Core principles and philosophical foundations of nursing practice

Philosophy of Nursing

Nursing is both a science and an art. Through nursing, individuals are provided with health care and their societal needs are met. In the health care industry, nurses are at the forefront of patient care, interacting with individuals, families, and communities to promote good health, provide medical education, encourage disease prevention, care for the ill, and rehabilitate those in need (Potter, Patricia, et al., 2000, pp. 24-25). Nurses must multitask, acting in collaboration with other health care disciplines to promote a healthy environment.

Perhaps the greatest philosophy of nursing is that health is the right of every individual and that health care is the responsibility of society. The philosophy of nursing goes a step beyond defining the role of nursing in society. The philosophy of nursing is concerned with how nursing activities are done, and what elements guide the practice of nursing.

Most people that enter the field of nursing have a preconceived idea of what the job will involve, as far as activities and duties. As nurses complete their education, these ideas change. Again, these ideas change when nurses actually enter the field. This is because the philosophy of nursing is constantly evolving.

The philosophy of nursing involves (Potter, Patricia, et al., 2000, pp. 132-135):

Ontology. What is the nature of nursing?

Epistemology. What is the nature of nursing knowledge?

Ethics: what is the nature of nursing conduct?

Simply defined, a philosophy is a group of principles or beliefs about something. A philosophy serves to explain the ideals and goals of a particular thing. The philosophy of nursing serves as a reminder to nurses of the ethical goals in education, in practice, in research and in theory generation.

Enforcing the Nursing Philosophy

State laws authorizes and obliges the Board of Nursing to promulgate and enforce regulations concerning nursing practice and education.".. As it deems necessary for the protection of the public health, safety and welfare, and for proper administration of its responsibilities." (Blais, et al., 2001, pg. 198) This means that the state plays a large role in determining if nurses meet the good moral character requirement for licensure.

Many state laws enforce the nursing philosophy. For instance, there is a state law against patient abandonment, which is defined as "abandoning or neglecting a patient or client under and in need of immediate professional care, without making reasonable arrangements for the continuation of such care." (Blais, et al., 2001, pg. 42)Therefore, if a hospital is understaffed, a nurse cannot refuse to work overtime as they are going against their professional judgment if they leave before reasonable care arrangements have been made for their patients. State laws also regulate nursing in regards to patient protection, drug administration, conduct and many other things.

The Joint Commission on Accreditation of Health Care Organizations has specifically designated standards regarding the assignment of nursing responsibilities. When assigning responsibility for providing nursing care to the patients, the registered nurse must consider factors related to 1) the patient, 2) the environment in which nursing care is provided, 3) the nursing staff member's competence, and 4) the degree of supervision required by and available to each nursing staff member assigned responsibility. (JCAHCO, 1990)

In the wake of a serious nursing shortage in the U.S., the American Association of Critical-Care Nurses sponsored a presentation titled, "Tell Me Again -- Why Did I Choose Nursing," in which nurses were asked to remember why they chose this field (NurseZone, 2002).

Many nurses have reported that they would not feel comfortable having a family member treated in the healthcare facility where they work because of the decline in ability to provide good care and the shortage of staff. This has led to much discouragement in the field.

This presentation was designed to show nurses that despite a serious nursing shortage, the role of the nurse in providing quality health care is more important than ever before, and that they needed to remember the philosophy of nursing through keeping a positive attitude, appreciating people, learning and teaching others, setting goals, and most importantly, not giving up their profession.

For example, nurses who are aware of any type of patient abuse and take steps to report it fulfill their role as patient advocates. In many states, this is a legal obligation, as well as a moral one. Failing to report abuse so can lead to serious criminal penalties. In the state of California, nurses must report any incidents of abuse they observe, reasonably suspect, or are told about by children and adults (Markus, 1999). Nurses who fail to report may be convicted of a misdemeanor, which carries a penalty of up to $1,000 and six months in jail.

Conclusions

The overall health of individuals, families, and communities is a perceived state that changes throughout the lifespan. The perceptions of individuals, families, and communities influence their reactions to the environment, leading to actions that promote, maintain, or compromise health. Health is greatly affected by cultural, social, economic, political, environmental and technological forces, and is expressed through both the body and mind.