Nursing is at least as old as recorded history. Fundamentally, nursing has been linked to a nurturing role to the ill, to the infirm, and to the less fortunate. Nurses writing about nursing from the 1800s to about 1950 stressed these as the essential characteristics of nursing:
1. Importance of observation and recording facts
2. The need to bring a sense of virtue to the care of the sick
3. The characteristics of a good nurse
4. The art of nurturing
5. A call for responsible social action that would better the lot of the sick
Since the 1950s, the focus of nursing knowledge shifted toward empirics, to the notion of knowledge as science. This shift transformed nursing education away from observation and nurturing, or anecdotal nursing, to areas such as efficiency, productivity, and knowledge as a commodity, the realm of scientific studies.
To paraphrase Bruce et al, we must realize that a great deal of reality can be accessed only in a way that is completely different from the scientific method, in which objects such as a four-chambered heart and the design of brain tissue are accessible. This way of knowing is the interface of philosophy and knowledge development in nursing.
The first ancient Greek philosophers believed that the wisdom required to understand ontology, epistemology, and ethics could only be achieved from self-knowledge. Later philosophers came to understand that knowledge can also be derived from the study of the ultimate, and the nature of existence and purpose. This way of knowing is not open to the “blunt observation” of the scientific method, but rather requires the language and methods of philosophy. McIntyre and McDonald philosophy provides nurses with “a way to think about their practice; a way to make sense of, to articulate, and to critique nursing.” In this way, “philosophy is every nurse’s business.”
Entire forests have been felled to provide the paper necessary to print the explosion of articles that deal with the subject of philosophy and knowledge development in nursing. The approach described by Bruce et al speaks to me in a special way. They describe a framework of philosophy in nursing as content, as method, and as way of life. Philosophy as content harkens back to the original tenets of nursing, and deals with questions related to person, environment, and health. Philosophy as method offers nurses the tools to analyze those clinical issues related to patient safety and ethical issues in nursing. Philosophy as a way of life describes the path to wisdom, wherein we not only know, but embody this knowledge in making a different me.
