Nursing Philosophy 

About: Nursing Philosophy is an academic journal published by Wiley. The journal publishes majorly in the area(s): Health care & Nursing theory. It has an ISSN identifier of 1466-7681. Over the lifetime, 813 publications have been published receiving 14824 citations.

The roles of embodiment, emotion and lifeworld for rationality and agency in nursing practice

Abstract: Nursing practice invites nurses to embody caring practices that meet, comfort and empower vulnerable others. Such a practice requires a commitment to meeting and helping the other in ways that liberate and strengthen and avoid imposing the will of the caregiver on the patient. Being good and acting well (phronesis) occur in particular situations. A socially constituted and embodied view of agency, as developed by Merleau-Ponty, provides an alternative to Cartesian and Kantian views of agency. A socially constituted, embodied view of agency is less mechanistic and less deterministic than Descartes' and Kant's radical separation of mind and body, and more responsive and generative than Kant's vision of moral agency as constituted by autonomous choice makers who are uninfluenced by emotion. The role of emotion in perception and judgement is explored in this paper. Distinctions between techne and phronesis are drawn. The role of emotion in market relationships and procedural ethics drawn for the abstract, general other are strategies for exchange of goods and services, but these same market relationships are dependent on well-functioning nonmarket relations of noncalculated giving and receiving.

Cultural safety and the challenges of translating critically oriented knowledge in practice

Abstract: Cultural safety is a relatively new concept that has emerged in the New Zealand nursing context and is being taken up in various ways in Canadian health care discourses. Our research team has been exploring the relevance of cultural safety in the Canadian context, most recently in relation to a knowledge-translation study conducted with nurses practising in a large tertiary hospital. We were drawn to using cultural safety because we conceptualized it as being compatible with critical theoretical perspectives that foster a focus on power imbalances and inequitable social relationships in health care; the interrelated problems of culturalism and racialization; and a commitment to social justice as central to the social mandate of nursing. Engaging in this knowledge-translation study has provided new perspectives on the complexities, ambiguities and tensions that need to be considered when using the concept of cultural safety to draw attention to racialization, culturalism, and health and health care inequities. The philosophic analysis discussed in this paper represents an epistemological grounding for the concept of cultural safety that links directly to particular moral ends with social justice implications. Although cultural safety is a concept that we have firmly positioned within the paradigm of critical inquiry, ambiguities associated with the notions of 'culture', 'safety', and 'cultural safety' need to be anticipated and addressed if they are to be effectively used to draw attention to critical social justice issues in practice settings. Using cultural safety in practice settings to draw attention to and prompt critical reflection on politicized knowledge, therefore, brings an added layer of complexity. To address these complexities, we propose that what may be required to effectively use cultural safety in the knowledge-translation process is a 'social justice curriculum for practice' that would foster a philosophical stance of critical inquiry at both the individual and institutional levels.

Truth and validity in grounded theory -- a reconsidered realist interpretation of the criteria: fit, work, relevance and modifiability.

Abstract: Grounded theory is a frequently used approach in nursing research. Over the years the methodology has developed in different directions with ambiguous answers to questions of truth and validity. This ambiguity influences the interpretation of the criteria for quality judgement of grounded theories: fit, work, relevance and modifiability. In particular, the criterion fit seems to be caught in a vacuum between different epistemological and ontological positions. Fit can be interpreted either from a realist or from a nonrealist position but both present problems. A realist position is problematic if it insists on an immutable empirical world and ignores the social and psychological aspects of human life. A nonrealist position can either be argued to rely on hidden realist assumptions and therefore to be inconsistent, or it can be relativistic, opening up the possibility of 'anything goes' attitudes in research and solipsistic confirmations of the world view of researchers with little or misleading practical impact. A reconsideration of the realist position is suggested, in which validity is regulated by the social constructed reality 'as it really is'. From this position fit is a matter of correspondence to facts in social reality. The criteria work, relevance and modifiability are argued to support the fitness of a theory, and to be useful in the broader evaluation of the quality of grounded theories.

Professional knowledge and the epistemology of reflective practice.

Abstract: Reflective practice is one of the most popular theories of professional knowledge in the last 20 years and has been widely adopted by nursing, health, and social care professions. The term was coined by Donald Schon in his influential books The Reflective Practitioner, and Educating the Reflective Practitioner, and has garnered the unprecedented attention of theorists and practitioners of professional education and practice. Reflective practice has been integrated into professional preparatory programmes, continuing education programmes, and by the regulatory bodies of a wide range of health and social care professions. Yet, despite its popularity and widespread adoption, a problem frequently raised in the literature concerns the lack of conceptual clarity surrounding the term reflective practice. This paper seeks to respond to this problem by offering an analysis of the epistemology of reflective practice as revealed through a critical examination of philosophical influences within the theory. The aim is to discern philosophical underpinnings of reflective practice in order to advance increasingly coherent interpretations, and to consider the implications for conceptions of professional knowledge in professional life. The paper briefly examines major philosophical underpinnings in reflective practice to explicate central themes that inform the epistemological assumptions of the theory. The study draws on the work of Donald Schon, and on texts from four philosophers: John Dewey, Nelson Goodman, Michael Polanyi, and Gilbert Ryle. Five central epistemological themes in reflective practice are illuminated: (1) a broad critique of technical rationality; (2) professional practice knowledge as artistry; (3) constructivist assumptions in the theory; (4) the significance of tacit knowledge for professional practice knowledge; and (5) overcoming mind body dualism to recognize the knowledge revealed in intelligent action. The paper reveals that the theory of reflective practice is concerned with deep epistemological questions of significance to conceptions of knowledge in health and social care professions.