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Enfermería: Cuidados Humanizados

versão impressa ISSN 1688-8375versão On-line ISSN 2393-6606

Enfermería (Montevideo) vol.8 no.2 Montevideo dez. 2019  Epub 01-Dez-2019 

Original Articles

The social place of Nursing knowledge: scientific editorials as linguistic artifacts read from a Certeau´s perspective

Juan D. González-Sanz1

Ana Abreu-Sánchez1

Margarita Rodríguez-Pérez1

Manuel Amezcua2

1 Departamento de Enfermería, Universidad de Huelva, España

2Fundación Índex, Granada, España


The purpose of this article is to analyze the process by which nursing knowledge is produced. It takes a philosophical perspective based on the concept of social place developed by Michel de Certeau. Social place comprises an institutional dimension, the procedures used to create knowledge and the values underlying it. In applying this epistemic framework to nursing, the authors focused on the Journal of Nursing Scholarship (JNS). The study took the form of a textual analysis, using Certeau’s epistemic categories, of all JNS editorials by Susan Gennaro from 2007 to 2018. The results of this analysis support the Certeaunian view that the JNS can be regarded as a knowledge institution, which maintains a tight relationship with power, makes contracts with authors and reviewers, and generates its own discourse about reality. The key procedures and conventions for contributing papers to the JNS were also identified. Finally, practice, social significance, efficiency, universality, good science and leadership emerged as the core values of the JNS. The findings of this study can help researchers to appreciate that knowledge (and linguistic artifacts associated with it) is never absolutely free from social constraints.

Keywords: Nursing; knowledge; production; scientific journals; Michel de Certeau.


El objetivo de este trabajo es analizar el proceso de producción del conocimiento enfermero. Este propósito se ha acometido desde una perspectiva filosófica, basada en el concepto de lugar social desarrollado por Michel de Certeau. El lugar social incluye la dimensión institucional, los procedimientos utilizados para generar conocimiento y los valores que lo sostienen. Para aplicar este marco epistemológico a la enfermería, los autores se han centrado en el estudio del Journal of Nursing Scholarship (JNS), a través de un análisis textual en el que se han estudiado los editoriales escritos por Susan Gennaro en JNS desde 2007 hasta mayo de 2018, aplicandoles las categorías epistemológicas certeaunianas. Después de una lectura atenta es posible afirmar que JNS puede ser visto como una institución del conocimiento, que mantiene una estrecha relación con el poder, establece acuerdos con autores y revisores, y que escribe su propio discurso sobre la realidad. También han sido identificados los procedimientos clave que marcan cómo ha de ser escrito un artículo para JNS. Finalmente, la práctica, la significación social, la eficiencia, la universalidad, la buena ciencia y el liderazgo han aparecido como los principales valores de JNS. Las aportaciones de este trabajo pueden ayudar a los enfermeros a comprender que ningún conocimiento (ni los artefactos lingüísticos asociados al mismo) está completamente libre de influencias sociales.

Palabras clave: Enfermería; conocimiento; producción; revistas científicas; Michel de Certeau.


O objetivo deste trabalho é analisar o processo de produção de conhecimento de enfermagem. Esse objetivo foi realizado a partir de uma perspectiva filosófica, baseada no conceito de lugar social desenvolvido por Michel de Certeau. O lugar social inclui a dimensão institucional, os procedimentos utilizados para gerar conhecimento e os valores que o sustentam. Para aplicar esse quadro epistemológico à enfermagem, os autores se concentraram no estudo da Journal of Nursing Scholarship (JNS), através de uma análise textual na qual os editoriais escritos por Susan Gennaro no JNS foram estudados de 2007 a maio de 2018, aplicando as categorias epistemológicas certeaunianas. Após uma leitura cuidadosa, é possível afirmar que a SNJ pode ser vista como uma instituição do conhecimento, que mantém uma estreita relação com o poder, estabelece acordos com autores e revisores e escreve seu próprio discurso sobre a realidade. Os principais procedimentos que marcam como um artigo para o JNS deve ser escrito também foram identificados. Finalmente, a prática, o significado social, a eficiência, a universalidade, a boa ciência e a liderança apareceram como os principais valores da SAN. As contribuições deste trabalho podem ajudar os enfermeiros a entender que nenhum conhecimento (ou os artefatos lingüísticos a ele associados) está completamente livre de influências sociais.

Palavras chaves: Enfermagem; conhecimento; produção; revistas científicas; Michel de Certeau.


Our contribution to the development of the body of nursing knowledge takes a philosophical approach. This implies the next premise: that the development of new knowledge or insight on nursing not always come from the increase of available data, but also from a different way to pay attention to something familiar to us. To do this rigorously it is first necessary to clarify our intellectual framework. Over the last decade we have been investigating the work of the French philosopher, Michel de Certeau. A broader-based presentation of its potential contributions to nursing can be found in a previous paper by authors 1 .

The analysis of the production of knowledge within the scientific disciplines is a solid line of research in Certeau’s works, focusing on “the study of writing as historical practice” 2 . Nevertheless, can nursing be included within this group of scientific disciplines and can Certeau’s approach be applied to nursing? Although there is a good deal of debate about the scientific nature of nursing, there can be little doubt that a body of nursing knowledge exists and that it is continuing to grow. In this respect, we start our reflections with the affirmation that Certeau’s premises about history and other disciplines can be applied to nursing as a scientific discipline.

Hence, the aim of this article is to study the process by which nursing knowledge is produced, in accordance with the theoretical background drawing on Michel de Certeau’s works. It is essential to clear here that our will is not to take sides with Certeau´s points of view (about the customs of academic culture, the power of elites or popular revolutions) but to leverage his scientific analysis model to study nursing knowledge. More precisely, to study with him, quoting Ian Buchanan, “the problem of what can be said” 3 in the field of knowledge production.

In order to achieve a degree of specificity we focused on a particular producer of nursing science. Many journals could be studied to get our objective, but we have no space enough to examine several journals here or to explain in detail the great complexity of Certeau´s ideas. We selected the Journal of Nursing Scholarship (JNS) because it is a well-known nursing journal, with a good presence in databases and rankings, many readers, and, in addition, because one of the authors is a collaborator of the journal in the capacity of reviewer, and this grants us some knowledge of the internal functioning of the journal.

How should we examine the JNS as a specific case to achieve our objective? We choose the analysis of a body of editorials as the way to do it. The Cambridge English Dictionary defines an editorial as “an article in a newspaper expressing the editor’s opinion”. To this extent, the editorial can be regarded as embodying the core aspects of a journal through the stated opinions of its editorial board and, in particular, its editor-in-chief. We believe that editorials could be a useful tool to get our aim because they show clearly how the scientific journals articulate asserts and facts on knowledge production. This dualism was identified by Certeau as a key problem after the revolution of May 1968. “A problem of structure has been revealed with a gap opened up between knowing and doing… In these methodologies of every discipline, a gap is opened up between their theory and their action” 4 .

Susan Gennaro started her tenure as editor of JNS in 2007, and continued to provide editorials on the JNS website for more than ten years. A complete study of all Gennaro’s editorials would serve our purposes very effectively, to gain a perspective on the JNS’own view of its mission and purposes, its procedures and rules. We ask readers to see this paper not as a tribute to Susan Gennaro but as an attempt to analyze how nursing knowledge is produced. This should not be incompatible with focusing on the major contribution to nursing science by a journal editor. It is for this reason that we are sure our reflections on nursing knowledge from a Certeaunian framework will be better if they are based on a reading of the JNS editorials by Susan Gennaro over the past eleven years (2007- May, 2018). The total number of editorials by Gennaro over this period is 41 out of a total of 52 (the remainder being guest editorials).

Production and action

In Michel de Certeau’s view, every product, including cultural products like scientific papers, are the result of an action. This is the reason why culture could and should be analyzed in the same way as other human activities (the economy, policy, and so on). “Here it is impossible to dissociate the act of understanding the environment and the desire to change it. ‘Culture’ obtains one definition from it: we can state the meaning of a situation only as a function of an action undertaken in order to transform it. A social production is the condition of a cultural production” 4 .

Certeau argues that scientific knowledge is always a discourse about reality. Furthermore, this discourse is the result of a process of production. From this epistemic perspective, a specific environment (social, economic, cultural, intellectual and historic circumstances) conditions this production. Authors are always rooted in a place and a time. The relation between knowledge and society is very close. “We now have to recognize in every scientific result the value of a product -such as what comes off the conveyor belt of a factory − relative to institutions, to axioms, and to procedures” 4 . In this sense, nursing scholars studying the history of nursing knowledge development argue, as P. D´Antonio, that “the relationship between intellectual activities and the social context in which they occur needs sustained investigation” 5 .

In this way, given that the process of scientific production generates scientific discourse, is it then possible that this latter is unable to genuinely talk about what is real? This is a key question for Michel de Certeau who grasps the core aspects from Ludwig Wittgenstein’s philosophy, centering on the idea of the limit 6 . Both philosophers are conscious of science’s desire to mask its epistemic weakness. The sciences, specifically history but all sciences too, “cannot give way to the vertigo that critical examination of these fragile boundaries might bring about: historiography does not want to know this” 2 .

This is the reason why he invites us to study how science produces scientific knowledge, because “scientific practice is based on a social praxis independent of knowledge 2 . Hence, this assertion casts doubts on the authenticity of scientific discourse and turns us to its verifiability, focusing on the procedures and practices related to the scientific production process. Certeau advises us to do not forget “the relation between limited scientific procedures and what they miss of the ‘real” 2 . The methodological models including these procedures tends to “become an imperialism and to define a new orthodoxy” 2 .

Social place

To this end, Certeau terms the social place of a scientific discipline all those elements that go to determine this social praxis 2 . We think that the role of this social place can be seen as something similar to “the constitutive role of space and artefacts in delineating the moral order of a specific context” 7 . To describe this social place, first he argues that every place is in a particular geographic location. Susan Gennaro subscribes to this view when she says: “the development of any science is surrounded by cultural contexts” 8 . Geographical influence affects the whole process, from the moment to plan research - “barriers exist both in South America and in Africa to ensure a stable process of knowledge development, dissemination, and acquisition” (8) - to the final papers communication “submissions (to JNS) were not equal from all geographic areas” 9 .

Secondly, Certeau indicates there are other essential subjects to explore in this place: institutions, procedures and values. Only by bringing to light these fundamental aspects of the social place (which will be dealt with below) is it possible, according to Certeau, for a discipline to call itself science: “A discourse can maintain a certain scientific character, however, by making explicit the rules and conditions of its production, and first of all the relations out of which it arises” 6 . In accordance with this argument, we want next to question ourselves about the social place of nursing knowledge, as Gennaro asks: “What drives production of nursing knowledge?” 8 .


In Certeau’s view, institutions are important societal elements. “In the broadest sense of the term, the authorities signify a reality that is so difficult to determine, but nonetheless necessary: the air that allows a society to breathe. They allow for social communication and creativity because they furnish, on the one hand, common references and, on the other, possible paths of pursuit” 4 .

Many nursing institutions have played the same role, and could be mentioned for their contribution to nursing knowledge development. Just as an example, we remember with D´Antonio the establishment in the USA of the National Center for Nursing Research in 1986, marking “the culmination of a long quest by dedicated men and women for professional legitimization, scientific recognition, and the power to determine the direction of their discipline” 5 .

In this respect, here we put the focus on the JNS as the official journal of Sigma Theta Tau (STTI), a significant nursing association. On different occasions, Gennaro addresses the JNS readership as “a member of Sigma Theta Tau” 10 , or as a “discerning community of scholars” 11 . She alludes to the references discussed by Certeau as “the things that we share in common” 12. On the other hand, she express a great determination to keep in contact with STTI readers: “let me ask you: “What do you need to read?”, “How do you read nursing articles? (...) I am eager to hear from you” 13 , “We are very interested in hearing from you” 14 , “if you aren’t already a peer reviewer and wish to be, please email me” 15 , “please send a copy of your CV to” 16 . But she doesn’t only show an interest in hearing from the STTI readers. She has a genuine will to help them: “We want you to enjoy the benefit of being a member of STTI” 10 . For these reasons we can affirm that the JNS is an institution for curating nursing knowledge in which many nurses can find “air to breathe”. Therefore, it is possible to regard the JNS as an institution for nursing knowledge.

Certeau establishes three key premises about institutions, which we will keep in mind in our consideration of the JNS. First of all, they always establish relationships of power. It is common in nursing science these days to understand power from a Foucauldian perspective. This is enlightening, but we could also benefit from a serious reading of Leo Strauss’ works on power so as to get a wider conception of this subject 17 . That said, it is clear that power can take different forms - political, economic, academic and so on. For example, who doubts about the struggle for power between the different scientific disciplines? In this sense, nursing institutions can embody the dialogue with other sciences and, by this way, help to clarify the nursing difference. How says Certeau, “the theoretical status of each discipline holds less to the definition that it ascribes to itself than to its relation with others, that is, its inscription in a network of reciprocal determinations” 4 .

On the other hand, we can ask to ourselves, it is possible to maintain a quality research trajectory without funding? Many people would say not. Economic power is always present in research because it is a complex business, even more so with “financial and feasibility constraints” 18 . Thus, as Gennaro recognizes, there is a strong connection between funds and success in research: “being a successful researcher has meant that I have had lots of grant funding” 18 . Because researchers usually need funds to develop their projects, they need to be attentive to the research priorities of potential funders, such as “in the United States the National Institute of Nursing Research priorities” 8 . On the basis of the political connections between the funding institutions, the government and political parties, the influence of political power in nursing research can be strongly felt. Gennaro advises researcher nurses thus: “It is important to periodically think about what is the significant research that important organizations are saying needs to be done and then check if you are doing it” 19 .

But money is not the only factor conditioning research. There are also academic powers. Although, quoting other editors, “academic requirements may not always be consistent with journal priorities and timelines” 20 . Journals, as knowledge institutions, can facilitate the aim of securing or holding on to an academic position. This is clearly the case of the JNS, as “in academia the coin of the realm that leads to promotion, tenure, and other important rewards is publishing” 14 . Hence, because the core power of the JNS (and ultimately also of its editor) is to decide which manuscript will be published, it has a great publishing power.

But not all papers published enjoy the same probability of being available to readers. How it is possible to determine if a paper will be more accessible than others? The difference is in the journal. There are institutions working in metrics about journal dissemination ability such as Thomson Reuters. Publishing its Journal Citation Reports, Thomson Reuters is highly significant (large power) for nursing journals and researchers by virtue of the so-called impact factor. The impact factor is considered as a mark of quality for a journal: “The Journal of Nursing Scholarship is read by over 130,000 nurses in 130 countries. It is indexed by all major health indices. It has an impact factor of 1.772 and is ranked 14/104 in nursing social science and 15/106 in nursing science by Journal Citation Reports. We are proud of the journal” 21.

The impact factor of a journal can have far-reaching consequences for authors, for example, in their dissemination capacity: “Ensuring that you publish in high-quality journals that are indexed in major databases also helps others to find and use your work” 15 . However, although the JNS has a very high impact factor, Gennaro underlines that although it is an important measure of quality, it is not the only one: “the Impact Factor is not the only measure of how other scholars use your work. You might also wish to examine other measures provided by Thomson Reuters” 22 ; “The Altimetrics score follows where an article is picked up by social media; it lets you see how your research is being disseminated in social media around the world” 23 .

The second premise establishes that institutions want to produce a discourse, which generates meaning. Every institution aims to create its particular discourse. “All scientific enterprise had included among its traits the production of autonomous linguistic artifacts” 2 . These artifacts are created in order to produce sense (the more powerful the institution, the more insistent the discourse it produces), and this sense aims to produce particular practices. These practices can maintain the power of the institution. Hence, nursing knowledge becomes books or papers published by scientific nursing journals, aiming to influence the actions of nurses. “I write to influence, to shape, to build, to change (...) I write because I wish to influence others” 14 . The choice of written mode is not random. As one of the most lucid works by Certeau 24) shows, the spoken and written modes of communication have been in conflict over the last few centuries, with writing the clear winner. The choice of writing is the cultural template of our time, and represents a remarkable change from ancient to modern nursing: “I am certain that writing is a much more successful modality to creating change than is speaking” 14 .

Thirdly, institutions constantly establish invisible contracts with the authors of knowledge. “The institution does more than give a doctrine a social position. It makes it possible and surrepticiously determines it 2 . As Carter writes in this respect, remembering Bourdieu's concept of habitus, “there is a strong argument that those who join a particular social organization are in some way predisposed to support and maintain social order”, which is called by Gennaro “knowledge management” (8, 25) . The most consistent contract is what can be considered a science. Which of the great number of manuscripts written will be recognized as a science by the reward of being published? Science is that discourse which scientists recognize as science, and institutions play a big part in this process because “the birth of -disciplines- is linked to the creation of such groups” 2 .


In this regard, there is no doubt about the importance of procedures for Michel de Certeau: “Every society always manifests somewhere the formal rules which its practices obey” 6. Formal rules are the institutional framework in which it is possible to think, to believe, to work, to write. The question to answer is about how. What are the data and the theoretical resources nurses build with their scientific texts? What are the rules of production they must adhere to? 26. The JNS’ rules of production include how the papers should be written, submitted, reviewed, published and read.

Sometimes a journal requests an author to write a paper on a particular subject. Although it is not normal for most researchers, this is a very typical editorial activity: “As editor, I spend a great deal of time encouraging manuscript submissions to JNS that ensure global utility” 27 . After the editorial board of JNS have been identified “emerging global trends in health care (...) we then identify authors who may be interested in writing a manuscript on a topic” 27. It seems to us it is not difficult to understand that the author will pay great attention to the editor’s desires and indications when writing the manuscript.

Before writing a manuscript, many researchers choose a journal to submit it to. This choice enables them to become familiar with and remember these procedures. The journal’s influence on the final version of a research paper starts just at the moment of this decision. Susan Gennaro asks authors “how do you pick the best journal for your work?” 22, and “how do you select a journal to disseminate your very important research?” 21.

Why should a researcher-nurse choose to submit a manuscript to the JNS and not another journal? Gennaro argues “JNS was ranked 11 out of 70 in the nursing category of the Social Science JCR (up from 21 out of 59 indexed journals in 2008) and was ranked 12 out of 72 in the nursing category of the Science JCR (...) JNS has been moving up in both rankings and impact” 22. This movement is growing: “our robust citations have resulted in our Impact Factor ranking us as number 6 in nursing journals in the world” 28.

The JNS, like all the other scientific journals, has a section on its webpage called “Authors guidelines”. There it is possible to find there a lot (sometimes too much) of advice about how authors should write their manuscripts. But this is not the only place to find it. Gennaro’s editorials are greatly concerned by this aim, as this editorial heading clearly expresses: “Publishing success: rules to live by” 29.

Throughout her texts she emphasizes this call to take care over the writing process noting, “the easiest way to get your research published is to conduct significant research in a rigorous fashion” 30, “Read author guidelines, proofread often, and ensure that you submit the best manuscript you can” 29 . She informs there are “things to studiously avoid when writing a manuscript for JNS” 31, “techniques to improve manuscript” 32.

Gennaro marks “titles”, “style of the journal”, “logic flow”, “methodological rigor” and the security that “all the words you use are your own” as the key “five tips I can share with you to improve the likelihood that your work will get published in a timely fashion” 33. On this matter, she brings supplementary indications about other features of a good manuscript: “Brevity and clarity, as Ruskin indicates, are essential in good writing” 21, “(you) must also communicate clearly” 33. Gennaro hopes her advice will be able to “help you in your quest to be a successful author” 29.

When an author thinks their manuscript is as close as possible to the journal requirements, the moment to submit arrives. This is not a period of calm for authors submitting to the JNS because as Gennaro states, “very rarely is a manuscript accepted for publication the first time it is submitted” 34 . Just after submission the process of peer-review begins.

Gennaro admits peer-review is not the panacea for nursing science. But she affirms it is the best process we have today to get the better papers we can. “When our readers receive JNS or access it online our goal is that each article read is categorized as worthwhile to our readers” 35; “A manuscript must satisfy all of these requirements to make a meaningful contribution to scholarship” 36. “The review process assures quality (...) peer review has ensured that experts agree the published work is significant, well done, and ethical” 37. This confidence in peer-reviewers as ethical warrantee clashes with the conclusion of a study on the ethical concerns of nursing reviewers, establishing that, after the report to the editor about an ethical dilemma, “lack of satisfaction (of reviewers) was most commonly related to feedback provided on resolution by the editor” 38 . Maybe editors not always attends the ethical alerts from their own reviewers?

The invisible contracts we have cited above also affect reviewers. There is a special relation between the journal and its referees, especially considering the great favor they are doing for the JNS. Knowing it is impossible to remunerate their work, the JNS attempts to show them the greatest esteem: “One of our goals is to have reviewers enjoy participating in the review process” 11 . Gennaro has no doubts about advising reviewers on the best method to review for the JNS 39: “Reviewer time is voluntary and precious (...) please don’t provide line-by-line corrections (...) Reviewers do not need to spend time helping authors to correct problems with punctuation, spelling, or grammar” 33. “Take no more than 3 weeks to provide an in-depth review of each manuscript (...) As an editor, I know that it is important to allow enough time for a substantial review but not too much as to delay dissemination” 37.

After all, despite the recognition of the importance of the current peer-review system (“Peer review is an integral part of our scientific system” 16 , Gennaro admits it is not the only way to obtain the best nursing science: “Of course, there are problems with peer review (...) Peer review isn’t perfect (...) Peer review does not ensure quality; it is just one measure of quality control” 16. Therefore, she preserves in her discourse the traditional editor’s role: “I read every manuscript that is submitted to JNS and clearly my opinions and knowledge are reflected in every article accepted for publication” 11. Putting it bluntly, “the editor is the boss” 34 .

To reflect on how procedures continue to exert their influence when a manuscript is accepted and published appears to us as an essential task, because as J. Thompson says, “nurses may not be aware of the ways in which their conceptual schemes and research skills are forming a layer of prejudice that influences the way they ask questions” 40.


Once the institutional dimension and procedural issues have been dealt with, it seems to us advisable to deal with the third aspect underlined by Certeau in his characterization of social place: values. Values are ideas indicating the way which is deemed as the right or the best. In other words, a value is a belief that mobilizes the personal energy in order to do a particular practice.

Scientific institutions have their own values. Accordingly, Certeau argues that “at the origin of a science, there are always ethical and cultural positions… Every human science has to introduce doubt into its own development in order to investigate where it stands in its historical relation to a social type” 4. Some of these values are expressly stated by Gennaro: “The mission of the Journal of Nursing Scholarship (JNS) is to ‘advance knowledge to improve the health of the world’s people’ 41, but others, more subtle, can only be perceived through a careful analysis of their editorials. Over the entire body of editorials by Gennaro the following values have been consistently prominent: practice, leadership, efficiency, universality, scientific rigor and social significance. This is more than just a list of keywords. Manuscripts received by the JNS are evaluated in terms of the extent to which they adopt these values.

Above all, in her editorials Gennaro holds fast to the notion that practice is the core of nursing: “I conduct research to inform practice” 18 . After “the global advent of the evidence-based practice movement”, she asks her professional colleagues: “Are we a discipline whose practice is based on science?” and affirms, “we need to continue to develop new methodologies that help us to answer the most significant practice questions” 42 . Her editorial work seeks “help you improve your nursing practice” 43. She dreams of a JNS having “the most up-to-date information possible to guide their practice” 44, helping “nurses providing informed care after reading JNS” 35.

Although is very common today a eulogize of scientific way by nursing scholars, based in the social sciences model, not all of them agree with it. Gary Rolfe, for instance, taking into account that nursing is in crisis, invites to “rethink the fundamental values and assumptions of nursing practice”, calling to understand nursing not only as “technical rational” discipline but also as “a fully human science” 45.

In this sense, Rolfe also argues that is very important to protect ourselves from metrics tyranny (“Lies, damn lies, and metrics”, in 46), as the only way to assess nursing scholarship. We think that Gennaro would agree with him, because as an editor, she might be forgiven for blindly pursuing an increase in the Impact Factor of the JNS. Nevertheless, she takes a nuanced approach to this quality indicator, saying: “how often your work (published in JNS) is used in clinical practice, which is the impact we would really like to measure. Unfortunately, this impact factor does not currently exist, but what a fabulous impact factor this would be!” 22; and “We realize that Impact Factor is an imperfect measure of quality, as it is based on citation frequency and not on how useful the content is in practice. We strive to insure that JNS is useful to practicing nurses as well as authors” 10.

On the second tier of values embodied in the JNS, just below that assigned to practice, is utility. Gennaro encourages potential contributors to the JNS to keep in mind the “relevance” 47 of their research, and to ensure that “the significance to nursing practice is clear” 34 . She insists that: “All researchers want to conduct research that meets societal needs and is responsive to current problems and concerns” 48 ; “This is the research that is needed by our discipline: research that will help our patients” 49. The specific manner in which contributions should be relevant, Gennaro states, is in their “clinical significance” 34. Papers that are considered too theoretical risk being rejected: “reviewers lack enthusiasm because they simply do not think that anything will be changed by publishing a particular study” 36) . Clinical significance, or “clinical credibility” is maybe a polemical concept within an academic framework 50.

The following assertion clarifies very well the strong connection between clinical relevance and the JNS frame of values: “Our mission is to improve the health of the world’s people. So if your manuscript does not have a statement of clinical relevance, it is likely you can’t tell us how you are helping to meet our mission” 31. This call for authors to foreground significance is not enough in itself. It is an aim which all members of the JNS must embrace: “The editorial board and staff want to ensure that every article published in JNS is helpful to our readers” 27.

But this significance must be visible in a global perspective. Papers published in the JNS should be able to “change nursing practice in more than one country” 34. The JNS aims to be a universal journal. “Nursing scholarship, in addition to being interdisciplinary and transformative, must answer global questions and ensure that infrastructure is built to enable international research and education” 51. This is an idea that builds a bridge between Gennaro’s tenure as editor and that of her predecessor Dina Diers: “One of the current contributions of the editorial board of the Journal of Nursing Scholarship is to maximize the dissemination of scholarship that embodies that global perspective Diers envisioned” 52. Gennaro’s global perspective considers “the global status of advanced practice nursing” 53 in order to publish papers “in the context of what is known globally, not just in our own country” 15 . However, it is possible to develop any knowledge that will be applicable all around the world? Is there a contradiction with the Certeau´s premise that establishes that always “a social production is the condition of a cultural production” 4 ? Can the nursing knowledge be autonomous from the cultural patterns of their producers?

The JNS develops a proactive role to make new nursing knowledge “something that is universally possible” 47: “We strive to collaborate in multi country teams and to disseminate our knowledge in global journals (such as the Journal of Nursing Scholarship, JNS) (...) the gap we are planning on closing is a gap in our global knowledge” 28 . Gennaro knows that nursing lacks journals with this global perspective: “most reviewers who have provided information about themselves and who review for nursing journals that are published in English are not reflective of the geographic, racial, and ethnic diversity that is needed” 11 .

She attempts to ensure that the JNS remains one of the very few with this outlook. To achieve this the very structure of the JNS must be influenced by this idea: “Our editorial board members represent the geographic regions where they live and work” 41 ; this permit to care for “questions about geographic differences in health habits, health systems, or management of health and illness in order to place knowledge in a context that is larger than national identity” 36 . However, no paper written with a global perspective will be useful if is not possible to access it from any place in the world. This is the challenge for the JNS: to facilitate the best research in as wide a manner as possible. Gennaro’s advice in this way has great strength: “Your first task as an author is to communicate 54) , “Conducting but not disseminating research is anathema to the scientific community” 49 .

We can see that Gennaro’s view of nursing is practical, useful and universal. But it is also efficient. “Efficiency is a very relevant theme to our lives in 2009 (...) Efficiency guarantees that we solve problems in ways that ensure the greatest good for the greatest number of the world’s citizens (...) In an efficient world, we would produce the research we need and use the research we produce” 47 . However, nurses find themselves with very little time to accomplish all the things they would like to do: “You lead a busy life” 10 . It is especially hard for people who would like to carry out research: “There are only 24 hours in a day, and it is easy to swerve a little too far so that getting back to your own research trajectory becomes difficult” 19 . Gennaro talks to authors to advise them how important are to use “that precious time only to write” 32 .

The JNS regards its own task as that of helping nursing researchers. With the JNS’ move to an online journal Gennaro hopes “that this is not only improving your access to scholarship but that these innovations are saving you time” 13 . The JNS’ own scientific quality is a key feature of its usefulness to nursing scientist in this way: “we often only have time to read the best work, i.e., that which is published in peer-reviewed journals” 16 ; “Only good science helps me to separate out how to spend my time to make the biggest and best difference for my patients” 18 .

Up to this point, the JNS values expressed by Gennaro’s assertions are very close to traditional nursing values. But in this latter assertion we can find something distinct from this tradition: Gennaro’s profound confidence in science. “Good nursing science makes a difference” 35 . But, what is good science? For Gennaro “the attributes of good science are readily identifiable” and include “the high degree of agreement JNS reviewers have in identifying which of the manuscripts submitted to the journal represent good science and which do not” 35 . Good science “provides new knowledge” 49 and it “closes an important gap in nursing knowledge” 36 .

In her description of what she considers good science can be found aspects such as “research trajectory” 19 , along with considerable advice about the right way to conduct research, but one thing stands out ever more clearly: the need for ethical conduct by researchers. The essentials of this conduct are compiled in “ethical guidelines (...) such as the Committee on Publication Ethics (COPE) guidelines” 32 . Firstly, Gennaro focuses on plagiarism, emphasizing that “you can’t publish something word for word that has already been published” 31 ; “It is unethical to use the words of another without proper attribution or proper quotation” 55 and “is not ethical to copy word for word from one publication to another” 56 . She notifies authors of the existence and use of a “software program, called iThenticate” 39 to detect plagiarism. By the same token, this is useful to detect self-plagiarism, another plague in current science: “When an article is published from a dissertation (...) is the only time that it may be considered acceptable to publish your own words in more than one venue” 39 . Secondly, Gennaro considers predatory publishing emphasizing that it “is such a large problem in nursing science (...) Predatory journals charge large fees for publication without the quality indicators we have come to expect in publishing” 21 .

As we can see, almost all Gennaro´s reflections about ethical conduct in nursing research spin over the question of truth. This is something very adequate because we are attending to the rise of the “false academy”, nurtured by the fact that “researchers today are under strong pressure to publish” 57 . It is very difficult to resist against this cultural wave, because “lying or being deceitful is a personal and professional comforting practice; it can bring a form of temporary social order. Attempting to tell the truth or just declaring than we will not intentionally deceive can have uncomfortable consequences” 25 .

Considered together, the values considered above provide a complete vision of the nursing profession. Sharing it, Gennaro strives to build a stronger profession, which is more aware of its mission to improve health around the world, and more aware, too, of its forces and its necessary leadership. However, nurses must maintain the effort to be better practitioners and researchers, including new knowledge and methods: “To meet the promise of the ‘Future of Nursing’ report, nursing scholarship must be increasingly interdisciplinary, transformative, and invested in changing how healthcare is provided” 51 . The role of the JNS is clearly oriented towards the future, “We look to thought leaders to see what new trends are evolving” 41 . The aim is to improve the path for “the next generation of nurse scientists” 58 . This is power of the JNS’ professional impact: “Journal of Nursing Scholarship published articles that were not only highly cited, but helped change health policy, support priorities for nursing research, and highlighted the needs of underserved populations” 52 .

Leadership is the final, but not the least important, value we would underline. Gennaro has understood her own editorial work as an effort to lead a collective effort to improve the quality of the whole nursing profession and to obtain real changes in the world: “Primarily I do research to change practice and policy” 18 . She dreams to get “a legacy that facilitates the work of future generations” 59 . From this desire to help nurses to be better we are sure all her contributions throughout her time as the JNS editor time must be read in an educational perspective. Not only because she associates research with education: “Writing helps me be the best scholar I can be” 14 . It is also because she closely connects this education-based science with nursing leadership: “Are we an independent, diverse, appropriately educated profession? (...) We’ve come a very long way in defining what nursing is and what nurses do and how they are best educated” 42 ; “I personally believe that excellent researchers must be excellent teachers and vice versa. My struggle has always been how to combine practice with teaching and research so that each informed the other” 18 .

We think that this educational aim, always present in Gennaro's editorials, would be better understood and criticized by putting it in the educational debate about nursing scholarship and the role of nursing professors. Gary Rolfe, David Thompson and Roger Watson have been some of its leaders, treating many of the key subjects discussed in this study, as the relevance of practice, the right place of research in nursing, or the values in the core of nursing (60-69, 45, 46) . This debate goes beyond nursing, involving the role of University as a whole 70) .


The findings of this study provide an overview of the process by which nursing knowledge is produced. Certeau´s epistemic categories are particularly suitable for nursing science because it enables researchers to grasp the hidden dimensions of this process. In this sense, in order to be rigorous and critical with nursing science, it is necessary to remember that the knowledge disseminated by scientific journals is the product of an action determined by the key conditions shown above. As we have seen, journals play a large role in the process in which a manuscript is accepted as a legitimate scientific contribution. Editorials, as linguistic artifacts, are implicated in the construction of a framework to do this legitimation through the work of reviewers and editorial team. They are the ones who can decide what and how can be said as nursing science.

Hence, this study of the JNS (based on the editorials by Susan Gennaro) allows us to argue that the JNS is a knowledge institution, in accordance with Certeau’s concepts. Therefore, the results found can be distinguished with difficulty from any other professionally focused academic journal in nursing. This reinforces us on our methodological option. This paper should be seen as providing theoretical background for researchers to widen the focus of the analysis about what nursing science is.

A greater emphasis needs to be given to the way in which nursing gets its own scientific outcomes. We believe that a wider study of body of editorials from other nursing scientific journals could help us to better understand the production process of nursing knowledge, and to redefine what nursing scholarship means.


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Note: We are grateful to Antonio Lastra, philosopher; to Myriam González-Sanz for her help with the review of the manuscript; and to the Library of the University of Huelva, a peaceful place

Authoral contribution: Authors do not manifest any conflict of interest

Received: May 07, 2019; Accepted: September 02, 2019

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