Philosophy of Nursing - Coursework Example

Philosophy of Nursing The philosophy of nursing is concerned with our beliefs and perspective regarding the nature of the profession, and it is based on this philosophy that we perform our nursing duties. The subject of nursing is both an art and a science. An individual exhibits both ethical aspects and scientific knowing while performing her nursing activities. Nursing has been known as the oldest art form. It has passed through many stages and has played an important role in society. The history of nursing has been surrounded by ignorance and misunderstanding. The activities of nursing evolve when events call for consideration towards the helpless people and sympathy towards those who suffer. During those ages when women were confined within their homes and family life, nursing had become a household art. Progress of nursing has been influenced by the duties of women and their economic independence. In earliest times, nursing was associated with motherly care of infants and was termed as wet nurse. By the 16th century the meaning of nursing meant to attend and care for the sick (Donahue, 2010, pp.4,6). The concept of nursing In early times it was believed that nurses required no formal education or training. They were unlicensed doctors, abortionists, midwives and counselors in the western history. For centuries, the nurses passed on their experiences to their neighbors or daughters. They were termed as “wise women” by the people. One early myth was that women were so trapped by their menstruation and reproduction cycles that they were not independent outside their homes. Another myth was that male professionals had superior technology. These myths were false since women were inherently healers for the poor. It was also found that male professionals depended more on ritualistic practices while women represented more humane approach to healing (Ehrenreich & English, pp.25,27). According to Jean Watson, professor of Nursing, “The nurse has a human responsibility to move beyond the patient’s immediate specific needs and help the patient reach his or her highest level of growth, maturity and health” (Clarke, 2011, p.406). Professor Margaret Newman has stated all contrasting experiences are equal like pain and pleasure, failure and success etc. Although, spiritually this makes sense, this is not practical when practicing nursing especially in cases where patients seek recovery from illness (Clarke, 2011, p.406). Philosophy of nursing The concept of nursing is often considered as informal care of patients and therefore most practicing nurses do not accept nursing models as relevant to their profession. Such situation is a matter of concern since it undermines nursing as a profession. There have been increasing incidents of nurses exhibiting their incompetence and behaving in an uncaring manner with the patients. There are others who fail to implement professional ethics in medical surrounding due to lack of power. In order to sustain the ethical aspect of nursing along with proper case of the needy, it is necessary that nurses follow relevant nursing models derived from appropriate research and theories. Meehan (2012) has explored the historical documents of 19th century Irish nurses to study their perspectives and philosophies, based on which Careful Nursing philosophy has been presented. In order to give more empowerment to nurses regarding patient care, several theories have come forward like studying nursing history to take a renewed vision of nursing. Also, like in the 19th century, nursing ethics can be pronounced by transforming hospitals into nurse-led institutions. Such transformations are already occurring in the United States through the immensely popular Magnet Recognition Program. This Program again asserts the requirement of nursing models, that is, “nursing model that directly addresses the structure, processes and values that are inherent in professional nursing practice” (Meehan, 2012, p.2906). The concept of careful nursing was developed after analyzing the contents of historical documents of 19th century Irish nurses, surgeons and so on. It is rather a philosophical interpretation of nursing and emphasizes “understanding of the nature of the person and the innate dignity and worth of all persons” (Meehan, 2012, p.2911). It attempts to balance the sensitive aspect of nursing with the clinical skills and knowledge of nurses. Other than being sensitive to the pain of the people who are suffering, nurses need to be able to provide spiritual care when demanded by circumstances. In Britain and America, spirituality is taken as superior to materialistic. The importance of spirituality in nursing is even more stressed when patients have serious illness or are nearing death due irreversibility of their disease. Spiritual care which is concerned with “what is mysterious, non-physical, transcendental, infinite, and of profound significance” (Hussey, 2009, p.72) is applied in addition to medical facilities. By examining the contrasting features of spiritual care and naturalistic nursing approach, it has been argued that the latter is not only more practice way of practicing nursing but is also more advantageous than spiritual care. This is because spiritualism has no absolute truth and therefore rational decisions are difficult to occur. On the other hand, science can provide tentative definitions of truth and therefore concrete decision processes exist in scientific theories. However, in case of nursing this debate is considered only after evaluating the caring component of nursing. In many cases, when patients suffer from intolerable pain they ask for spiritual relief. In order to deal with such difficult situations, nurses need to know the components of spirituality and their importance. There are however three practical issues concerned with nursing that explains how spiritual care in the absolute sense is practically impossible. Firstly, in most cases patients get the care of nurses belonging to different religion resulting in different belief systems between patient and caretaker. Secondly, it is not possible for nurses to know every history, background and beliefs of their patients, and in most cases attempting to know everything is considered as excessively intrusive. Similarly, even patients do not know about the philosophies and beliefs of their nurses. Thirdly, patients suffering from terminal illness are hardly expected to behave in rational manner. More often they are depressed and suffer from loneliness, pain and guilt for which end up behaving aggressive and resentful manner. In such cases, even though complete trust is necessary between patients and their nurses, in the practical world this is most of the times not possible (Hussey, 2009, p.78). Issacs et. al (2009) have attempted to find out the practicality of Richard Rorty’s philosophy against reasoning. Rorty has emphasized on moral values to be used for making logical judgements and a moralistic approach to caring activities. According to Rorty moral values include tolerance, respecting the opinion of others, eagerness to listen to others’ expression of pain, implementing persuasion over force, and focusing on communication. Rorty has said that solutions cannot be discovered by researchers but by communities sharing same culture and language. In essence, Rorty focuses on the human side of nursing which means recognizing patients as human beings rather than mere subjects to be treated. However it has been argued by other theorists that nursing approaches should be a relationship between research and practice. This is because nurses deal with complex situations comprising myriad behaviors and perceptions of human beings. Therefore, there cannot be any one absolute solution to the exclusion of others. As nurses, we need a philosophical basis for our practical activities and also for the caring aspect of nursing. In order to understand the consistency between what is expected from nurses and the scientific system of nursing, it is needed that nurses enter into meaningful conversations with their patients. This again supports Rorty’s philosophy that stresses on communication over agreement and truth (Issacs et al., 2009, pp.83-84). Nursing intuition In nursing, intuition is considered acceptable since it is a direct perception and hence is based on information. Effken (2007) explores the philosophical basis of this argument. Through intuition in nursing, it is possible to acquire knowledge that may not be absolute truth but is more realistic and consistent with the goals of the observer. Intuition is more reliable if the nurse is skilled and experienced and provides knowledge for activities that need to be undertaken within a specific clinical or administrative situation. Nursing intuition allows a nurse to make decisions in unexpected situations, for instance, a nurse may notice change in color, muscle tone or eyes of an infant which may not fit with pre-presented report. From this the nurse can conclude serious complications with the infant and will make her take prompt action. Intuition is both fast and accurate. Accuracy is more like practical conclusion leading to appropriate action. In order to include intuition as part of science of nursing, it is needed to ascertain the information that provoked the intuition, and whether the information requires the kind of action that has been decided through the intuition (Effken, 2007, p.197). Clinical-scientist role Nursing so far has underestimated the necessity of clinical-scientist role within its premises. Mackay (2009) sees the reason for this as different approaches that exist towards knowledge development in nursing. The author has suggested that this role can be enhanced “by achieving agreement that science is a necessary, worthy pursuit for nursing, and that rigorous science conducted from a clinical perspective serves nursing well” (Mackay, 2009, 287). The Canadian Institutes of Health Research (CIHR) have recognized clinical-scientists as distinct researchers. In most European countries, there is no national strategy for nursing research. Likewise, in many Asian countries there is no infrastructure for nursing research. Since clinical-scientists are more focused on science, and the concept of nursing is more about caring, therefore the very name acts as one of the barriers (Mackay, 2009, pp.288-290). Positivism and post-positivism influences Cruickshank (2012) compares critical realism and social constructionism which are two schools of postpositivism. Critical realists support the positive application of knowledge and their method is based on unobservable structures rather than empirical regularities. Social constructionists reject pre-established truth as they believe that researchers should advocate skepticism. Positivism is concerned with implementation of knowledge in a positive way to support human progress. It is contrary to speculative knowledge which is not based on any scientific knowledge that can help in advancement of medicine and technology. Positivism adopts a “correspondence view of truth, with true statements taken to correspond with the knowable facts of reality” (Clark, 1998, p.1244). The current modern age is regarded as positive age since today we can positive implement scientific knowledge to develop medical science and technology. Moreover, in this current era, society as science can also be applied for policy making process. Nursing belongs to both critical analysts and social constructionist schools since it needs to positively apply knowledge and embrace skepticism. Logistic positivists use inductive method to define science. For instance, when two chemicals mix to result in an explosion, then observer can conclude that mixing of the chemicals is the cause while explosion is the effect. However, for users of hypothetico-deductive (H-D) method, inductive method is not logical since it only describes events without explaining them. In case of nursing, it is the H-D method that can result in making progresses in nursing aspects (Cruickshank, 2012, pp.71-72). For nurses, grounded theory has become very important and popular since it helps to explore new facets of nurses’ lives. The traditional postpositivist form of it has become difficult for those nurses to accept for whom mutual relationships between themselves and their patients are of utmost importance (Mills, et al., 2007, p.7). Conclusion In essence, nursing means alleviating the suffering of those who are ill by providing care and treatment of human response. However, there is much more to nursing and my personal nursing philosophy includes knowledge, compassion, honesty and protection of privacy of patients. I have chosen this career to show care and concern for others. I consider having knowledge of diseases and treatments is critical for nurses to be effective. Honesty and compassion should also be included in bedside manner for taking care of patients. I believe that a nurse should be able to understand health care issues in relation to personal diagnosis of patients. As a nurse I attend many patients on daily basis, and so time management is another important issue for me. It is also important to establish good rapport with patients, and therefore I indulge in conversation with them to know about their interests and needs. Emotional support is also vital for effective nursing. References Clark, A.M. (1998) The qualitative-quantitative debate: moving from positivism and confrontation to post-positivism and reconciliation. Journal of Advanced Nursing, 27(6), 1242-1249 Clarke, L. (2011) So what exactly is nursing knowledge? Journal of Psychiatric and Mental Health Nursing, 18(5), 403-410 Cruickshank, J. (2012) Positioning positivism, critical realism and social constructionism in the health sciences: a philosophical orientation. Nursing Inquiry, 19(1), 71-82 Donahue, M. P. (2010) Nursing, the Finest Art: An Illustrated History, Mosby Elsevier Effken, J.A. (2007) The informational basis for nursing intuition: philosophical underpinnings. Nursing Philosophy, 8(3), 187-200 Ehrenreich, B. and English, D. (2010) Witches, Midwives, and Nurses: A History of Women Healers, Feminist Press Hussey, T. (2009) Nursing and Spirituality. Nursing Philosophy, 10(2), 71-80 Issacs, S., Ploeg, J. & Tompkins, C. (2009) How can Rorty help nursing science in the development of a philosophical ‘foundation’? Nursing Philosophy, 10(2), 81-90 Mackay, M. (2009) Why nursing has not embraced the clinician–scientist role? Nursing Philosophy, 10(4), 287-296 Meehan, T.C. (2012) The Careful Nursing philosophy and professional practice model. Journal of Clinical Nursing, 21(19/20), 2905-2916 Mills, J. et al. (2007) Grounded theory: a methodological spiral from positivism to postmodernism. Journal of Advanced Nursing, 58(1), 72-79 Read More