An M.Phil./PhD. transfer paper for a research seminar at the University of Bath, to be held on the 14^th January 2004

Reverend Je Kan Adler-Collins

Assistant Professor of Nursing

Fukuoka Prefectural University

Japan

Summary

The cultural context of my question is the Faculty of Nursing at Fukuoka Prefectural University in Japan. The history, economics and politics of this social context are important to my enquiry as I am seeking to influence the education and the social formation of a new faculty of nursing through the design and pedagogisation of a curriculum for healing and enquiry nurses. This is a context for my own learning as I ask, research and answer the question, 'How am I developing a curriculum and pedagogy for healing and enquiring nurses in living my life of learning in educational enquiry?'

The spiritual context of my question is my life of learning and enquiry as a Buddhist Priest, in which I seek enlightenment in relation to the four noble truths of Buddhist doctrine, and explore their significance in my search to enhance the quality of the curriculum and learning of healing and enquiring nurses.

The professional workplace context of my question is my enquiry into the transformation of my own embodied knowledge, as a healing and enquiry nurse, into the curriculum and pedagogy of nurse education in the Faculty of Nursing at Fukuoka University.

The research context is focused on my knowledge-creation as I seek to contribute to the development of a new epistemology for a new scholarship of educational enquiry for healing nurses. The development of this epistemology will be studied as part of the process through which the embodied knowledge of nursing practitioners is validated and legitimated in the Academy. This will involve the clarification of the embodied values and knowledge of healing and enquiring nurses in the process of their emergence in nursing practice. It will also involve the clarification of my own embodied values and knowledge, in my practice as a professional nurse educator, as I design and pedagogise a curriculum for the healing and enquiry nurse. In the process of this clarification, the embodied values and knowledge will become transformed into living educational standards of judgment and practice that can be used to evaluate the validity of my knowledge claims.

In order to see this paper in its full context, it is necessary to take a few moments to place the journey with its differing strands of enquiry into the framework of an understandable process. This is far harder than one would think, as the emerging research threads, critical in the weaving of this story, did not emerge in a neat, clean, logical time sequence. In fact, they often evolved out of times of distress and dis-ease. This narrative has answered a few questions along its journey but, more importantly, it has given rise to new questions that are unfolding new forms of knowledge as the journey, the process and "I" co- enquire. This co-enquiry is a living process in the true sense of the word - shifting, changing, reframing and reforming in an intricate dance of knowledge creation with each different partner unsure of the steps and, on occasions, stumbling.

Holding with that metaphor, I have had many partners and danced many different forms of dance. I have confidence that I have learned the dance well enough to move this enquiry forward to the next phase of the dance, that of the emerging PhD enquiry.

As part of my educative process I am aware of the importance of publishing and making my claims to know open to public scrutiny and challenge. I attach as an annex a copy of my most recent paper, which was accepted for publication in December 2003.

I accepted a tenured appointment as Assistant Professor of Nursing in the Faculty of Nursing of Fukuoka Prefectural University on its opening in April 2003. The need for a new Faculty of Nursing in the Fukuoka Prefecture was related to a perceived connection between the health needs of the population and the high levels of unemployment in the Prefecture following the demise of the coal mining industry. My purpose in accepting the appointment was to develop a curriculum for the healing and enquiring nurse that would contribute to the development of a research-based approach to professionalism in nursing. Before accepting the appointment, I knew that the Japanese Ministries of Education and of Health had accepted my curriculum outline. Hence my work and research at Fukuoka began with a curriculum outline I had designed, developed and piloted over the last seven years from the ground of my embodied knowledge as a healing and enquiring nurse.

This outline was produced in the course of my MA degree programme at the University of Bath, 1995-2000. During this period I founded my own school of Healing Studies in Bath City, United Kingdom. I focused my concerns around the issues of healing, its teaching and its claims to know. I used the MA course in Education to ground my course in a solid educative structure and a framework of research. The methodology I settled on to show my research process, both in terms of educative process and of healing enquiry, was that of Action Research. During this programme I also developed an understanding of a form of scholarship that extended Boyer's notion of the scholarships of discovery, teaching, application and integration, with a scholarship of educational enquiry ( Adler-Collins, 2000). This extension is and remains a critical part of my emerging enquiry.

In 1995, I was ordained as a Buddhist Priest for Shingon Mikkyo and in 1996 undertook a 100-day fast as part of my desire for spiritual enlightenment. My spiritual journey and learning were documented by the BBC (Adler-Collins, 1998) and my self-study of this learning in relation to the Four Noble Truths of Buddhism formed an assignment for my masters programme (Adler-Collins, 1999). The integration of action research processes with Buddhism has been advocated by (Winter, 2003) and is consistent with the methodology of my action research. My methodological inventiveness (Dadds, 2001) has involved the clarification of the educational influences of my spiritual, aesthetic and ethical values in my own learning as a healing and enquiring nurse, and in the learning of my colleagues and students. It was at this time, when I was giving a key- note address on Holistic Nursing at Wasada University in Tokyo, that I first met my future Dean, who was a member of the audience. From this meeting came the invitation to join her new university when it was opened in 2003.

In 1997 I was fortunate to receive the assistance of Professor Andre Dolbec, from the University of Quebec, in clarifying the meanings of my embodied values and knowledge as a healing nurse. This included the transformation of my embodied value of the creation of a 'safe healing space', through this clarification in a collaborative action research enquiry (Adler-Collins, 1997).

Frequent visits to Japan to continue my esoteric priest training followed over the next three years. After each visit I modified the course with the new insights I had gained, often to the confusion of my supervisor! As the course evolved in the United Kingdom, it was modified by the research outcomes resulting from the MA process at Bath, and then it moved to Japan where I had opened another school in April 2000. From 2000 to 2003 I continued to develop the course as part of my M.Phil/PhD enquiry. Translating the curriculum into Japanese with a pilot course of students in Kumamoto City was the focus of events until I was notified that my curriculum had been accepted and my offer of appointment made.

One of the qualities of the cultural context that brought me to Fukuoka University was their holistic belief in forms of healing energy with a spiritual base. My Dean and other faculty members held this belief. It was a calculated risk on the part of my Dean to include Healing as part of a University curriculum, for the first time here in Japan. Healing is and will remain a risk until evidence is found as to what the healing process is.

I believe that healing is a complex process that has much that cannot be explained and much that can. However, such explanations bring with them tensions that are not so easily addressed. For example, Science has the power to police what is and is not seen as acceptable forms of knowledge and knowing. This power is derived by science from its ability to generate funding and research in Universities that are also funded by commercial interests. These establishments/social formations set the levels as to what is and is not acceptable knowledge within their interpretation of what the shape of their society should be. The state works with a mixture of political will, supported by commerce, and the will of the middle and upper classes who have a vested interest in maintaining the system that they have aspired to. Education works with the power of the political will of state and acts in a role of policing knowledge. Policing that which is acceptable to the institution (state) and rejects that which is not. Acceptable forms of knowledge are rewarded by academia with the status of higher degrees, tenures and titles, whereas unacceptable knowledge is ridiculed and/or rejected.

I would argue the position that changes are a foot and that with the advent of the World Wide Web. Knowledge and knowing are no longer in or under control of the state. Social formations have to look to the future with the advent of the virtual Universities and direct access to the Professors and authors of the books that the institutions lay the claim to be gate holders of. The authority of the institution is under challenge in terms of knowledge but still maintains a firm grip on power. (Burnstein, 2000) expresses the opinion:

It is these power issues that make my enquiry at this point in time so exciting for me as I see the winds of change slowly gathering pace in the most unexpected of places.

For example, some scientists are even asking the same questions as healing researchers, as shown by (Pert, 1999), who asks the question: What is this 'energy' that is referred to by so many alternative healers, who associate it with the release of emotion and the restoration of health? Her answer is consistent with my own beliefs:

I also draw on and am inspired by insights from the work of (Rayner, 1997) on the dynamic properties that underlie the functioning and ecological and evolutionary responsiveness of living systems. I share his view on the importance of developing patterns of relating to those systems that enhance quality of life for all living systems in a state of nested holiness. I share his commitment in the development of a knowledge-base for healing and enquiring nurses, in order to contribute to a future in which we human beings can enjoy more empathic relationships with one another, other life forms and our surroundings. In the course of my research I will be exploring the development of such empathy with my students as we develop their insights as healing and enquiring nurses.

Fukuoka University offered me the chance to move the healing curriculum into a social formation and give it validity in terms of academic rating. I was given the freedom to talk about love and compassion in a nursing curriculum. I am able to challenge consciousness and thinking and what actually makes nursing and nursing knowledge. These are all issues which are fundamental to my life and its values.

I have been given the chance to see, by research, if science and healing are so very far apart or if they share a common ground. Slowly, I believe I am finding the evidence that there is a quiet revolution taking place within the sciences, and I hope that it will move osmotically over to the science of education and then into the actual practice of nurse teaching.

In his research into the scientification of love, (Odent, 2001) offers an interesting thought as he puts forward the contentious view that our capacity to love (encapsulated in the not very complex molecule of oxytocin), and especially the capacity to love and protect our planet, is the prerequisite of global survival:

Love, its exploration and understanding in terms of the safe loving of the compassionate nurse, is a fundamental cornerstone of my enquiry. In the development of my scholarship of enquiry Adler-Collins, 2000) I demonstrated the capacity of my originality of mind and critical judgement to create my own unique way of developing a scholarship of educational enquiry. This human capacity for self-organisation has been explored by (Roberts, 2003) in connecting his life of inquiry (Marshall, 1999) with the creation of his own living educational theory (Whitehead, 1989). Rather than starting with a 'method' of enquiring, the action researcher trusts that their own creative and critical capacities will find a methodological form emerging in the course of the enquiry. This is consistent with the findings of Dadds and Hart (2001):

In her work on changing conversations in organisations, (Shaw, 2002) draws on the work of (Scharmer, 2000) to describe a methodology of generative learning that resonates with my own approach:

Adopting the approach of generative learning in my enquiry means studying the collective forming, enacting and embodying of a common will with my colleagues as we work to enhance our qualities of aspiration, vision and intention in the Faculty of Nursing. I see this as an act of loving, and this process to date has been one that has required the ability to compromise and find work-around solutions - I seek not to impart my forms of knowing and ideas yet another form of imported white colonialism. By this I consciously seek to avoid the grafting of my ideas into the university’s curriculum as a token element of Internationalism. Rather I wish to see my forms of knowing challenged, modified and evolving into an original co-operative concept of knowing between me and my Japanese colleagues and students.

The Dance of Loving my Colleagues.

Enthused as I am with the introduction of the idea that a living theory approach to action research could help to raise the aspiration, vision and intention of the Faculty and that of local nurses. Engaged in the active practice of nursing and nurse research, it is not without its tensions. These identified and emerging tensions will without doubt make the writing of the research anything but a sanitised, victory narrative. Encouraging others to examine their practices as teachers, learners and researchers is not always a process that is free from conflict. The recording of how the conflicts can act upon the research is part of the growth of the co-operative enquiry. A living research journal is maintained by posting to the discussion forum of the Living Action Research web site at http://www.jiscmail.ac.uk/lists/living-action-research.html which is evolving into an educative community of over 90 members in nine countries. The development of this forum over the last two years has become one of the successful outcomes of my research to date.

As part of this process of moving the enquiry into its strand of co-operative community research, regular action research meetings with staff in the Faculty and the local hospitals were started which offered an immediate positive form of evidence and enthusiasm as the passion for enquiry and voices was echoed by its members. Evidence of this will be the hosting of an International Action Research Conference for Nurses in August 2005 at Fukuoka University, run by the group, with a Conference theme "Voices in the Silence, The Telling of our Stories". This conference will explore the possibility and challenges of developing a democratic process of evaluation for judging the validity of our accounts of the learning of the group in enhancing the quality of our aspirations, vision and intention. Students and staff from the University and junior staff nurses and head nurses from the local hospitals will be encouraged to participate as part of making the reflective process of their practice the norm of good practice. I hope this process will bring about "Presencing":

I take the process of becoming fully present for my students, colleagues and community to include a process of intuiting their learning needs as I support their emergent realities. While I am conscious that my focus is on the learning of the students in the Healing Curriculum, I cannot see them in isolation but as future colleagues and members of my living community, a matrix of the past, the present and the future. (Shaw, 2002) encapsulates many of my feelings and values as she continues to engage with (Scharmer, 2000) powerful writings:

My curriculum for the healing and enquiry nurse includes this process of generative learning as a co-enquiry with my students and colleagues. The process includes testing the validity of our intuitions as we create and share our interpretations of a transcendent whole in connection with our own well-being. I share an assumption with my colleagues that we are all in need of some form of healing and that we can share an understanding of the influence of such a transcendental whole in our own learning about our well being.

In the development of my action research methodology I am mindful of (Winter, 2003) questions as he advocates an action research approach as an appropriate model of inquiry for the caring professions.

Winter asks: what model of inquiry is appropriate for 'research' in the caring professions, such as nursing and social work? He says that it is increasingly important to pose this question as we see the apparently insoluble problems resulting from the attempt to use a model derived from the logic of natural science. He puts these problems in the form of questions: If individuals and settings are unique, how can research be replicable? How can research findings be translated into effective practice? Are randomised controlled trials ever really valid (technically) and, anyway, are they ethical? Are not 'performance criteria' obviously amenable to political manipulation? Perhaps, most importantly of all, how is it that practitioners and patients are largely excluded from defining the purposes of research and the meanings of data, i.e. from the purposes of their own life-worlds?

The fundamental assumption in my own research is that its purposes and the meanings of my data are intimately connected to the purposes of my own life-world. By this I mean that my life-world is a matrix of construction through the filters of my Buddhist understandings. These understandings give a value to how I live, and that value is that I am committed to loving, compassionate service to my world. In the course of my research programme I intend to answer the questions that Winter (2003) asks:

As Winter says, action research has a long history in education and community settings and the first textbook on action research in education was (Corey, 1953) action research to improve school practices. More recently, action research approaches have been developed for enquiries into health practices (Bellman et al., 2003); and I have set out my own living theory approach in my scholarship of enquiry (Adler-Collins, 2000). Exploring the strengths and weaknesses of an action research approach when applied to nurse education is a critical strand of my enquiry. There are considerable tensions around what is considered to be nursing knowledge and the power relationships between the dominant medical model and the representation of an appropriate nursing model of knowing. (Ceci, 2003, Chaboyer et al., 2001, Chang et al., 1999).

Addressing these tensions in the arena of my classroom teaching practice forms another thread of my enquiry. I have used the term ‘arena’ deliberately, as the classroom is being used for educative power battles in terms of conflicting methodologies. I hold that the classroom should be a safe space for learning, and for defending that space, while implementing a new methodology in a culture that is not my own is providing ample critical incidents for analysis. Tensions have been highlighted at this early stage around the colonial attitudes prevalent in Japanese education and nursing education.

My positional stance is that of a post-colonial researcher seeking to find out how the emergence of a Japanese form of knowing can emerge from our collective enquiry, as the students, my colleagues, the faculty, social formation and I have to address the issues found in my introduction of a healing curriculum.

 The next section of this paper is linked to live World Wide Web (www) sites linked to my PhD research site ( http://www.living-action-research.net ) which will give some indication of the depth of data and assets being used, and how they can be expressed in a multimedia format.

The web-based design and delivery of the curriculum ( http://www.living-action-research.net/writings/curriculum.doc ), together with the assessments, can be accessed at ( http://www.living-action-research.net/Fukuoka_University/fukuoka_index.htm )

This web-page, together with the e-forum and the learning resources for the nursing curriculum, plus the assessments, are now being used with the first cohort of nurses for the 2003-2004 academic session. The evaluation of the students' learning will include portfolio evidence provided by the students as part of their assessment, as well as their test scores from the web-based assessments ( http://www.living-action-research.net/Fukuoka_University/Healing_index.html ). The evaluation of the students’ engagement with and experience of my teaching, its quality and content, will be researched and evidenced by the students completing web-based session questionnaires ( http://www.living-action-research.net/webquiz/quizzes/eval-wepage.asp ). The data from these questionnaires will be used, as a management tool, as part of the real-time evidence of the quality of the students’ experience. Analysis of this data at the completion of the first cohort’s sessions will be a cornerstone piece of evidence, as will be the recommendations for modifications to be made to the course and piloted in the second cohort starting in April 2004. At the anticipated completion date for this PhD in 2005, three cohorts of nursing students will have completed the healing theory and healing practice Units of their training providing a rich data archive for analysis.

Informed consent and Research consent are evidenced as an annex to this presentation along with the lesson presentation powerpoint slides, and sampler evaluations and resulting consents of the students. The tensions and problems involved in the process of getting informed consent from the ethics committee is also evidenced and will serve as a future enquiry thread as to the question: What is the role of ethics and the ethics committee in Action Research: support or suppression?

A copy of the powerpoint presentation given to the course on the issues of informed consent can be found on a CD Rom in Annex B of this paper.

Informed consent has been given by 100% of the students.

Research consent was given by the university’s ethics committee for this PhD project’s classroom research element to be conducted in Fukuoka Prefectural University. Restrictions and modifications placed on me by the committee directly changed the type of research I wished to carry out as an action researcher. There is a tension around the use of power by the ethics committee to enforce their values on the researcher rather than being there to review and assist the ethical issues of the research. The exploration of this tension will provide an interesting strand to the enquiry as it moves between not only cultural differences but methodological ones as well.

In July 2003 Fukuoka University provided an £8000 research grant to support the development of my enquiry into the physiological changes, in the patients and nurses, that can be related to the therapeutic practices of the healing nurse. Enquiries into these changes will initially be focused on the physiological events that can be connected to the creation of a 'safe healing space'. The standard of judgement of a 'safe healing space' will follow the procedure developed in the collaborative action research study carried out at the Laurel Farm School of Complementary Medicine in 1997 with Professor Andre Dolbec (Adler-Collins, 1997).

In the development of living educational theories of learning in the lives of healing and enquiring nurses, I want to meet Noffke's criticism of living theories that they seem incapable of addressing social issues in terms of the interconnections between personal identity and the claim of experiential knowledge, as well as those of power and privilege in society.

I intend to meet this criticism through developing what Smith has called for in the development of shared living theories:

A characteristic of curriculum decision making in the Japanese context of the Faculty of Nursing at Fukuoka University is that loyalty to the collective is valued more than individual creativity and initiative. While this commitment can tend to stifle individual enquiries of the kind, 'How do I improve what I am doing?' it elevates a commitment to 'we' enquiries of the kind, 'How do we improve what we are doing?'. In the course of my enquiry I will be exploring the possibility of contributing to the creation and testing of shared living theories of learning in the development of the curriculum for the healing and enquiry nurse at Fukuoka University.

Part of my research context is communities of discourse on the web. As much of my own learning takes place through inner dialogue and dialogue with others, including my supervisor, I have documented many of these conversations over the past three years and they are archived at http://www.living-action-research.net. As part of the extension of my cognitive range and concern in my living educational theory, I will analyse my learning through these conversations as I show the growth of my understanding of how to pedagogise the embodied knowledge of a healing nurse.

I am using pedagogy in Bernstein's sense that it is:

 In summary

My research is intended to extend the range of living educational theories legitimated in the Academy through an enquiry that includes my own education, my educational influence in the learning of others and my contribution to the education of the social formation of Fukuoka University's Faculty of Nursing.

Annex

1. Adler-Collins, J. (2003) Research or not Research? The tensions around the use of Action Research methodology to add to the database of Nursing knowledge by the use of self-narrative studies: Voices in the silence. FPU Journal of Nursing Research 1(1). In print December 2003.
2. CD Rom. Informed Consent. Power point Presentation (Bi-lingual). Author Adler-Collins, J. Translation Ohmi, Y. (2003)
3. Sampler Copy of Student Consent document.

Author. Reverend Je Kan Adler-Collins MA PGCE REMT RN

Address: Fukuoka Prefectural University

Faculty of Nursing

Ita 4395 Tagawa City

Fukuoka Prefecture

Japan

825-8585.

Employment. Assistant Professor of Nursing

Number of words. 4613

Our voices as nurses and those of the patients in our care have, I believe, great importance and value in holding us to account in terms of our healing influence as nurses. Often our voices and those of our patients are committed to the void of silence for multiple reasons. These reasons include the power relationships between the knowledge base of the medical model and the knowledge base of the nursing model in terms of what constitutes, and who actually decides what can and cannot constitute, legitimated forms of nursing knowledge.

These power relationships and the tensions they evoke have a very direct influence on the moulding and formation of our nursing profession. The criticism that, I believe, could be and is levelled at the Nursing profession is that of the absence of our individual authentic expressions of our nursing practice and those of our collectively represented voices standing alongside those voices that persistently dominate.

To address this criticism, this paper calls for the creation and integration of a new form of nursing knowledge from the action research of healing nurses into their own practices. This knowledge will be created by the representation of what we know as nurses through the telling of our educative stories in our authentic voices. These voices and stories embody our claims to know, grounded in our professional experience and practice. This knowledge can be validated and legitimated in the academy through the stories being subjected to critical analysis by peer and public examination. This analysis will give rise to a confidence in our professional knowledge base that incorporates our authentic values as nurses. These values can then be used as public benchmark standards against which our professional knowledge can claim its authority and be held to account.

"We are still novices in the art of thinking. Great discoveries in ourselves and in our cosmos at large will depend on the invention of new forms of thinking. You are what you think" (p169).

It may seem strange reading the words "Healing Nurse" and "Stories" in a professional journal of Nursing Research Practice. I hope, however, that by the end of this introductory paper this feeling of strangeness will have given way to a shared feeling of anticipation and excitement, similar to that which I am experiencing as I write this paper to you.

Our voices as nurses and those of the patients in our care have, I believe, great importance and value in holding us to account in terms of our healing influence. Often our voices and those of our patients are committed to the void of silence for multiplereasons (Hess, 2003; Walker, 2002). These reasons include the power relationships between the medical model and the nursing model in terms of professional knowledge (Chaboyer & Patterson, 2001; Chiarella, 2000; Manias & Street, 2001). These power relationships, and the tensions they evoke, have a very direct influence on the moulding and formation of our profession. The criticism that, I believe, could be and is levelled at the Nursing Profession is that of the absence of individual authentic expressions of our original voice and that of our collectively represented voices standing alongside those voices that persistently dominate (Aranda, 1999). By "authentic" I mean our own opinions and ideas based on our beliefs, experience and living values, grounded in our practice and validated by our professional knowledge base.

In keeping with Clark, Dudley & Edwards’s, (1986) position as cited by Waterman (1998), where they are referring to the positioning and framing of the enquiry to assist the reader, I am framing the writing of this paper through the filters of a Buddhist Priest, an ex Soldier in the British Army, an educator and a Nurse.

My concerns about the voices of nurses arose from my recent hospitalisation in a Japanese hospital, where I observed the interactions of doctors with nursing staff and nurses with patients at first hand. What I witnessed triggered my enquiry as I had taken up a post as a Nurse educator and I needed to explore this tension.

The purpose of this paper is to formulate appropriate questions and present a case for others to engage with in seeking to address these tensions.

My writings as part of my educative discourse are one of the ways in which I give a form to my life. In this sense I see myself as an artist who is giving a form to his own life through his productive work. In forming my life, as a post-modern writer, I am working without rules in order to formulate the rule of what has already been done. Lyotard (1984) writes about ‘terror’ in relation to repression of ideas by institutions of knowledge. I have certainly felt the disciplinary power of my university in ways which resonate with Lyotard’s analysis:

I agree with Lyotard as he continues:

I seek to meet and challenge such use of academic terror wherever I meet it within the profession of nursing and as a nurse educator. I passionately believe that, as a profession, nursing needs to develop the authority of its own voices, grounded in its professional knowledge and practice of healing. I believe that this knowledge and practice can be supported by scholarly academic practices that cross self-imposed research methodological considerations and disputes. These considerations, so vigorously defended by nurse researchers as to what is or is not the correct paradigm for "Nurse research", often act as divisive influences on our profession, fragmenting our knowledge base and preventing the holistic formation of nursing knowledge that embraces the many different methodologies. These differing methodologies can be brought together in a holistic form of research that can stand up to external rigour and examination by what are often hostile power relationships embedded in the positional stances of interested bodies. Such a database of nursing knowledge would give rise to nurses having the authority to hold their values and advocacy of their patients (Snelgrove et al., 2000). The fact that we have a long way to go, and the tragic consequences of our failure, is well reflected on in Chiarella’s paper (Chiarella, 2000) "Silence in Court".

There are many ways for the representation of knowledge and knowing. The lack of recognition on all levels of the value of the healing nurse, according to the medical model, is an obstacle that can only start to be addressed by nurses engaged in the healing art of nursing: valuing their own practice, researching their own practice and seeing themselves as knowledge creators within that practice. I am using the word healing to mean that nurses by definition are part of the healing process of their patients and that that process is a complex one (Glaister, 2001).

The next most important step would be making public our claims to know in the telling of our stories. Stories have been used for centuries to pass down teachings, values, messages, warnings, morals, or just for entertainment (Koch, 1998). This process will bring about new forms of knowing which arise from our experience of doing. The different knowledge bases presented by the multi-facetted aspects of the very different forms of knowledge and knowing are what a nurse is required to master.

A nurse in his/her practice often moves between different mindsets of knowledge and knowing, these being those of clinician and healer. Such movements can often be problematic and can be, and often are, viewed to be mutually exclusive.

Within my own practice, I see them to exist in a state of mutual harmony, each informing the other. The professional healing Nurse should not be forced to decide which camp he/she will adopt in order to establish the status of a professional. Rather he/she should be encouraged to integrate equally and be able to move comfortably between the different forms and bodies of knowledge. By so doing the Nurse will enhance his/her skills and add to the knowledge base of our nursing profession.

If the profession of Nursing as a whole listens to the authentic voices and stories of practice nurses and nurse educators, and the voices of our patients, then the opportunity for collective collaboration occurs. This collaboration can be in the form of emergent enquiry that can nurture and inform our database of professional knowing.

This will act as an empowering force for good on and within our profession, helping to equip and inform the Nurse of the future with the necessary skills to practice our art. However, it will be necessary to instigate new forms of critical thinking and enquiry along with original approaches to Nurse-led research. I am thinking of the kind of Action Research enquiries, as proposed by Dr Jack Whitehead of Bath University, that engage, alongside self-study of nursing practice, with questions of the nature, "How do I improve my practice as a nurse?" Moreover, "How do I generate my own living educational theory of nursing?"

If, as professional Nurses, we critically reflect on our practice and seek the evidence of our claims to know and to have influenced the dynamic database of our living knowledge, we have a fundamental problem that needs to be placed into the public forum for debate, namely that of our evidence for our claims to know. Such evidence would ideally be sought from our patients. There are strong ethical considerations to address in the design and application of Nurse-led research, which by its very nature seeks to use the patient as a data resource. I firmly believe that there are areas and times where it is inappropriate to seek the evidence of our claims from this source. This tension can and does bring about what McNiff, Lomax and Whitehead talk about:

"Living contradiction…is to feel the discomfort of knowing that we are not acting in accordance with our values and beliefs" (p.48).

Academically this presents a conflict not only of ethics and of morality but also on the level and academic value of the critical evidence we use to present to our peers and those outside of our profession in supporting our claims to know. It is, and shall no doubt remain, one of the greatest challenges for the paradigm of the healing Nurse to find suitable ways for the representation of our healing experience in terms of evidence in ourselves and in the healing process of others.

What I am suggesting is that the face of nursing knowledge needs to change in order to reflect the stories, knowledge, and authentic voices of nurses. This voice, embodying our claims to know and passing through the process of being subjected to critical analysis in the arena of peer and public examination, gives rise to a confidence that our claims incorporate our authentic values as nurses. These values can then be used as public benchmark standards against which our professional knowledge can claim its authority. Then our claims to professionalism, and their legitimisation and defence, will arise from our own knowledge base rather than that of another profession.

Nursing needs to be aware that it is involved in what Gage (Gage, 1989) and Schön (Schön, 1995) refer to as the paradigm wars:

The recognition of this tension and its possible solution offers nursing a unique chance to find an original platform for the representation of our authentic claims to know. This original platform is that of the Action Researcher.

I am consistently surprised that Nursing, as a profession, allows those who are not nurses to control what counts as nursing knowledge. More worryingly, the hands-on skills of nursing, including those of safe healing touch and basic nursing care on which our profession is built, are seen as less significant than cognitively acquired forms of knowing. These forms have become separated from and given more value than what I believe is our embodied knowledge as healing nurses: our practice.

There are many fundamental questions and issues facing modern nursing today. Some examples are questions of the kind: What is nursing knowledge? What is nursing research? What is nursing scholarship? What is nursing practice?

Often in discussion with other nursing professionals I am asked, what is research? The academic answer could be along the lines of Stenhouse (1975) where he states that research is "a systematic enquiry made public." Bassey (1995), as quoted by McNiff et al (1996), offers the opinion that there are three categories of research:

McNiff et al (1996) extend these points to include systematic enquiry made public; informed, committed, intentional action; and worthwhile purpose. Winter (1998) tells us that the practice of Action Research as a methodology involves risk, by which he implies that a degree of vulnerability and openness is required.

Are we as Professional Nurses prepared to take a risk and represent our authentic voices in the telling of educational journeys that will embody all that we have seen and learned?

Each of us has a story to tell: our humanness and the journey that we take is no different from that of our patients. Our knowledge is in our experience. Nurses are trained observers; we have direct contact with our patients and can see the patterns of dis-ease, sickness, and healing occur. An experienced nurse is a living database of knowledge and expertise that is often not acknowledged. All forms of research link new knowledge with that of existing knowledge. Action research in itself differs because it requires action as an integral part of the research process. It is focussed by the researcher’s professional values, instincts and enquiries as well as by methodological considerations.

I am mindful as I write this paper that it will be challenged from the positional stance of scholarship, even more so when words such as healing, love, and compassion enter the text. Apple (1997) tells of some of the problems he encountered with his statement, "Academic boundaries, themselves are culturally produced, and often results of complex policies of policing actions by those who have the power to police and the power to enforce them" (p.1). Bernstein (1971) reminds us: "listen carefully, to the use of …linguistic, emotional, and cognitive imagination to grasp what is being said in "alien" traditions…{without} either facilely assimilating what others say to our own categories and language….or simply dismissing them…as incoherent nonsense" (p.48).

In keeping with these views I need to make explicit the views I hold in such a manner that they speak directly to you. I am mindful that a dilemma has given rise to the strange system we have now in nurse research, this dilemma being that we follow, by instruction or design, the dictates of the medical model. I would strongly contest that this course of action does not serve nursing well, for nursing knowledge is humanistic in nature, based on observation, reflection in the moment and modification of practice: all centred on the nursing needs and care of the patient.

Dewey reminds us that: "Education is a social process…Education is growth…Education is not a preparation for life; Education is life itself."

I am thinking at this stage of my life-long learning. This includes: my experiences as a British soldier; the teachings I received through my injuries/illness and subsequent journey to recovery; my teachings as a Nurse practitioner in Complementary Alternative Medicine (CAM); the study of my relationships and learning up to and beyond my ordination as a Shingon Priest in Japan; the ongoing teachings of my educational journey through the academic systems of both the United Kingdom and Japan. Each one of these stages of my life developed and informed the next through the filter of conscious enquiry, where I sought to remove the separation of self as a single entity and integrated it to an inclusive form of wholeness. This understanding and the values I hold influence my practice as a healing nurse and a nurse educator and produce the account of my living story.

The written or spoken word is not that which is received and/or read, and the many forms and methods of our ability to understand will be challenged by the filters of our different cultures, the use of language and even in the translation. True communication starts with the deeply held desire to communicate, followed closely by the searching for safe and clear means to achieve that communication. Safety, as a descriptor, is a word that I will use often, and by safety I understand that, in this medium of text, a space is created in which all can bring their different ideas and values, offer them into a neutral space without an agenda and/or attachment, and engage with the ideas and values of others through conversation. Through this engagement, we can choose to pick up and assimilate or engage with the ideas and values of others through our own choice. By so doing we maintain our integrity and respect the position of others.

Nurses need to develop their story-telling skills, for each original authentic story will be rich with the wisdom of experience grounded in practice. I think this is consistent with the ideas of in accounting for ourselves in the problematic of representing action research. In trying to capture the essence of what we are doing, there is a sense in which we could destroy the thing which uniquely characterises this kind of work. Carter says that a story,

"Is a theory of something, what we tell and how we tell it is a revelation of what we believe.... (Stories are) products of a fundamentally interpretative process that is shaped by the moralistic impulses of the author and by narrative forces or requirements." (p.9)

Lomax et al., say, "Story is another way of representing action research without constraining it within the traditional prepositional form there is no necessary logic of connectedness in story". (p.301). My story is created in the context of my own practice as a healing nurse, and is a self-reflective action research enquiry where I examine my claims to know, through the methodology of a critical enquiry in my reflective practice . My story represented a journey of several inter-woven strands of my "I", those of soldier, nurse, Shingon Shu Buddhist priest, teacher, and researcher. This journey was held up to critical examination and reflection over a 5-year period of completing a Masters Degree in Education at Bath University, United Kingdom . It remains unfinished as it continues to evolve in an ongoing journey of life-long learning. This is now forming a framework for my doctoral thesis.

The medium of story is a safe way for me to make explicit my values to the reader and show how traumatic life events can be transcended, re-examined and turned to the positive through engaging with finding the values of my "I", in terms of creating my living educational theory. I continue to engage with the educational issues of the day, focusing around research methodology, claims to know, representing forms of knowledge and scholarship, its validation and the tensions these issues bring into my research and practice. As part of the process, I struggle with finding a form of knowledge which allows me to hold my fundamental values while seeking academic accreditation and advocating the professional status of the healing nurse professional.

My story continues to weave a path of learning in my own voice as I move into and out of phases of confusion and tension, towards a new understanding, changing and modifying my understanding of my "I" as a result of the learning and insights achieved. The telling of our collective educative healing journeys and stories as nurses, fathers mothers, lovers, and patients will fill the silence with experience, compassion, love, tenderness and the transformation of our profession where we can once again re-connect to our art so beautifully encapsulated in the words of Skolomowski :

Our stories have currency in terms of knowledge, learning and academic value. The increasing publication of nursing and academic texts that support this position is resulting in re-evaluations of the content of what constitutes Nursing knowledge. It will require courage, persistence and compassion to stand against the power bases of established forms of knowledge. Historically, these are not qualities found lacking in Nurses. Action Research offers a unique chance to nursing. Action Research is not a total solution. Action Research offers new challenges and new problems: original thinking will be needed to meet these. If we as a profession address these issues, then perhaps one day a paper such as you have just read will not be titled an "opinion" or "positional paper" but stand in it own right as a testament to the value of story as a contributor to nursing knowledge.

References

3. Sampler of Informed Consent