Sociology provides theoretical frameworks from which to consider the meaning and influence of the culture in which nursing and nursing education exist. The choice of content for a PD program and approach to a PD program on caring nursing practice may be influenced by three sociological perspectives each with its own focus and implications for nursing education, as summarised in Table 3.2.
Table 3.2 Influence of sociological perspectives and their influence on educational approach and content of CPD programs Focus &
theorists
Perspective Education approach & questions Education content
Structural functionalism
Balance and the status quo.
Examines social constructs such as Nurse Education in terms of the structure of society and the
function of its parts. In this approach the construct of Nurse Education is considered in relation to the structure of society and its interaction and mutual influence and adjustment with other parts of the social system. Process such as cooperation, competition, conflict and accommodation are considered in order to draw conclusions about the construct.
Structural functionalist education looks at supporting a coherent functioning system and is used to make adjustments to the system in order to maintain system integrity. From this perspective education is used to support the system and support planned system changes.
Questions: What is nursing and what role does it have within societal structures such as: hospital, health care system and how do these structure work towards an integrated functioning society? What is the role of CPD?
Content might include: the structure of the health care system and the place of nursing within that system. It might also include information on why health is important to society and the role of the nurse.
The question arises with regards to conflict and the extent to which conflict may be seen as a system adjustment or process leading to overthrow of a system. Conflict may be examined from a structural functionalist view as an
adjustment to the system.
What conflicts exist between nursing goals of caring and goals in other parts of the health care system and society? Does the inability of nurses to engage in the role of caring result in conflict and change within the system? How is conflict resolved and what is its effect on health care?
Content might include: factors
supporting and detracting from caring in particular social structure: the
organisation and/or society, historical changes in nursing especially watershed moments in practice and education which highlight concepts about the goals, roles and function of nursing; the impact of national plans to manage staffing shortages on staffing and nurses ability to care.
Focus & theorists
Perspective Education approach & questions Education content
Conflict theorists Tensions and conflict which increase, and which ultimately result in collapse of the system or radical change.
View society in terms of human aggressiveness and emphasise conflict as a creative or inevitable social force. The use of conflict theorists is generally in analysis of whole of society change such as occurs in changes is ideology for example the rise and spread of Christianity overthrowing the Roman Empire or Marxism overthrowing capitalism or Marxism supporting Christian ideals of justice for working classes as occurs in liberation theology and education (Cortez, 2009).
View that education may be used to support conflict by supporting and imparting ideas and evidence which is suggestive of the need for radical change. Such ideas and evidence are not conducive to maintain the status quo within the system. From this perspective education is not seen as passive. It is used to challenge the whole of society system which may result in system collapses or radical change. In these circumstances, education is seen as catalysts in radical whole of society change and is dealt with within the predominant conflict modus operandi: exiled, tortured or murdered (as was Socrates). Here, education is used to
overthrow the system.
Questions: What types of health care system should operate and what is the role of caring nursing practice in capitalistic versus socialistic societies? Should there be a health care system where all people have equal access and services and ‘care’? Where ‘equal’ means exactly the same access and services for all people. How would a health care system of equal access and services affect caring nursing practice? What would ‘care’ mean in such a system?
Content might include overview of different types of health care systems. Health economics and social inequities in health care provision. Socialist, communist and capitalist health care systems and their roles in supporting the ruling class.
Focus & theorists
Perspective Education approach & questions Education content
Interationalist theorists Social norms and social roles rather than individual stimulus response of human behaviour
A third view of society in terms of social interaction of two or more persons who create meaning and shared understandings. Shared meanings have a reciprocal effect on behaviour, expectations, and thought (Theodorson &
Theodorson, 1969). Interactionism is a sociological approach which emphasises action and reaction of persons and groups interacting with each other.
Education is used to shed light on the extent to which meanings are shared in order to support common understandings which avert system changing conflict and support structure and function of a system. For internationalists, education is used to understand and support shared meaning within the system.
Questions: What is the social norm with regards to caring by nurses? Do different groups in society view caring by nurses differently? How do differing groups negotiate different understandings about what it is to care in nursing? How do senior nurses respond to nurses who take time to care?
Content might include: information what nurses understand about the term caring; how the understanding of the term caring is applied by different professions; the patient perspective of caring and what patients want in terms of caring by nurses; and how ‘care’ is negotiated and understood by different health care professionals.
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