What use is philosophy for nursing?

According to natural views of the nature of nursing and the nature of philosophy, there is no natural connection between the two disciplines. Nursing is an essentially practical activity. It is aimed at caring for and, where possible, improving the health and wellbeing of people. Philosophy is an essentially abstract and contemplative discipline. There is no link between the two. But that is a mistaken view.

Because of the demands made on it, nursing faces conceptual challenges, challenges arising from the underlying nature of its key concerns. Understanding and managing these well calls for reflection to accompany practice.

Thus for example: There is simultaneous emphasis on the use of Evidence Based Medicine and on Person Centred Care. But good EBM is based on population wide generalisations whilst person centred care is tailored to the needs of the individual in his or her particular circumstance. So how can the general and the particular be reconciled?

Other examples are:

competing models of healthcare (such as bio-medical, recovery etc). How should we assess their rival claims?

the nature of understanding (by contrast, perhaps, with explanation) when applied to people. What is the nature of the skill involved in being open to others’ minds?

the role of principles in value judgements. Although medical ethics has been dominated by the attempt to codify the duties of health professionals any such set of principles faces a dilemma:

- If the principles are high level then they may hold true universally but do not guide practice.
- If they are sufficiently low level to have clear content and guide practice then they will clash with other principles.

(And where do we get the principles from in the first place?)

Recognising this puts weight instead on a kind of clinical judgement: being sensitive to the competing reasons for action pulling in different directions in any given situation and trying to work out which are the best reasons.

But weighing reasons (reasoning!) is a piece of philosophy. So good nursing practice is a matter of putting philosophy into practice.

The slides for this session are here.