Posted: September 19th, 2022

Florence Nightingale

Discuss whether nursing is a profession or an occupation. What can current and future nurses do to enhance nursing’s standing as a profession? How was Nightingale the most influential in shaping our profession and why? 

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Chapter 1

Philosophy, Science, and Nursing

Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins

Topics for Discussion

Is nursing a profession or an occupation?

Is nursing a science? If yes, what type of science?

What is nursing’s theoretical base?

What are different kinds of knowledge?

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Nursing as a Profession

Characteristics of occupations

Varying levels of training or education

Variable defined knowledge bases

Varying levels of skill

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Nursing as a Profession—(cont.)

Examples of professions

Medicine

Law

Clergy

Education

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Question
Tell whether the following statement is true or false:

Nursing is a profession.

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Answer
True

Rationale: Nursing is a profession. Nursing meets the characteristics of a profession, and nurses are valued by society because the services they provide are beneficial to members of the society.

*

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Nursing as a Profession—(cont.)

All professions are occupations, but not all occupations are professions.

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Nursing as a Profession—(cont.)

What is our knowledge base?

Authority over education?

Registration?

Altruistic service?

Code of ethics?

Formal training?

Socialization process?

Autonomy?

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Nursing as an Academic Discipline

Discipline—a field of inquiry

Unique perspective and terminology

Determination of what phenomena are of interest

Determination of the context in which phenomena are viewed

Determination of what questions to ask

Determination of what methods of research are used and what evidence is proof

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Nursing as an Academic Discipline—(cont.)

A unique perspective

An identifiable philosophy

Conceptual frameworks/theories

Acceptable methodologic approaches for development of knowledge

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Academic Disciplines

Basic sciences

Physics

Biology

Chemistry

Sociology

Humanities

Philosophy

History

Fine arts

Languages

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Academic Disciplines—(cont.)

Professional disciplines

Medicine

Law

Dentistry

Engineering

Nursing

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Science

Science is concerned with causality (cause and effect).

Science is both a process and a product.

A body of empirically tested knowledge

A system of gathering and verifying information (process)

Science represents knowledge and is generated by the application of methods to acquire that knowledge.

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Science—(cont.)

A discipline’s science:

Focuses on solving problems related to the discipline

Directs answering questions of the discipline

The science contains the research aspect of the discipline.

A discipline’s science is tied to its philosophy.

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Classification of Sciences

Natural sciences

Chemistry, physics, biology, geology

Basic or pure sciences

Mathematics, chemistry, physics, language

Human or social sciences

Psychology, anthropology, economics

Practice or applied sciences

Engineering, medicine, pharmacology, law

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Classification of Sciences—(cont.)

Nursing draws on basic/pure sciences (physiology, biology).

Nursing has characteristics of social sciences.

Nursing is without question an applied science.

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Philosophy

Philosophy is the “study of . . . the nature of existence, knowledge, morality, reason and human purpose.”

Philosophy seeks to:

Discover knowledge and truth

Identify what is valuable

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Philosophy—(cont.)

Philosophy is concerned with:

Purpose of human life

Nature of being and reality

Source(s) of knowledge

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Question
Which of the following do science and philosophy have in common?
A. Hypothesis testing
B. Nature of being
C. Goal of increasing knowledge
D. Verifiability of information

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Answer
C. Goal of increasing knowledge

Rationale: Science and philosophy share the common goal of increasing knowledge. Science is tied to the philosophy of the discipline, with a shared goal to increase the knowledge of the discipline.

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Branches of Philosophy

Metaphysics—study of nature of reality and existence

Ontology—study of the theory of being

Cosmology—study of the physical universe

Epistemology—study of knowledge (ways of knowing)

Logic—study of principles and methods of reasoning (inference and argument)

Ethics (axiology)—study of values (right and wrong)

Esthetics—study of appreciation of arts or things beautiful

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Nursing Philosophy

Statement of foundational and universal assumptions, beliefs, and principles about the nature of knowledge and thought (epistemology) and the nature of entities represented in the metaparadigm (i.e., nursing practice and human health [ontology])

Provides perspectives for practice, scholarship, and research

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Science and Philosophy—Worldviews

Empiricism/positivism (received view)

What is experienced is what exists.

Examines parts to understand the whole (reductionistic)

Individuals learn by being told or receiving knowledge.

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Science and Philosophy—Worldviews—(cont.)

Empiricism/positivism (received view)—(cont.)

Knowledge is described and verified through scientific methods (experimentation).

Theories are generated which describe, explain, and predict phenomena of interest.

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Science and Philosophy—Worldviews—(cont.)

Empiricism/positivism (received view)—(cont.)

Dominant worldview of the pure and basic sciences (e.g., physiology, biology)

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Science and Philosophy—Worldviews—(cont.)

Perceived view—phenomenology, constructivism, humanism

Focus is on perceptions of the subject and the researcher.

Phenomena are studied and described from lived experiences, interrelatedness, interpretation, and learned reality.

Desire is to understand the actions and meaning of individuals.

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Science and Philosophy—Worldviews—(cont.)

Perceived view—phenomenology, constructivism, humanism—(cont.)

What exists depends on what individuals perceive to exist.

Knowledge is subjective and created by individuals.

Research investigates the individual’s world.

Emphasis is on subjectivity, multiple truths, trends and patterns, discovery, description, and understanding.

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Science and Philosophy—Worldviews—(cont.)

Perceived view—phenomenology, constructivism, humanism—(cont.)

Dominant worldview of the social/human sciences (e.g., psychology, sociology)

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Science and Philosophy—Worldviews—(cont.)

Received View—Empiricism
Perceived View—Humanism

Reality/truth considered separate from context
Reality/truth considered in context

Objective
Subjective

Prediction and control
Description and understanding

Deductive
Inductive

One truth
Multiple truths

Quantitative research methods
Qualitative research methods

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Nursing Science

System of relationships of human response in health and illness (includes biologic, behavioral, social, and cultural domains)

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Nursing Science and Worldviews

Nursing is both a practice science and a human science.

Practice sciences typically use quantitative research methods (e.g., controlled experimentation) to develop knowledge.

Human sciences typically use qualitative research methods (e.g., phenomenology, ethnography) to develop knowledge

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Nursing Science and Worldviews—(cont.)

Until very recently, quantitative methods for research were most valued.

Nursing scholars are still undecided about which method (quantitative or qualitative) best demonstrate the essence and uniqueness of nursing.

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Nursing Science and Worldviews—(cont.)

In recent years, it has been argued that both approaches are important and essential for nursing science.

Thus, multiple approaches to knowledge development and methodological pluralism should be encouraged.

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Question
Tell whether the following statement is true or false:

There is only one research method of value for use in nursing.

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Answer
False

Rationale: Quantitative and qualitative research methods are both of value for use in nursing research.

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Ways of Knowing in Nursing

Nursing epistemology is the study of the origins of nursing knowledge, its structure and methods, the patterns of knowing of its members, and the criteria for validating its knowledge claims.

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Ways of Knowing in Nursing—(cont.)

Understanding how nursing knowledge develops

Allows judgment of the validity and appropriateness of the knowledge

Determines appropriateness of methods used to develop knowledge

Nursing has both scientific knowledge and knowledge that can be termed “conventional wisdom.”

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Ways of Knowing in Nursing—(cont.)

Empirics—the science of nursing

Esthetics—the art of nursing

Personal knowledge in nursing

Ethics—moral knowledge in nursing

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Question
Tell whether the following statement is true or false:

The only true way of knowledge development is through empirics and science.

Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins

Answer
False

Rationale: There are multiple ways of knowing and knowledge development. There are many theories on knowledge and learning. Nursing epistemology is the study of the origins of nursing knowledge and encompasses much more than empirics.

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Empirical Knowledge

Objective, verifiable, and generally quantifiable knowledge

When verified through research/testing, empirical knowledge becomes laws, theories, and principles that explain and predict.

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Empirical Knowledge—(cont.)

The most emphasized way of knowing in nursing

Purpose is to describe, explain, and predict phenomena of concern to nurses.

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Esthetic Knowledge

Expressive, subjective, experiential understanding

Includes sensing the meaning of a moment

Expressed in actions, conduct, attitudes, and interactions of the nurse

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Esthetic Knowledge—(cont.)

Relies on perception

Incorporates empathy, intuition, values, and understanding

Not expressed in words

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Personal Knowledge

Subjective view of the self and the client

Promotes integrity in personal encounters

Incorporates experience, personal maturity, knowing, encountering, and actualizing the self within the practice

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Personal Knowledge—(cont.)

May include spiritual or metaphysical elements

Largely expressed in personality—therapeutic use of self

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Ethical Knowledge

Moral code for nursing

Based on obligation to service and respect for human life

Occurs as moral dilemmas arise in ambiguous and uncertain situations

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Ethical Knowledge—(cont.)

Requires evaluation of what is good, valuable, and desirable

Must address conflicting norms, interests, and principles

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