There is ongoing dialogue among nursing faculty and scholars regarding when and how students are introduced to and understand what nursing is. Nursing curricula have been adapted based on state regulations and accrediting bodies with an emphasis on evidence-based practice (EBP), interprofessional approaches, and high-stakes licensure examination. 1,2 We conducted this study to determine whether 4 concepts representing the focus of the disciplinecontext, holism, health, and caring-were present in web-based program and course descriptions. We used a content analysis of the programmatic materials and first 3 nursing courses in 300 4-year bachelor of science in nursing (BSN) programs in the United States to achieve the study aim.
BackgroundNightingale lamented that the "very elements of nursing are all but unknown." 3 Nurses have debated this lack of clarity on what defines nursing for decades 4 and it remains a challenge today. Chinn et al 5 referred to a "stubborn cloud" of unclear identity lingering over the nursing landscape, evidenced by the persisting question, "What is nursing?" Several definitions of nursing exist, 3,[6][7][8] as well as multiple ideas about concepts that make up the focus of nursing. [9][10][11] In fact, there may never be consensus on what nursing is, how to define the discipline, or whether it can even be defined. Several authors have identified concepts including person, environment, health, nursing, wholeness, and caring as central foci of nursing. While not exhaustive, these concepts, and the relationships among them, apply to nursing practice, research, and education. 4,9,10,[12][13][14] There is concern that rather than drawing on the knowledge of the discipline, many nurses look to evidence from other disciplines. 5,[15][16][17] Questions arise about whether nurses understand that nursing has its own body of literature, knowledge base, and disciplinary focus. If nurses are going to build on discipline-specific concepts in education, practice,