Nursing Philosophy最新文献

This article reflects on the concepts of health, well-being, gender, and dignity when providing nursing care to older adults, focusing on their wisdom and the phenomena that can affect their health or improve their quality of life. These concepts are analyzed based on the current health conditions of older adults and their needs, on the perspectives of authors in this field of research, and on Patricia Benner's philosophy: the integration of science, clinical wisdom, and ethics in nursing practice. Furthermore, this article aims at contributing to the health, well-being, gender, and dignity of older adults, despite the discrimination that they may face, as well as to the reality of nursing practice. As such, this study stems from the observed reality, experiences as caregivers and reflection of nurses committed to the values of the profession. Therefore, the article begins with the conceptualization of health, well-being, gender, and dignity, subsequently analyzing the health-disease status of older adults from a gender perspective, addressing nursing care for older adults based on Patricia Benner's philosophy and concluding with reflections on nursing practice for a better future for older adults.

Social justice is consistently upheld as a central value within the nursing profession, yet there are persistent inconsistencies in how this construct is conceptualized, further compounded by a lack of empirical inquiry into how nurses enact social justice in everyday practice. In the current context in which structural inequities are perpetuated throughout the health care system, and the emergency department in particular, it is crucial to understand how nurses understand and enact social justice as a disciplinary commitment. This research examines how nurses' talk and institutional texts discursively construct social justice within the institutional context of the emergency department, and how such discourses shape the enactment of social justice within nursing practice. Guided by Iris Marion Young's theorizing of distributive and systemic social justice paradigms, this Foucauldian discourse analysis draws on emergency department nurses' talk (N = 25 interviews) and institutional documents (N = 27) as key texts that visibilize dominant and excluded discourses of social justice within the institutional context of the emergency department, and implications for how social justice is enacted through nursing practices. This analysis identified one overarching discursive pattern, in which social justice was discursively constructed through a hegemonic distributive paradigm, yet also resisted through nurses' conceptualization and enactment of a systemic social justice paradigm that facilitated their recognition and remediation of inequities. This central discursive pattern is explored through three exemplars of nurses' enactment of social justice as resistance: triage, harm reduction, and care planning. Findings from this analysis demonstrate that while a hegemonic distributive paradigm has dominated conceptualizations of social justice within nursing, a re-construction of social justice through a systemic paradigm may guide nurses in enacting practices that remediate inequities in health and health care.

The concept of performance has gradually become established in health policies. Presented as necessary and positive, it is often reduced to efficiency, which results in policies and management styles aimed at optimisation. While they are supposed to guarantee the sustainability of our healthcare systems, these practices have made them fragile. Insights from the life sciences help us understand why. Indeed, biologists observe that living beings do not prioritise optimisation but robustness. To cope with fluctuations, a robust organisation operates with redundancies, apparent waste, heterogeneity, organised fluctuations, slowness, and hesitation. It functions sub-optimally. This article offers a theoretical reflection and management directions for more robust healthcare systems.

Nursing's efforts at organizing in the United States have encompassed various approaches to creating change at a systemic and political level, namely shared governance, professional associations, and nurse unions. The United States is currently experiencing the effects of an authoritarian sociopolitical agenda that has taken aim at our profession's ethic of providing equitable care for all people through legislation that bans gender-affirming care and abortions. Nursing is simultaneously experiencing a crisis of burnout and moral distress, as we navigate the everyday functions of a for-profit healthcare system under the Capitalocene. As we situate ourselves within these policies and practices of late-stage capitalism and an increasingly authoritarian nation-state, we are compelled to think deeply about how nursing is currently organizing ourselves. Our paper will explore the evolution of various forms of organizing through the lens of intersectionality, which offers a framework for considering the ways that power operates, creating a matrix of sociostructural processes that fuel injustice. Intersectionality also compels us to examine whether our organizing has resisted, or perpetuated, a matrix of oppression. We will conclude by offering examples of radical imagining for a future of nursing resistance, where our collective organizing has a greater impact and responsibility for dismantling the status quo to achieve justice and liberation.

During the COVIDicine, many nurses awoke to the ways that the Healthcare-Industrial Complex (HIC) dictates the care we are able to provide. Using the Foucauldian concepts of pastoral power and governmentality, we explore the ways that nurses participate in upholding power structures within the HIC and reproducing them in our work, contributing to a carceral culture based on hierarchy and power dynamics. We also explore the ways nurses are both agentic in this system and subject to it, reluctant to make waves and lose our place within a system that can offer nurses safety and security in, and most importantly, a paycheck. This paper articulates a prefigurative anarchist approach to nursing praxis. Through the writing of Emma Goldman, we locate a historically founded philosophical basis for practical tactics that nurses can use to actualise this praxis. Both individually and as a collective, nurses can assert their own ethic and power through direct action, micro-insurgency and solidarity to build the world we know can be. Our only limitation is our imagination.

Despite being considered the proverbial backbone of our healthcare systems, nursing still seems to struggle to scientifically demonstrate its contribution to care experiences and patient outcomes. This leads to erosive tendencies that threaten the development of the profession and its progress as an academic discipline. With this paper, we want to contribute to the theoretical discourse concerning the nature of nursing and the research into its effectiveness. We begin by outlining a set of prevailing paradoxes and their consequences relating to nursing and nursing research: the issue of demonstrating its unique contribution despite a clear societal mandate; a discrepancy between subjectively experienced effectiveness and objectively ascertainable effectiveness; and a mismatch between theoretical premises of nursing and task-oriented cultures in practice environments. Using an example of a seemingly simple nursing intervention, we intend to demonstrate the qualities and complexities of nursing. We further illustrate this by drawing on several of our research projects using theory-based evaluation methodologies. From these illustrative examples, we distil two insights relating to nursing interventions that we consider fundamental: the nurse, as a person, is central to its unique effectiveness; and there is always an interplay between context, intervention and its intended effect. We summarise our considerations and argue the case for conceiving research designs in alignment with theoretical premises of nursing.

Nursing has improved over the centuries from the physician's handmaiden to a recognised profession. Yet, the image of a nurse is often associated with notions of caring and nurturing- attributes considered feminine. Indeed, cultural, and societal biases exist that can deter men from entering the nursing profession where their sense of masculinity is questioned. Several studies have highlighted the existence of gender-based stereotypes, stigma, rejection, loneliness and discrimination which impact the retention of men in the nursing profession. Despite the established evidence regarding negative experiences, it appears limited attention has been paid to the men who decide to stay in nursing: how do they thrive in a profession wherein biases are evident within and in the wider societal context? Undoubtedly, several factors such as job security and financial incentives may contribute to men remaining in nursing. Beyond these, we borrow the notion of 'constructive resistance' to underscore that though the biases may be apparent, male nurses are able to construct alternatives that accommodate the image of a man in the nursing profession. Strategies such as developing the image as a 'super nurse' can create opportunities for male nurses to be preferred by other healthcare providers as well as female nurses. Thus, although resistance may usually appear as a negative phenomenon, constructive resistance represents hidden advantages which offers an opportunity to retain male nurses. These need to be highlighted and explored more as they can offer deeper insight into strategies that can be employed to improve retention and representation of men in nursing particularly at a time when the impact of nursing shortage remains a global issue.

Since the COVID-19 pandemic, ongoing reports have highlighted the urgency of addressing anti-Black racism within Canada's healthcare system. The paucity of research within a Canadian context has created growing concerns among Millennials and Generation Zs for healthcare to address growing health disparities and health inequities that are attributed to institutional and structural racism. Recognizing the paradigm shift that has occurred because of the pandemic and the sleuth of racial killings, the nursing classroom has witnessed a change and a need for nursing education to be relevant for the cohort of nursing students who are seeking answers. The scarcity of nursing literature addressing diverse forms of learning demonstrates the need for nursing education to explore new ways of being diverse, inclusive and innovative when teaching intergenerationally. In this paper, the author challenges nurse educators to revisit the student-educator relationship by introducing critical digital pedagogy to dismantle anti-Black racism and promote student-educator engagement for transformative learning to occur. As an educator, the author implements the use of digital illustration as a tool of resistance for students and educators to assess, engage, act and reflect on creating change within nursing education. Using Black feminist thought and culturally responsive learning, the author introduces an arts-based approach through the innovative design of an illustration, titled, 'Ain't I a Nurse. Combining historical stories with contemporary socio-political experiences, the author demonstrates how students and educators can enter a cognitive learning experience where they can connect mentally and emotionally, and in so doing re-envision and recreate a new world that centralizes equity, diversity and inclusivity through critical discourses. Through the illustration anti-Black racism is challenged and anti-Black racism resistance is discovered as an antidote in dismantling anti-Black racism within nursing education.