Philosophy of Nursing



Philosophy of Nursing

Introduction

Nursing has traditionally had a subservient role: physicians prescribe and order, nurses carry out the orders. This role is increasingly unsatisfactory to medicine and nursing alike. Better models are emerging but are not yet clearly defined.

Philosophy of Nursing: A Discussion

Nurses began to consider professional independence in the 1960s when nursing research first began to make an impact. This led to the realization that autonomy meant also greater accountability, and hence professional and legal responsibility for care given. The production of codes of professional conduct, the necessity of nurses to adhere to them and the revolution in nurse education have sharpened the debate about autonomy (Affara and Styles, 2005).

In the view of Affara and Styles, two leading members of the International Council of Nurses (2005, p. 20): 'nursing does seem to be an occupation in transition to mature professional status.' They see university education of nurses and increased capabilities by nurses as decisive factors in modifying and expanding the scope of nursing practice. Nursing cannot and does not strive to be independent of other professions, but seeks to be a body with its own skills and areas of expertise, and with a clear understanding of its responsibilities.

Concentrating on matters of internal regulation and organization seems to have distracted nursing from pursuing a vision or direction. This has been noticed by Johnstone (1994: 509) who urges that 'unless the nursing profession assumes a much higher public and political profile than it has until now, it may, in the final analysis, find that it is in no position to fulfil its broader moral as well as professional responsibilities towards the community at large' (McClure, 1978).

According to nurse theorist Jean Watson (1989), 'the future of medicine and nursing belongs to caring more than curing. A more radical thesis is that there is movement out of an era in which curing is dominant into an era in which caring must take precedence.' This is not understood as nursing doing the 'caring' while medicine is doing the 'curing', with curing having the more effective and prestigious role, but that caring itself is more important than curing. The cost of curing - at least in developed countries - has escalated to the point where it is all but ruining the economy in general. High-cost life-saving treatments will therefore be less and less available; low-cost caring will take precedence. This is where nursing has ...