Despite two or three generations of scholarship, the relationship between the practice of nursing and the conceptual knowledge that is supposed to drive it remains ambiguous and confusing. The extensive body of theoretical writing in nursing journals suggests that conceptualizing holds a persistent allure for those seeking to wrestle with the theoretical challenges inherent in a ‘practice discipline’ such as ours.

Whether writing about a particular concept or analysing the notion of conceptualizing itself, a legion of scholars has attempted to set straight our thinking about the intellectual core of the profession and the epistemological structure of the discipline. They have drawn on what I see as three distinct varieties of conceptual theorizing. First is concept analysis in which the scholar attempts to deconstruct the origins and meanings of theoretical constructs central to the discipline. In this process, contradictions associated with terminological options are illuminated and examined. Second is concept definition in which a singular understanding is drawn from the deconstruction process and an authoritative claim staked on a particular definition as being the most appropriate for nursing, whether based on practice expertise, research or scholarly reasoning. A third form, concept measurement, wrestles these mental images from the grasp of their embedded context and complexity so that they emerge as objective entities, amenable to quantification and such scientific manoeuvres as quantification permits.

Each of these intellectual exercises helps us think differently about a concept and this may prove quite useful. However, the activity of conceptualizing may derail us from the ultimate purpose of knowledge production if we allow ourselves to believe that we are making ‘progress’ along some invisible continuum when we may be engaging in what Paley (1996, p. 572) described as a ‘vacuous exercise in semantics’. Certainly in non-applied academic disciplines, theorizing in and of itself is the actual point of their intellectual exercises. The ‘stuff’ of nursing, however, always must be grounded in our service mandate. The mental representations we create through our conceptual work become the tools that nurses draw upon in the delicate dynamic of applying the general to the particular: that is, selecting from an infinite set of ideas and facts those that illuminate and explain a phenomenon in the unique and local conditions in which nurses interact with patients.

So, conceptualizing is a crucial activity but only – I argue – when it has the purpose of enhancing knowledge for practice. Nurses now recognize that what constitutes nursing is never only the tasks carried out by the nurse but, more importantly, the intellectual activity which necessarily accompanies their selection and the manner with which those tasks are approached. Therefore, the importance of conceptual knowledge is now recognized as the intellectual scaffolding with which nurses make sense of the complex clinical problems with which patients confront them.

The ability to conceptualize – arguably the characteristic that makes human thought unique – constitutes the essence of the disciplinary basis of our practice. For nursing, conceptualization provides the capacity to grasp abstract and complex ideas that pertain to the health and illness of human individuals and groups, so that we might communicate these ideas and apply them in increasingly effective and meaningful ways. Only when we have created a mental image of a concept such as chronic sorrow, empowerment or existential anxiety, can we see it in our practice, understand it, and draw upon the ideas of others to work with it. We bring concepts that may have some practice utility into our disciplinary discourse so that we can examine the promise that theorizing about them may hold with regard to our ability to enhance the contribution of nursing.

The ideas of interest to nursing are inherently and wonderfully slippery and dynamic. For this reason, I believe that our theoretical project ought to be motivated toward the goal of deeper reflection and expanded critical interpretation, not defining, constraining, or concretizing ideas. We ought to regard our disciplinary concepts not as monuments to particular theorists, but as living, breathing communications about core elements within nursing's intentionality and complexity. Our allegiance to concepts should depend entirely on their utility in informing excellent nursing toward the ultimate outcome of making a difference to those we serve – and that's the point of conceptualizing.


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