Question

1. Discuss conceptual and philosophical underpinnings of nursing practice.
2. Explain the influence of current and historical nursing theories on professional practice.

Answer 1

Nursing practice is perceived as a method to help others reach the goal of better health and saving precious lives through science, physiology, and psychology. It is about a person’s perception of the profession to care for ailing patients and the reason behind their actions and participation in the nursing field. It has an in-depth spiritual meaning and ethical satisfaction that extends beyond medicine, physiology, and psychology. Nursing practice is about the fundamental nursing concepts including health and wellness, stress, illness, and health promotion. Nurses work in harmony with physicians and other healthcare professionals in a variety of medical/community settings. They aid in providing primary, preventive, acute, and chronic care for ailing patients. They are present everywhere in a healthcare setting contributing immensely with their skills in medication administration, restorative care, health information, and emergency care. Nursing care focuses on the protection and promotion of physical and mental health for patients and for the community.

Florence Nightingale defined nursing for the first time over 100 years ago as "the act of utilizing the environment of the patient to assist him in his recovery( Nightingale,1860). According to her, a well-ventilated, clean, and quiet environment is necessary for recovery. In her theory, Nightingale projects a community health model where the surroundings of human beings are considered in relation to their health. Nightingale's concepts of the theory are simple, brief, and easy to understand. It is still applicable to practice today. In fact, it is the foundation on which nursing was built. It encourages the nurses to care more efficiently by using intuition about patient care and modification of the environment.

According to Jean Watson’s theory, as explained in ‘The Philosophy and Science of Caring’, there are four major concepts: human being, health, environment/society, and nursing. She refers to the human being as “a valued person in and of him or herself to be cared for, respected, nurtured, understood and assisted; in general a philosophical view of a person as a fully functional integrated self. Human is viewed as greater than and different from the sum of his or her parts.” Health is defined as a “higher level of overall physical, mental, and social functioning; a general adaptive-maintenance level of daily functioning; and the absence of illness, or the presence of efforts leading to the absence of illness.” Watson’s definition of environment states that nurses have existed in every society and that caring is an attitude transmitted through generations by nursing culture, profession as a way of coping with its environment. Watson’s nursing model states that nursing is concerned with promoting health, preventing illness, caring for the sick, and restoring health. It focuses on health promotion, as well as the treatment of diseases. Watson believed that holistic health care is central to the practice of caring in nursing. She defines nursing as “a human science of persons and human health-illness experiences that are mediated by professional, personal, scientific, esthetic and ethical human transactions.” Modern nursing is well aligned with Watson's theory and philosophy of nursing.

Another theory, Orem’s self-care deficit nursing theory, considers mature love, which overlaps with many of Watson’s ideas. Orem identified components of mature love as care, responsibility, respect, and knowledge about the patient. This underlying philosophy of Orem’s theory is quite often overlooked.

According to Anne H. Bishop, a nurse, and John R. Scudder Jr., a philosopher, nursing is the practice of caring. They employed hermeneutic phenomenology to describe the meaning of nursing (Bishop and Scudder, 1990, 1991). Nursing is a practice that aims at caring for patients and fosters the patient's well-being. The moral values of nursing inherent in the caring relationship between nurse and patient is disclosed by phenomenological interpretation. Bishop and Scudder called the study of nursing the "discipline" of nursing to differentiate it from the practice. They stressed the importance of maintaining the discipline of nursing as a human science because it studies how nurses care for patients.