My past philosophy of cyclical time functions only as a fragment under the umbrella of my present philosophy. This cyclical time portion of my philosophy carries great significance as it conscripts the recollection of my nursing roots (Ondrejka & Barnard, 2011). Mental commemoration of such events potentiates my capacity to provide empathetic care (Ondrejka & Barnard, 2011). My present nursing philosophy is pragmatically grounded in reason. I feel that nursing science is an attempt to explain health-related affairs through the lens of truth as opposed to unsupported claims.
Nursing professionals have the ethical accountability to be altruistic, meaning a nurse who cares for patients without self-interest. This results in a nurse functioning as a patient advocate, making decisions that are in the best interest of the patient and practicing sound nursing ethics. Since ethical dilemmas are not always easily answered through the use of The Code of Ethics, ethical decision-making models are effective tools that can assist nurses in dealing with ethical issues. Ethical decision-making models provide a framework for working through difficult choices. They seek to define the limits of what is morally acceptable and help clarify the guidelines for making those difficult decisions.
At a first look, the definition of “caring” would appear to be rather generalized. As a grand theory, it has broad philosophical framework with practical implications for transforming nursing practices. However, as the concepts are defined, the theory does become more complex and the assumptions and concepts are deeply interconnected as the nurse comes to know self as caring person. Boykin & Schoenhofer defined key several concepts in their Nursing as Caring theory, which was originally published in 1993 (Alligood 2014). The first fundamental concept of the theory is that all are persons are caring.
Brier-Mackie suggests that nurses' focus on care and nurture, rather than cure of illness, results in a distinctive ethics. Furthermore, nursing ethics emphasizes the ethics of everyday practice rather than moral dilemmas. Nursing ethics is more concerned with developing the caring relationship than broader principles, such as beneficence and justice. For example, a concern to promote beneficence may be expressed in traditional medical ethics by the exercise of paternalism, where the health professional makes a decision based upon a perspective of acting in the patient's best interests. However, it is argued by some that this approach acts against person-centered values found in nursing ethics.
This course challenged me to visually portray or draw what caring in nursing means to me. My initial drawing of caring focused on physical interventions such as assessing and reassessing the patient. I knew that caring was crucial and that it consisted of more than just nursing interventions, but I was still having difficulty in defining “caring” and depicted it as being solely beneficial to patients. My original picture included the word, “acceptance.” Acceptance is a part of caring and is described in Leininger’s Transcultural Nursing Theory. Leininger understood that each person is a unique individual and that their differences should be appreciated in order to build a nurse/patient relationship based off of mutual trust and respect (Bailey, 2009).
These views imply that real life experiences test theoretical foundation, allowing for an individual to gain what is referred to as practical knowledge. This knowledge consists of a combination between theory and practice, allowing for a more holistic approach to patient care. Benner credits her differentiation of “knowing how” and “knowing that” to the ideals of philosophers Kuhn and Polyani. The premise of “knowing how” is related to nursing practice, whereas the basis for “knowing that” is associated with nursing theory. Due to the complex circumstances surrounding different clinical situations, theory alone would be inadequate for providing proficient patient care.
Healthcare professionals must remember that although their following a proven set of guidelines, it is important to treat each patient as an individual as well. The nursing theorists have taken individuality in care into account and mentioned the importance of structuring nursing based on each individual’s needs, (Wadensten and Carlsson, 2003). Diiferent theorists have come up with different points on view on the practice of nursing. For example, Martha Rogers and Betty Neuman are both theorists that developed different theories to describe human-environment interaction. Martha Rogers believed in using three principles; reasonancy, helicy, and integrality to predict human behavior influencing healing.
Compared with medical professionals, nurses appear to be reluctant to rely on professional rationales for their actions, preferring to use managerial justifications and implementing ‘top down’ approach to care. (Adamson, 2013). When a gap in nursing care is perceived, theory is often used to improve these outcomes. Theory provides an overall vision and understanding of the profession of nursing by offering guidance. Not only in nursing, but theory can be applied to any profession as it serves as a tool for guidance of practice.
We, as nurses, can educate and inform, but eventually it is the patient’s right to refuse or accept treatment. This writer feels that when good morals and character are in place, the best possible ethical decisions can be made. These decisions are not necessarily right or wrong, but the best choices for the patient and their care based on the patient’s right to
Watson’s Theory of Human Caring philosophy is used to guide new models of caring and healing practices in diverse settings (Parker, 2001). There are many different definitions for the word care. Webster defines care as, “effort made to do something correctly, safely, or without causing damage” (Merriam-Webster’s online dictionary, n.d.). Quinn, Smith, Ritenbaugh, Swanson, and Watson (2003) defines caring as “a nurturing way of relating to a valued other towards whom one feels a personal sense of commitment and responsibility (p. A68). As nurses, the word care or caring is not only apart of our vocabulary but it is also the driving force behind how we treat our patients and their families.