Nursing's Boundary Work: Theory Development and the Making of Nursing Science, ca. 1950-1980.

BACKGROUND: Beginning in the late 1950s and intensifying through the 1960s and 1970s, nurse educators, researchers, and scholars worked to establish nursing as an academic discipline. These nursing leaders argued that the development of nursing theory was not only critical to nursing's academic project but also to improving nursing practice and patient care. OBJECTIVES: The purpose of the article is to examine the context for the development of nursing theory and the characteristics of early theory development from the 1950s through the early 1980s. METHODS: The methods used were historical research and analysis of the social, cultural, and political context of nursing theory development from the 1950s through the early 1980s. How this context influenced the work of nurse theorists and researchers in these decades was addressed. RESULTS: The development of nursing theory was influenced by a context that included the increasing complexity of patient care, the relocation of nursing education from hospital-based diploma schools to colleges and universities, and the ongoing efforts of nurses to secure more professional autonomy and authority in the decades after World War II. In particular, from the 1960s through the early 1980s, nurse theorists, researchers, and educators viewed the establishment of nursing science, underpinned by nursing theory, as critical to establishing nursing as an academic discipline. To define nursing science, nurse theorists and researchers engaged in critical boundary work in order to draw epistemic boundaries between nursing science and the existing biomedical and behavioral sciences. DISCUSSION: By the early 1980s, the boundary work of nurse theorists and researchers was incomplete. Their efforts to define nursing science and establish nursing as an academic discipline were constrained by generational and intraprofessional politics, limited resources, the gendered and hierarchical politics, and the complexity of drawing disciplinary boundaries for a discipline that is inherently interdisciplinary.

"Coming to grips with the nursing question": the politics of nursing education reform in 1960s America.

The 1950s and 1960s were decades of change for the American nursing profession. A new generation of nurse educators sought to create greater professional autonomy for the nurse by introducing new models of education that emphasized science-based learning over technical skills and bedside care, and creating new clinical roles for the nurse, based on advanced graduate education. They confronted resistance from an older generation of nurses who feared becoming "second-class citizens" in increasingly academic nursing schools, and from academic health care institutions all too comfortable with the gendered hierarchy on which the traditional model of nursing education and practice was predicated. Using the University of Minnesota and University of California-Los Angeles (UCLA) as case studies, and based on institutional records and more than 40 oral histories with nursing and medical faculty, this article describes the generational conflicts this new cadre of nurse educators confronted within schools of nursing, and the institutional politics they struggled with as they sought to secure greater institutional status for the schools among the universities' other health science units.

Bioequivalence: the regulatory career of a pharmaceutical concept.

Generic drugs cannot be marketed without regulatory and clinical demonstration of "bioequivalence." The authors argue that the concept of "bioequivalence" is a joint regulatory and scientific creation, not purely a technical concept, and not purely a legal concept. It developed at the interstices of networks of pharmacologists, regulators, food and drug lawyers, and American and European policy makers interested in "generic" drugs. This article provides a situated perspective on the history of bioequivalence, which emphasizes the shaping role of the state upon scientific processes, networks of regulators and scientists, and the centrality of transnational dynamics in the formation of drug regulatory standards.

"Who's winning the human race?"Cold war as pharmaceutical political strategy.

Between 1959 and 1962, Senator Estes Kefauver led a congressional investigation into the pricing practices of U.S. drug firms. As part of its defense, the industry mobilized the rhetoric of cold war and promoted the industry as a critical national asset in the global war against communism. The industry argued that any effort to undermine corporate innovation by inviting, as Kefauver proposed, greater government involvement in drug development threatened the public's health and invited socialism-in the form of socialized medicine-into the domestic political economy. This strategy proved critical to the industry's efforts to build political support for itself, particularly among the medical profession, and undermine Kefauver's reform agenda.

Allied against reform: pharmaceutical industry-academic physician relations in the United States, 1945-1970.

During the 1960s, the drug industry was the subject of two congressional investigations into its business practices and pricing policies, and in 1962, passage of the Drug Amendments mandated greater Food and Drug Administration authority over pharmaceutical development. In this article, I examine the industry's efforts to circumvent these political challenges by drawing on its longstanding relationship with academic physicians and the American Medical Association. Using the medical profession's shared concern about expanding government oversight over therapeutic practice, the industry called on academic physicians to join forces with it and establish an expert advisory body to guide government officials on pharmaceutical policy. Drawing on research in the archives of the University of Pennsylvania and the National Academy of Sciences and a careful reading of the trade and biomedical literature and congressional documents, I argue that by positioning themselves as pharmaceutical experts, the members of this industry-academic alliance gave industry a seat at the policy table and enabled it to challenge the efforts of pharmaceutical reformers to further increase the government's role in drug development.