing business as well – unless a guaranteed supply of helpless people poured out of our schools each year. We’ve built a way of life that depends on people doing what they are told because they don’t know any other way. For God’s sake, let’s not rock that boat!
In lesson five I teach that your self-respect should depend on an observer’s measure of your worth. My kids are constantly evaluated and judged. A monthly report, impressive in its precision, is sent into students’ homes to spread approval or to mark exactly – down to a single percentage point – how dissatisfied with their children parents should be. Although some people might be surprised how little time or reflection goes into making up these records, the cumulative weight of the objective-seeming documents establishes a profile of defect which compels a child to arrive at a certain decisions about himself and his future based on the casual judgment of strangers.
Self-evaluation – the staple of every major philosophical system that ever appeared on the planet – is never a factor in these things. The lesson of report cards, grades, and tests is that children should not trust themselves or their parents, but must rely on the evaluation of certified officials. People need to be told what they are worth.
In lesson six I teach children that they are being watched. I keep each student under constant surveillance and so do my colleagues. There are no private spaces for children; there is no private time. Class change lasts 300 seconds to keep promiscuous fraternization at low levels. Students are encouraged to tattle on each other, even to tattle on their parents. Of course I encourage parents to file their own child’s waywardness, too.
I assign “homework” so that this surveillance extends into the household, where students might otherwise use the time to learn something unauthorized, perhaps from a father or mother, or by apprenticing to some wiser person in the neighborhood.
The lesson of constant surveillance is that no one can be trusted, that privacy is not legitimate. Surveillance is an ancient urgency among certain influential thinkers; it was a central prescription set down by Calvin in the Institutes, by Plato in the Republic, by Hobbes, by Comte, by Francis Bacon. All these childless men discovered the same thing: Children must be closely watched if you want to keep a society under central control.
It is the great triumph of schooling that among even the best of my fellow teachers, and among even the best parents, there is only a small number who can imagine a different way to do things. Yet only a very few lifetimes ago things were different in the United States: originality and variety were common currency; our freedom from regimentation made us the miracle of the world; social class boundaries were relatively easy to cross; our citizenry was marvelously confident, inventive, and able to do many things independently, to think for themselves. We were something, all by ourselves, as individuals.
It only takes about 50 contact hours to transmit basic literacy and math skills well enough that kids can be self-teachers from then on. The cry for “basic skills” practice is a smokescreen behind which schools pre-empt the time of children for twelve years and teach them the six lessons I’ve just taught you.
We’ve had a society increasingly under central control in the United States since just before the Civil War: the lives we lead, the clothes we wear, the food we eat, and the green highway signs we drive by from coast to coast are the products of this central control. So, too, I think, are the epidemics of drugs, suicide, divorce, violence, cruelty, and the hardening of class into caste in the U.S., products of the dehumanization of our lives, the lessening of individual and family importance that central control imposes.
Without a fully active role in community life you cannot develop into a complete human being. Aristotle taught that. Surely he was right; look around you or look in the mirror: that is the demonstration.
“School” is an essential support system for a vision of social engineering that condemns most people to be subordinate stones in a pyramid that narrows to a control point as it ascends. “School” is an artifice which makes such a pyramidal social order seem inevitable (although such a premise is a fundamental betrayal of the American Revolution). In colonial days and through the period of the early Republic we had no schools to speak of. And yet the promise of democracy was beginning to be realized. We turned our backs on this promise by bringing to life the ancient dream of Egypt: compulsory training in subordination for everybody. Compulsory schooling was the secret Plato reluctantly transmitted in the Republic when he laid down the plans for total state control of human life.
The current debate about whether we should have a national curriculum is phony; we already have one, locked up in the six lessons I’ve told you about and a few more I’ve spared you. This curriculum produces moral and intellectual paralysis, and no curriculum of content will be sufficient to reverse its bad effects. What is under discussion is a great irrelevancy.
None of this is inevitable, you know. None of it is impregnable to change. We do have a choice in how we bring up young people; there is no right way. There is no “international competition” that compels our existence, difficult as it is to even think about in the face of a constant media barrage of myth to the contrary. In every important material respect our nation is self-sufficient. If we gained a non-material philosophy that found meaning where it is genuinely located – in families, friends, the passage of seasons, in nature, in simple ceremonies and rituals, in curiosity, generosity, compassion, and service to others, in a decent independence and privacy – then we would be truly self-sufficient.
How did these awful places, these “schools,” come about? As we know them, they are a product of the two “Red Scares” of 1848 and 1919, when powerful interests feared a revolution among our industrial poor, and partly they are the result of the revulsion with which old-line families regarded the waves of Celtic, Slavic, and Latin immigration – and the Catholic religion – after 1845. And certainly a third contributing cause can be found in the revulsion with which these same families regarded the free movement of Africans through the society after the Civil War.
Look again at the six lessons of school. This is training for permanent underclasses, people who are to be deprived forever of finding the center of their own special genius. And it is training shaken loose from its original logic: to regulate the poor. Since the 1920s the growth of the well-articulated school bureaucracy, and the less visible growth of a horde of industries that profit from schooling exactly as it is, have enlarged schooling’s original grasp to seize the sons and daughters of the middle class.
Is it any wonder Socrates was outraged at the accusation that he took money to teach? Even then, philosophers saw clearly the inevitable direction the professionalization of teaching would take, pre-empting the teaching function that belongs to all in a healthy community; belongs, indeed, most clearly to yourself, since nobody else cares as much about your destiny. Professional teaching tends to another serious error. It makes things that are inherently easy to learn, like reading, writing, and arithmetic, difficult – by insisting they be taught by pedagogical procedures.
With lessons like the ones I teach day after day, is it any wonder we have the national crisis we face today? Young people indifferent to the adult world and to the future; indifferent to almost everything except the diversion of toys and violence? Rich or poor, schoolchildren cannot concentrate on anything for very long. They have a poor sense of time past and to come; they are mistrustful of intimacy (like the children of divorce they really are); they hate solitude, are cruel, materialistic, dependent, passive, violent, timid in the face of the unexpected, addicted to distraction.
All the peripheral tendencies of childhood are magnified to a grotesque extent by schooling, whose hidden curriculum prevents effective personality development. Indeed, without exploiting the fearfulness, selfishness, and inexperience of children our schools could not survive at all, nor could I as a certified schoolteacher.
“Critical thinking” is a term we hear frequently these days as a form of training which will herald a new day in mass schooling. It certainly will, if it ever happens. No common school that actually dared teach the use of dialectic, heuristic, and other tools of free minds could last a year without being torn to pieces.
Institutional schoolteachers are destructive to children’s development. Nobody survives the Six-Lesson Curriculum unscathed, not even the instructors. The method is deeply and profoundly anti-educational. No tinkering will fix it. In one of the great ironies of human affairs, the massive rethinking that schools require would cost so much less than we are spending now that it is not likely to happen. First and foremost, the business I am in is a jobs project and a contract-letting agency. We cannot afford to save money, not even to help children.
At the pass we’ve come to historically, and after 26 years of teaching, I must conclude that one of the only alternatives on the horizon for most families is to teach their own children at home. Small, de- institutionalized schools are another. Some form of free-market system for public schooling is the likeliest place to look for answers. But the near impossibility of these things for the shattered families of the poor, and for too many on the fringes of the economic middle class, foretell that the disaster of Six-Lesson Schools is likely to continue.
After an adult lifetime spent in teaching school I believe the method of schooling is the only real content it has. Don’t be fooled into thinking that good curricula or good equipment or good teachers are the critical determinants of your son and daughter’s schooltime. All the pathologies we’ve considered come about in large measure because the lessons of school prevent children from keeping important appointments with themselves and their families, to learn lessons in self-motivation, perseverance, self-reliance, courage, dignity and love – and, of course, lessons in service to others, which are among the key lessons of home life.
Thirty years ago these things could still be learned in the time left after school. But television has eaten most of that time, and a combination of television and the stresses peculiar to two-income or single-parent families have swallowed up most of what used to be family time. Our kids have no time left to grow up fully human, and only thin-soil wastelands to do it in.
A future is rushing down upon our culture which will insist that all of us learn the wisdom of non-material experience; this future will demand, as the price of survival, that we follow a pace of natural life economical in material cost. These lessons cannot be learned in schools as they are. School is like starting life with a 12-year jail sentence in which bad habits are the only curriculum truly learned. I teach school and win awards doing it. I should know.
This originally appeared in the Fall 1991 issue of Whole Earth Review.
June 22, 2010
Taylor Gatto is the author of Weapons of Mass Instruction: A Schoolteacher’s Journey through the Dark World of Compulsory Schooling, The Underground History of American Education: A School Teacher’s Intimate Investigation Into the Problem of Modern Schooling, and Dumbing Us Down: The Hidden Curriculum of Compulsory Schooling. He was 1991 New York State Teacher of the Year.
Copyright © 2010 John Taylor Gatto
by Pat Heyman | Apr 7, 2010 | Nursing
Schools of nursing at major academic institutions would seem to be unlikely places to find beliefs in the paranormal and crackpot scientific theories being taught and personality cults flourishing. The author shares his surprise and alarm.
Jef Raskin
Reality does not exist but appears to exist as expressed by human beings.-–Martha Rogers
"Read this!" my wife said when she came home from the start of a new term at nursing school. The book she handed me was Martha Rogers’ "The Science of Unitary Human Beings". The more I read, the more I thought I was the butt of an elaborate joke she had somehow put together. "You’ve got to be kidding," I said.
"I’m not. This is one of the texts for our Nursing Theory course," she replied, with a tone of voice and facial expression that showed her disapproval.
It wasn’t just the book that was suspect. My wife’s Nursing Theory course itself had a number of the hallmarks of a cult indoctrination: Any serious intellectual challenge to the basic ideas was treated as troublemaking, the leader was held in reverent awe and was regarded as having knowledge beyond the current reach of science. As I did more research into the topic, I discovered that this brand of nursing theory was widespread. For example, as an alumnus of Penn State, I was not pleased to read that Sarah H. Gueldner, Director of the School of Nursing at the Pennsylvania State University believes that "Paranormal events such as precognition and clairvoyance may hold potential as evolving communication techniques of space travel and living." (Christensen, Sowell and Gueldner, 1994).
Courses in nursing theory are taught at the University of San Francisco, Penn State, Rutgers, Wayne State University, New York University, Case Western Reserve University, the University of Rochester and many other institutions. Rogerian nursing theory is also taught overseas, for example, I’ve corresponded with prominent nursing theorists and educators in England and Australia.
Martha Rogers and Her Theory
Martha Rogers (1914-1994) was dean of nursing at New York University, and published many books and articles on nursing theory. A quote from Afaf Meleis’s book, "Theoretical Nursing: Development and Progress" (1997) summarizes a number of Rogers’ teachings: "To Rogers, a unitary human being is an irreducible, indivisible energy field and a unitary one… In fact, human beings and environments do not have energy fields; they are energy fields. They are open for exchange and extend to infinity. Energy fields are identifiable through dynamic-nonstatic wave patterns and organization that changes from ‘lower frequency, longer wave pattern to high frequency shorter wave pattern’ based on the principle of resonancy. Energy fields are pandimensional, transcend time and space, and therefore may have imaginary boundaries that are unique and changeable."
To better understand what Rogers was talking about, I studied the literature and had email discussions with nursing theorists, including a number of nursing PhDs and a present and past president of the Society of Rogerian Scholars. To get started in relating Rogers work to concepts with which I am familiar, I asked each of the nursing theorists these two questions (among others): Just what are the frequencies of the energy fields? Rogers says that these frequencies increase, how did she determine this? Not one of my sources was able to answer either question.
The practice of therapeutic touch is one of the techniques that, as Meleis put it, "demonstrated the [Rogerian] theory’s principles" (see Krieger 1987). Therapeutic touch consists of moving the therapist’s hands over a patient, without physical touching. "Assessing" is done by "holding the hands 2 to 6 inches away from the individual’s energy field while moving the hands from the head to the feet in a rhythmical, symmetrical manner." Later, "treatment is accomplished by moving the hands to the areas that seem to need attention" and the hand motions are effective in "facilitating the symmetrical flow of energy through the field" according to the web page of Nurse Healers – Professional Associates International, Inc. which says that it is "the recognized professional organization for the education, practice, and research of Therapeutic Touch." How you can hold your hands 2 to 6 inches from energy fields that "extend to infinity" is not explained.
In a classic and widely-reported experiment which began as a grade-school science fair project, practitioners of therapeutic touch who had stated that they could sense human energy fields (and thus the presence of a human) with their hands discovered that they could not. (Linda Rosa et al 1998). In comparing the therapeutic touch literature from before that article appeared with that published more recently, claims of the ability to detect the hypothesized energy field as well as trauma and disease through therapeutic touch have been eliminated or are couched in terms that make the ability untestable. You now read, "some practitioners may feel…" instead of "practitioners can detect…"
Why There Can Be No Theory of Nursing
The idea of a comprehensive theory of nursing is a strange one. We could not, for example, formulate a general theory of biology, though we can state biology’s essential thrust. Biology is the study of life; it is not a theory of life. Its methods range from field observation and laboratory investigations to building mathematical models. Biology includes many theories, such as the theory of natural selection and the theory of the structure and function of DNA. There is no overarching theory of biology from which we derive biological principles. Biology, in turn, is based on chemistry and, ultimately, on physics. Similarly, there is no theory of physics, but a collection of theories about the physical world. Even if the grand unified theory now being contemplated were to be completed, the various branches of physics would not disappear. There will still be surprises from the physical world, and much work would still remain to be done even in centuries-old and well-established fields such as fluid dynamics.
The range of tasks and disciplines that nursing includes are extremely broad. An effective nurse must understand both the human and the physiological aspects of illness. A nurse administers medication and performs procedures such as vaccinations, installing intravenous catheters, and attending wounds; a nurse checks on the propriety of medicines and dosages, sees to the physical needs of patients who cannot tend for themselves, observes and records their physical and emotional status, and can serve as the effector and senses of a doctor. In practice, though not officially, nurses often suggest diagnoses and therapies to doctors. Nurses also become mediators or ombudspersons for the patient with regard to other health care professionals, organizations, governmental bureaucracies, and commercial entities such as insurance companies. This list covers but a fraction of the extraordinarily varied tasks that nurses carry out. In short, a nurse must have a disparate and broad range of interpersonal, organizational, clerical, and technical skills. The knowledge and skill base is compounded from multiple disciplines, including physiology, sociology, psychology, and bookkeeping.
Nursing educators should realize that it makes no sense to claim that there is a single theory of nursing, although the overarching goal of nurses’ professional practice – to improve the wellbeing of their patients – underlies all the other activities. Trying to impose a "scientific" theory on such a wide range of skills and techniques detracts from the credibility of the profession.
Nursing Theory and the Philosophy of Science
The nursing theory research literature reveals the practitioners as trying to achieve the cachet of science while at the same time distancing themselves from its methods. For example, a section of Meleis’s chapter on Rogers’ work called "Theory Testing" begins "Gill and Atwood (1981) attempted to use Rogers’ theory as the basis for a study of wound healing in animals, but were legitimately criticized by Kim (1983) for reductionism, causality, and inappropriate use of the animal model." Reduction, of course, is one of the essential contributions science makes to our understanding of the world. When Newton showed that the orbiting of the planets, the trajectory of projectiles, and the falling of objects toward the ground were all described by the same equations, and due to the same cause, he achieved a remarkable reduction, and thereby an advance in our understanding of nature.
Nursing theorists often use the word "reduction" to name the unfortunate tendency of some clinicians to regard patients as a set of symptoms and subsystems rather than as a person with cultural, social, and psychological attributes. This confusion of two meanings of the same word leads some nursing theorists to disregard the beneficial aspects of reduction (in both senses). For example, it is by isolating specific causes of diseases that medicine has been able to eliminate so many of them as threats. Nursing theory should embrace reduction where it is appropriate, while at the same time resisting any tendency toward treating individual patients as less than full human beings.
To critique an experimental study for treating events as causal again takes nursing theory out of the realm of science, which is preeminently concerned with questions of cause and effect. Even where events seem to be acausal (as in the case of the radioactive decay of atomic nuclei), the phenomena are still detectable, demonstrable, measurable, repeatable, and well described by statistical laws. Nursing theorists, by contrast, are averse to causal reasoning and criteria such as repeatability because the phenomena in which they believe, including the paranormal, do not meet with these common-sense standards. Nursing theorists also tend to avoid crucial experiments which could jeopardize the theory in the rare cases where the theory is coherent enough to permit testing; or, as noted for therapeutic touch, reinterpret the theory to make it impossible to test. The experiments that do appear in the literature usually depend on subjective judgments, rely on anecdotal reports, or are purely speculative.
For the most part, nursing theory has insulated itself from logical or experimental evaluation by avoiding precision and prediction – or even meaningfulness: for example, Rogers said (1980 p.333, quoted in Meleis, 1997), "Reality does not exist but appears to exist as expressed by human beings".
The Vested Interest
Nursing theory has an academic structure that is medieval in style. Academic titles take on great significance, and most nursing theorists display at least three sets of initials after their name. For example, an article that tells us that "From the purview of Rogerian thought, VR [computer-mediated virtual reality] is not artificial as one is already everywhere since Persons are energy fields and energy fields are infinite" lists Elizabeth Ann Manhart Barrett RN; Ph.D.; FAAN as the author. Many aspects of nursing theory are far closer in style and substance to religious beliefs than to science; Martha Rogers wrote that there is a "critical need for a body of scientific knowledge specific to nursing." [1970 p. 83]. She does not explain why the knowledge must be specific to nursing, but her desire to create some special nursing science is evident, her desire for nursing to be on an academic and intellectual par with physics is clear. Starting from Glenn Seaborg’s analogy that compared scientific research to mountain climbing, Rogers said that "To reach the upper altitudes [of nursing theory] requires the knowledge and tools implicit in doctoral study of stature." [op. cit. p. 112].
Until the advent of nursing theory, which allowed nurses to write papers of apparently vast theoretical scope, there was far less of a rationale for awarding a Ph.D. in nursing. By establishing a Ph.D. in nursing, academic institutions – which usually require their faculty to have Ph.Ds – became staffed at the highest levels with nursing theorists (in accord with the use of the word "doctoral" in Rogers’ quote). These theorists have a vested interest in not having their work questioned. Additionally, because Ph.D. nursing theorists occupy many of the higher positions in academic settings, they control who obtains Ph.Ds, and they exclude any skeptical students who would challenge their hegemony. It is a closed system, which can, to its own satisfaction, reject any attack from outside by pointing out that the critics do not have Ph.Ds. in nursing, and therefore do not properly understand nursing theory. The situation is such that many nurses do not go forward to a Ph.D. in nursing because they would have had to publicly subscribe to the absurd tenets of the theory, as has been repeatedly reported to my wife (a nurse and a nursing supervisor who moved to nursing after studying for a Ph.D. in experimental pathology).
In my correspondence with nursing theorists, I have found them to be well-meaning. Like the vast majority of nurses, their principal desire is to do what is best for their patients. They believe that they are doing so. I would expect that they would want to demonstrate that their claims are objectively true. However, as a reading of many published papers, theses, and the perusal of hundreds of abstracts of other papers, has shown me, their ranks seem devoid of people who have the necessary background to create a rational critique from within, and the system is such as to exclude those whose training allows them to see the weaknesses of nursing theory.
The Status of Nursing in the Medical Professions
As any medical intern will tell you, nurses are often the most knowledgeable people, especially with regard to patient status and treatment, in the hospital. At the same time they are undervalued, underpaid, have low social status, and are institutionally subservient to MDs and hospital management. Outside the hospital setting, their situation is not much better. This creates justifiable resentment, and, I believe, helped give rise to a strong psychological impetus to create a platform for nurses where they can publish papers, do research, feel as if they are part of the cutting edge of technology, and have outward trappings comparable to that of other disciplines. Without the real possibility of a theory of nursing comparable in scope and depth to the physical sciences or mathematics, a simulacrum or the appearance of such a theory of nursing was created.
The more you study Rogers’ work, the more you see that substance is lacking. Any competent referee outside nursing would judge the overall quality of nursing research as pathetic. Nursing theory, as we have seen, is built on undefined jargon and unfalsifyable hypotheses, it is a structure of self-perpetuating myths taken on faith by its practitioners. Nursing theory has become a home for new-age fallacies, "alternative medicine", and hyperbole. Unlike science, nursing theory has no built-in mechanisms for rejecting falsehoods, tautologies, and irrelevancies.
I believe that nursing does deserve academic status, and that there is valuable and valid nursing research to be done (two obvious examples: Studies of the causes of medication errors or the effect of the frequency of dressing changes on the rapidity of wound healing). There is justification for Ph.D. level studies in nursing, but the justification does not require a fictitious theory of nursing. Academic nursing should not be satisfied with the low standard of intellectual honesty it has set out for itself, and academic institutions should not tolerate the lack of rigor in the field. Until the Ph.D. programs in nursing are revamped, universities and colleges should look to broader qualifications for instructional positions in nursing, and downplay the importance of Ph.Ds, especially those earned in Rogerian nursing theory.
Conclusions
This article has concentrated on Rogerian nursing theory because it is the most prominent and possibly the most widespread theory in the field. There are other broad theories of nursing, such as Margaret Newman’s "Health as Expanding Consciousness" or Rosemarie Parse’s "Theory of Human Becoming" that I have not discussed. On the positive side, Orem’s Self-Care Model presents a direction (rather than a theory) for nursing that does not exhibit Rogerian excess. Some of the topics taught in nursing theory are not altogether nonsensical, but that there are some reasonable topics presented under the name of nursing theory does not rescue the rest or establish that there is a general theory of nursing.
I hope that this article will help academic nursing come out of the dark ages of authoritarianism and mysticism so that it legitimately can take its rightful place in academia and in medicine.
=== SIDEBAR: ROGERS, IN HER OWN WORDS ===
Analysis of quotes from Rogers, Martha E., An introduction to the theoretical basis of nursing. Philadelphia, 1970. F.A. Davis Company.
Until you read her works, it is hard to believe how confused and vague are Rogers’ theoretical writings. Where she does get precise enough to judge the validity of her thought, she is often simply wrong. For example, Rogers’ concept of negative entropy, which she calls "negentropy", is based on her misunderstanding of thermodynamics. After claiming, without examples or citations, that, "With the rise of modern science, evidence that man did not develop according to accepted physical laws became more explicit" she found that, "The second law of thermodynamics, useful in predicting the physical world, was inconsistent with the ways in which living systems behaved" because "An increase in entropy posited a trend toward degradation to homogeneity of organization in contrast to a trend towards heterogeneity and complexity." She concludes that there is a "failure of physical laws to explain the evolution of life." [all the above quotes from p. 51]. She quotes, and summarily dismisses, the correct explanation, "Rapoport endeavors to deal with this problem by stating that ‘no living system is a closed system and so the second law does not apply to it.’ " [p. 52] There is no contradiction between the laws of thermodynamics and the behavior of living systems.
Rogers confounds Darwinian evolution, which she misunderstands, and the common use of the word "evolution" to mean change over time. "Geological evolution is written in the rocks, and cosmic change is evidenced in the processes of star formation and development. The evolution of life has been traced in fossil records, in identification of growing complexity in life forms, and in discoveries of artifacts of man’s emergence." [p.56] Of course, the earth’s geology does not evolve in the Darwinian sense, and Darwinian evolution is not identified by noting growing complexity in life forms (animals, notably some parasites and cave-dwelling animals, have evolved into less-complex life forms.) Rogers still accepts the long-abandoned evolutionary hierarchy with man at the top, "life encompasses the simplest organism to the most complex in an evolutionary hierarchy… At the top of this scale man stands triumphant." [pg. 67]. All that evolution predicts is improved adaptation, which may lead to greater or lesser complexity. In no sense does the discovery of artifacts give any evidence of the evolution of life. Early human artifacts demonstrate our progress in learned skills, but give no evidence of biological evolution. It would be hard to get much more wrong in so brief a quote.
Speciation is often associated with the isolation of a portion of a population, without such isolation or a change in the environment, species tend to be stable. Rogers gets this backwards when she opines, "Heretofore isolated societies are bypassing centuries of Western World development as they are introduced to the fruits of technology. The [human] gene pools of the planet Earth are intermingling as never before and presage further evolutionary events." [p. 59]. Intermingling makes further speciation of Homo sapiens less likely.
Rogers is as fuzzy with physics as with biology. She says (getting both the scientists’ name and usual English name of the principle wrong), "Heinsenberg’s principle of indeterminacy postulates an uncertainty in all knowing." [p. 57]. This is not true: Heisenberg’s uncertainty principle casts no light at all on logical or mathematical certainty, and does not say that we cannot predict with certainty outcomes of macroscopic events. If a swiftly moving bowling ball directly strikes a bowling pin, we can predict with certainty that the pin will move, even if Heisenberg himself had launched the ball. Also, the principle was not "postulated" but derived from observation and earlier work. Rogers also tells us that "human beings are radiation bodies" [p. 113], but not what a radiation body is. "Radiation body" is not a term of art from physics or physiology, it is a phrase she has invented, and which (as is all too usual in her work) she presents without definition, leaving you to guess its meaning. Any critique you make of her conclusions can be countered by a nursing theorist saying that you have not understood the term correctly. This is coupled with a reluctance on the part of the theorist to define the term with precision.
Rogers’ theory is based on a number of what she calls "assumptions", and she is often "postulating" concepts. Assumptions and postulates are more the tools of mathematics than of science, because in science the fundamental principles are not assumed or postulated but are based on observation. Here is a typical example: "The principles of homeodynamics… are four in number, namely: principle of reciprocy, principle of synchrony, principle of helicy, and principle of resonancy. These principles postulate the way the life process is and predict the nature of its evolving." [p. 79]
Another characteristic of her writing is stating the obvious as if it is a deep insight: For example, "Man’s capacity to adapt to a wide range of environmental stresses has received considerable attention and has been proposed to be a significant factor in his survival" [p.49]. Rogers’ "second assumption on which nursing science builds may be stated thus: Man and environment are continuously exchanging matter and energy with one another." [p.54] This is no assumption, but a simple fact. She is not above window-dressing with high-sounding jargon. Her third "assumption" is: "The life process evolves irreversibly and unidirectionally along the space-time continuum." [p. 59] In plain English: "The processes of life cannot be time-reversed." When she says that "Ontogenesis and phylogenesis evidence a lengthening of conscious awareness (the waking state) through time" [p. 93], she is claiming both that during the development of an individual and during humanity’s evolutionary history, people stay awake for longer periods of time. However, some people need increasing amounts of sleep as they age, and there is no evidence at all about the sleep habits of our prehistoric ancestors.
A large part of Rogerian theory is based on the idea of an energy field. She says, without any substantiation, "An energy field is the basic unit of living things. It is this field which imposes pattern and organization on the parts." [p. 61] She mentions that the "the electrical nature of this field is well documented" [pg. 104] but gives no citations to the claimed documentation. Rogers never takes her own advice to provide the "clear unequivocal concepts" needed for "a body of scientific knowledge" [p. 81] and we are left with no guidance as to how to detect or measure this field. She does get very specific at one point and tells us that "A series of studies… were designed to investigate the relationship between electrical potential differences, as measured by the Keithley Microvoltmeter, Model 153. "[p. 104]. On what or where the potential differences were measured, a far more important piece of information, she does not report. In any case, it doesn’t matter, for she then tells us that no positive results were obtained with this device, and the matter is dropped. Why then the specific mention of the piece of apparatus used? Because, I believe, Rogers felt that it sounded impressive.
Martha Rogers was not put off by contradictions in her theory. For example, she says that "At death the human field ceases to exist." [pg. 91] and also, a few paragraphs later, that "The field projects into the future as well as into the past." She speaks of "delineating the boundary of the human field" with measuring instruments [page 113] and also that "The environment is defined as all that which is external to a given human field and is thus stated to be the environmental field." [pg. 97]. But she also has told us that the human field extends to infinity in all directions, so it has no boundary and nothing is external to it.
Mathematics and symbolic notation are not ignored. Rogers, without an explanation of what topology is likely to be able to tell us, says that "A fundamental question needing exploration concerns the topology of the human field." [p. 112]. She introduces equations such as R = f(M1 « E1) which "can be read as: ‘Reciprocy [R] is a function of the mutual interaction between the human field [M] and the environmental field [E].’ " [p. 97] The subscripts are never explained or even mentioned. No use is made of the notation except as an alternative to words: The only justification for the symbolic form that I can see is to introduce something that looks like mathematics into the book.
Lastly, Rogers accepts sources uncritically. "Further evidence of nature’s lawfulness has come about through biorhythm research, expanded recognition of the cyclical nature of physical phenomena, and significant findings pointing up interrelationships between the two." [p.62] Biorhythms were a fad at the time she was writing. She also thinks that "In recent years, scientific respectability has been granted to the study of extrasensory phenomena. The existence of paranormal occurrences is well documented." [p.72] Perhaps often discussed, but not well documented. Scientific respectability will be granted only when the phenomena can repeatably produce positive results under conditions which rule out cheating and experimenter bias, an event for which we are still waiting.
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Acknowledgements
I wish to thank Linda S. Blum, R.N., Aza Raskin, and Julie Ososke for their suggestions, as well as the nursing theorists who have patiently responded to my questions via email.
Author Note
Jef Raskin is a writer, interface design consultant, and cognitive psychology researcher. He created and led the Macintosh project at Apple Computer Inc. He is a contributor to the new book, Information Design (1999. Jacobson, R. ed., MIT Press) and the author of the new book, The Humane Interface, published by Addison Wesley Longman and the ACM Press.
Citation
Raskin, Jef. “Rogerian Nursing Theory: A Humbug in the Halls of Higher Learning”, Skeptical Inquirer 24;5 September/October 2000 pp 30-36
References
Christensen, P., R. Sowell and S.H. Gueldner. 1994. Nursing in Space: Theoretical Foundations and Potential Practice Applications within Rogerian Science. Visions: The Journal of Rogerian Nursing Science 2.
Meleis, Afaf. 1997. Theoretical Nursing: Development and Progress, 3rd ed. Philadelphia: Lippincott, Williams & Wilkins.
Krieger, D. 1987. Living the Therapeutic Touch: Healing as a Lifestyle. New York, NY: Dodd Mead.
Rogers, Martha E. 1970. An Introduction to the Theoretical Basis of Nursing. Philadelphia: F.A. Davis Company.
Rosa, L., E. Rosa, L. Sarner and S. Barrett. 1998. "A Close Look at Therapeutic Touch". JAMA 1 April: 1005-1010.
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