I’m not a nurse, but I am an honorary Sigma member. I believe nursing is a STEM discipline. And I believe nursing is an exemplar among the healthcare professions when it comes to solving society’s greatest need—namely an inclusive approach to upstream policies that achieve equity in the practice of sustainable development, local to global.
Sigma’s mission, “Developing nurse leaders anywhere to improve healthcare everywhere,” is vital to achieving the United Nations (UN) Sustainable Development Goals (SDGs). And from my own personal experience as an environmental engineer, I believe that achieving sustainable development requires convergence—deep integration where new frameworks emerge to solve societal challenges. Examples of convergence between nurses and environmental engineers include:
On 1 January 2016, the 17 SDGs of the 2030 Agenda for Sustainable Development came into force. Adopted by the UN General Assembly in September 2015, the origin story of the SDGs includes the much earlier publication of the “Report of the World Commission on Environment and Development: Our Common Future.” Widely known as the “Brundtland Report,” in honor of Gro Harlem Brundtland former prime minister of Norway and chairwoman of the commission, one of the most commonly cited definitions of sustainable development is found within its pages: “Humanity has the ability to make development sustainable to ensure that it meets the needs of the present without compromising the ability of future generations to meet their own needs.”
The unique function of the nurse in sustainable development
The emphasis on the term “needs” is particularly relevant to the profession of nursing. For example, luminary nurse theorist Virginia Henderson famously wrote, “The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will, or knowledge.” Certainly, a mother would meet the needs of her child if she could, by providing a full belly of healthy food, the security of a loving home, and access to schooling to realize a brighter future. These would be examples of meeting needs, and nurses—working both at the beside as well as beyond the bedside in the community—would find unique professional satisfaction in helping a mother to meet these needs of her child.
But this is not the complete quote from Henderson. Indeed, the text goes on to state, “And to do this [meet needs] in such a way as to help him gain independence as rapidly as possible.” Henderson was clear. The practice of nursing is not an exercise in cultivating dependence, but rather the opposite. The unique function of the nurse is to accompany a patient on a path toward realization of the patient’s own goals of sustainable development.
In a similar fashion, immediately after offering a definition of sustainable development, the “Brundtland Report” goes on to note, “The concept of sustainable development does imply limits—not absolute limits but limitations imposed by the present state of technology and social organization on environmental resources and by the ability of the biosphere to absorb the effects of human activities.” Brundtland, just like Henderson, envisioned a world where the sustainable pursuit of aspirational goals of personal and global development occurs at the interface of technological innovation and environmental limitations.
Thus, the successful practice of nursing to achieve sustainable development as envisioned by Henderson must reside at the successful convergence of multiple professions as envisioned by Brundtland. This convergence—where deep integration creates new frameworks to solve societal challenges—includes the technological innovations offered by the practice of engineering as well as upstream policies that achieve equity.
Comparing Henderson’s nursing theory and engineering grand challenges
In 2008, a select panel convened by the National Academy of Engineering of the United States, with input sought from experts and invited from the public, published a seminal report entitled, “Grand Challenges for Engineering.” As described in the introduction, “Rather than attempt to include every important goal for engineering, the panel chose opportunities that were both achievable and sustainable to help people and the planet thrive … in each of these broad realms of human concern—sustainability, health, vulnerability and joy of living—specific grand challenges await engineering solutions.”
While the term “nurse” is never once included in the engineering report (and to the best of my knowledge no nurses were invited to contribute), a comparison of the 14 components of Henderson’s Nursing Need Theory and the 14 Grand Challenges for Engineering shows a high level of similarity, even though not every pillar of Henderson’s theory is a perfect match to each of the 14 engineering Grand Challenges.
Nursing Need Theory | Grand Challenges for Engineering |
Physiological needs |
|
1. Breathe normally. | 13. Develop carbon sequestration methods. |
2. Eat and drink adequately. | 9. Provide access to clean water. |
3. Eliminate body wastes. | 12. Manage the nitrogen cycle. |
4. Move and maintain desirable postures. | 7. Restore and improve urban infrastructure. |
5. Sleep and rest. | 6. Advance health informatics. |
6. Select suitable clothing—dress and undress. | 10. Provide energy from fusion. |
7. Maintain body temperature within normal range by adjusting clothing and modifying the environment. | 2. Make solar energy economical. |
8. Keep the body clean and well-groomed and protect the integument. | 5. Engineer better medicines. |
Safety needs |
|
9. Avoid dangers in the environment and avoid injuring others. | 11. Prevent nuclear terror. |
Love and belonging |
|
10. Communicate with others in expressing emotions, needs, fears, or opinions. | 8. Secure cyberspace. |
11. Worship according to one’s faith. | 4. Reverse-engineer the brain. |
Esteem |
|
12. Work in such a way that there is a sense of accomplishment. | 14. Engineer the tools of scientific discovery. |
13. Play or participate in various forms of recreation. | 3. Enhance virtual reality. |
14. Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities. | 1. Advance personalized learning. |
Access to air, water, and food as well as the elimination of wastes have been and continue to be needs to be met for each and every member of humanity, locally to globally. Safety from harm, communicating with others, and opportunities for personal growth and learning are human needs that demand the full attention of the profession of nursing and the profession of engineering. A careful review of the side-by-side comparison of Henderson’s work with the work of an expert panel of engineers leaves no doubt that both professions are focused on meeting human needs.
Toward consilience through convergence
The practice of nursing and the goals of engineering are pointing toward the same thing: the SDGs. When this happens—multiple, independent lines of research pointing toward the same theory—the terms used to capture the phenomena is called “consilience.” Originally described by William Whewell in 1840 in his work, “The Philosophy of the Inductive Sciences,” consilience was more recently shared with the public in the title of Edward O. Wilson’s scientific novel, Consilience: The Unity of Knowledge (1998).
Wilson is a professor emeritus of entomology at Harvard University, and a widely regarded advocate for the environment. His book, “Biophilia” (1984), introduced to the public the theory that humans have an affection, or love, for other humans and other forms of life. Thus, while humanity aspires to meet our needs through technological innovation, we are genetically programmed and culturally conditioned to avoid the whole-sale destruction of the natural world. Despite legitimate criticism of some of Wilson’s points of view, the idea that humanity’s quest for sustainable development is intimately entangled with the long-term success of life on planet Earth brings our discussion full circle to the “Brundtland Report” and the notion that what humanity does today should not intentionally compromise our own existence in the form of future generations of humans.
Conclusion
Achieving the aspirations of the SDGs will require the unique contribution of nurses. It will require the technological innovation of engineers. And it will require our combined commitment to an inclusive approach towards upstream policies that achieve equity. Starting with Henderson’s Nursing Need Theory, let’s recommit to the importance of applying nursing theory to meet society’s greatest need—an inclusive approach to upstream policies that achieve equity in the practice of sustainable development, local to global. Let’s make strides toward convergence where nurses and other professionals, including engineers, work together to solve society’s challenges. And let’s recognize that that there is much in common between the profession of nursing and the profession of engineering as demonstrated through an improved understanding of consilience and the UN SDGs.
Daniel B. Oerther, PhD, PE, BCEE, FAAN, ANEF, professor of environmental health engineering at the Missouri University of Science and a lifetime honorary member of Sigma.