Nursing Philosophy Research Articles

A philosophical exploration of rural health and nursing based on an undergraduate United States-Australian collaboration through the lens of 'positionality'.

Growing nursing workforce maldistributions impede rural healthcare access globally. In-depth exploration of underlying philosophical ideas about rural health in nursing curricular could support recruitment and retention of nurses who are well positioned to support and advocated for health care and services relevant to their communities. Through a lens of positionality, the purpose of this paper is to explore rural health and nursing within the United States and Australia from the perspective of undergraduate students. Recognizing that both countries have 'first world' health services, issues of access to services associated with systemic and structural biases were significant features identified by participants. Their perceptions were supported by discussion with attendees of the 26th International Nursing Philosophy Conference from several countries, during a presentation titled 'What is different about rural health nursing: A philosophical exploration.'This international consistency suggests that systemic and structural biases are global phenomena. While exposure to rural health and rural nursing may be beneficial for recruitment, preparing nurses for rural practice requires more than educating students to complete clinical tasks. Uncovering collaboration, advocacy and policy development opportunities for nurses in rural communities could move the dial from recruiting rural nurses to fulfill immediate needs to retention of well-educated and highly skilled nurses. Building a stronger philosophical base for rural healthcare inclusive of all people, honouring their distinguishing characteristics such as age, gender, ethnicity, is long overdue. Positionality can inform how nurses across the globe relate to other countries' governments, cultures, norms, values, expectations, etc., which can influence the advancement of the profession and address social inequities among rural populations.

Accepted poster abstracts for the 26th International Nursing Philosophy Conference in association with IPONS: Re-imagining a nursing ecosystem in an uncertain world.

Accepted poster abstracts for the 26th International Nursing Philosophy Conference in association with IPONS: Re-imagining a nursing ecosystem in an uncertain world.

Accepted podium abstracts for the 26th International Nursing Philosophy Conference in association with IPONS: Re-imagining a nursing ecosystem in an uncertain world.

Accepted podium abstracts for the 26th International Nursing Philosophy Conference in association with IPONS: Re-imagining a nursing ecosystem in an uncertain world.

Isabella Barbour 'Ella' Pirrie (1857-1929): Pioneering contributions to British nursing.

Miss Isabella "Ella" Barbour Pirrie (1857-1929) made substantial contributions to nursing through her work in Belfast and Edinburgh. Born to a notable medical family, Pirrie's inclination toward nursing was influenced by her father's profession. She trained at the Liverpool Royal Infirmary and was mentored by Florence Nightingale, whose guidance shaped her nursing philosophy and practices. Notably, Pirrie's role in the Belfast Union Workhouse Infirmary was transformative; she championed the implementation of standardized nursing uniforms, enhancing the professional standing and recognition of nurses. Her efforts led to the establishment of a formal nursing training program in Belfast, despite facing significant resistance and challenges. In 1894, Pirrie moved to Edinburgh to become the First Matron at the Lady Grisell Baillie Memorial Hospital. Her tenure there was marked by significant advancements in nursing education, including the establishment of a community and district nursing department. By the end of her service, over 140 nurses had been trained, with many pursuing international missions. Despite her resignation in 1914 due to health issues, Pirrie continued her work as the superintendent of the Deaconess Rest Home in Edinburgh until her death in 1929. Her legacy is commemorated by a statue at Belfast City Hospital and a plaque at Greyfriars' Charteris Sanctuary, reflecting her profound impact on nursing education and the professionalization of the field.

Holistic Physical Assessment: A New Framework for Nursing Practice Honoring the Whole Person.

Scholars have argued that standard physical assessment is based on a medical framework instead of nursing theories and philosophy. We argue that standard physical assessment is task-oriented, lacking emphasis on the whole-person and neglecting a least-to-most invasive assessment process. While holistic health assessment is person-centered and multidimensional; addressing aspects such as physical, emotional, and spiritual well-being, there is not a comprehensive explanation on how to holistically perform the physical examination portion of a holistic health assessment. Proposed is a new framework for holistic physical assessment in the hospital environment, honoring the whole-person, their background, and lived experiences. The framework builds on the holistic nursing philosophy, integrative nursing principles, and trauma-informed approach, and systematically arranges physical assessment from least invasive to most. The seven sequential assessment steps incorporate self-care and awareness into the preparation and closure of the assessment-(1) the self, (2) the space, (3) least invasive, (4) moderate invasive, (5) most invasive, (6) the space, and (7) the self. This framework can have significant implications for nursing practice and education settings, providing valuable guidance for a holistic physical assessment that emphasizes whole-person care.

Doctoral graduates’ attitudes toward scholarly work and Institutional Review Board and Quality Improvement Committee education and submission processes: A pilot study

BackgroundEducators are challenged to find better ways to prepare doctoral nursing students to conduct scholarly work involving human subjects. PurposeTo better understand doctoral nursing students’ attitudes toward programmatic scholarly work and Institutional Review Board (IRB)/Quality Improvement Committee (QIC) education and submission processes. MethodsRecent Doctor of Nursing Practice (DNP) and Philosophy of Nursing (PhD) graduates were recruited using convenience sampling techniques to participate in this cross-sectional, descriptive, mixed-methods pilot study. Data were collected using two researcher-developed instruments. DiscussionNineteen doctoral nursing students participated in this study. Students most often used a quantitative approach with health care providers to complete their scholarly work requirements. Both PhD and DNP participants were overall satisfied with the IRB/QIC content in the curricula and the submission process. Four themes were identified: (a) Efficiency, (b) Collaboration, (c) Faculty Mentorship, and (d) Areas for Improvement. ConclusionFindings from this pilot study may be used to enhance IRB/QIC processes through revision of administrative processes and student education.

Visibility of Care Ethics in Adventist Professional Nursing Education from a Philosophical Perspective

Objective: To analyze the scientific evidence on the visibility of care ethics in the professional training of nursing from an Adventist philosophy perspective. Methodology: This study is a literature review. Information was sourced from online databases including Scopus, Web of Science, CINAHL plus, MEDLINE (PubMed), Wiley, Lilacs, and Google Scholar. Selection criteria included original and review articles from 2009 to 2020. Thirty documents related to nursing philosophy and Christian philosophy were analyzed. Of these, 21 met the inclusion criteria, which highlighted the Adventist vision and worldview, the value of human life, care ethics, patient valuation, love for one's neighbor and God, who is the Creator, sustainer, and redeemer. Results: Nursing professionals who incorporate religion into their training adhere to care ethics. Adventist nursing philosophy focuses on the individual and their worldview, encompassing knowledge, logic, epistemology, action, and ethical values. Conclusions: The literature showed that the philosophy of Adventist nurses strengthens and magnifies professional practice. Adventist nursing bears witness to the practice of Christian principles and values throughout its training and professional practice, providing holistic care that covers physical, mental, social, and spiritual aspects.
 
 Received: 5 July 2023 / Accepted: 14 December 2023 / Published: 5 January 2024

Achieving Health Equity and Eliminating Health Disparities Based on Nursing Philosophical, Theoretical and Ethical Perspectives

Background: Nowadays, there has been a growing emphasis on the topic of health equity, which refers to the fundamental principle of addressing and resolving disparities in health outcomes and the factors that influence them, such as social determinants. The pursuit of health equity entails a dedicated effort towards achieving the utmost level of health and wellbeing for every individual, while also paying particular attention to those who are most vulnerable to experiencing poor health due to their social circumstances. Purpose: This paper aimed to delve deeply into the concepts of health equity and disparities in healthcare from nursing perspectives, exploring various philosophies, theories, and ethical principles. Furthermore, it aimed to highlight the crucial role that nursing professionals play in promoting health equity and eradicating health disparities. Methods: A scoping review was conducted to identify relevant international reports and literature published in English, multiple electronic databases including Cumulative Index to Nursing and Allied Health Literature (CINAHL), ProQuest, MEDLINE, Google Scholar, SAGE Journals, and PubMed were searched. Results: Nursing professionals have a significant role in achieving health equity and eliminating health disparities. Therefore, there has been a growing emphasis on the importance of achieving health equity, enhancing caring and healing connections as the core of professional nursing, alongside the use of theory-guided practice approaches, and nursing philosophies. Consequently, professionals in the field are actively seeking more practical methods that incorporate a sense of purpose and significance into their work to achieve equity based on essential nursing philosophies and theories. Conclusion: Nurses have a unique and advantageous role in the healthcare system, as they have the ability to make a substantial impact on addressing the underlying factors that contribute to health disparities. Furthermore, nurses work closely with interdisciplinary teams, harnessing the power of collaboration and teamwork to effectively implement a range of strategies aimed at promoting fair and equal access to healthcare for all individuals. Implications for Nursing: Nursing professionals have a crucial role in promoting and maintaining health equity, which has been increasingly recognized and emphasized. In addition, they are in a unique position to lead the way in patient care and can make a significant impact in addressing the underlying causes of health disparities by understanding and acknowledging the various factors that influence a person's health and overall well-being. Keywords: Nursing philosophy, Nursing theories, Ethic principles, Health equity, Health disparities.

Development Of The Emergent Theory In Fostering Caring And Leadership Resiliency In Times Of Public Health Emergencies

Nurse Leaders managing hospitals and healthcare facilities are challenged with their traditional inherits of caring and resiliency. Their nursing philosophy of caring and resiliency tested their leadership abilities and the scope of their governance in managing their clinical units. Nurses are becoming sick and resulting positive with rapid test kits on the disease. Others are resigning from their posts to protect their families and significant others. The nursing shortage is becoming evident and being felt by nurse leaders. Their leadership and governance were caught unaware of the existence of these global disease outbreaks, leading to countless works and untiring delivery of holistic care among patients with COVID-19 cases. As regards, the paper focuses on the construct of emerging theory in caring and resiliency among nurse leaders holding the highest position in the nursing service, meeting a lot of challenges in the new normal of their praxis on nursing management during the pandemic crisis. As front-liners in the healthcare system experiencing a pandemic crisis, fear, anxiety, and their psychological well-being are at risk while burnout and compassion fatigue are at stake to be observed. It is high time for nurse leaders to revisit their leadership and management programs to ensure that they are creating a cross-cultural environment where nurses foster holistic caring and resiliency.

Exploring the factors that impact Saudi Arabian nurses on holistic nursing care in patient outcomes: A qualitative study

Holistic nursing is a patient-centered approach that integrates various aspects of health to support overall well-being and improve quality of life. Exploring the factors that influence nurses' provision of holistic care from the nurses' point of view and perspective can significantly contribute to improving patient care. Despite the benefits of this modern nursing philosophy, it is still underutilized in Saudi Arabia. To examine the factors that influence the holistic nursing practices of Saudi Arabian nurses in the city of Hail, Saudi Arabia. This study used a qualitative-thematic analysis design and involved 12 nurses selected through purposive sampling criteria. Thematic data analysis of nurses' practices and experiences in providing holistic nursing care in Hail, Saudi Arabia, revealed four key factors affecting patient outcomes: inadequate nursing care, inadequate support for nurse empowerment, negative family attitudes and expectations toward nursing responsibilities, and disproportionate nurse staffing ratios. Challenges to holistic care delivery by nurses often fall within the realm of management. Practical strategies to address these challenges include reviewing and updating operational nursing policies to incorporate rotations, increasing staffing levels, implementing a reward system, ensuring adequate resources, promoting open communication, and valuing the well-being of the team.

The place of philosophy in nursing.

Philosophy adds humanness to nursing and facilitates holistic care. Philosophies like Ubuntu which purports that a person is only a person through other people and emphasises community cohesion and caring for each other can add humanness to nursing. Because Ubuntu validates subjective experience and its meaning in the lifeworld, it exemplifies the basis of holistic and individualised caring in nursing. Although nurses can make their own philosophy through critical reflexivity, the convergent point is the goal of meaningful caring that is, sustaining health and the well-being of patients and significant others. Philosophy transcends job description, it encompasses visceral experience, personal beliefsand goals, resulting in purpose and deeper meaning to the nursing profession of caring as emulated by Florence Nightingale. While contemporary philosophy has been met with criticism as being detached from human concern, narrowly focussed and technical, it evokes critical thinking and promotes sociality in nursing practice. The Covid-19 pandemic vividly brought philosophy to the fore as nurses sacrificially and vulnerably rose to the challenge of caring not only for the sick, but also for families who through infection control measures were deprived of sociality. This paper argues that philosophy adds humanness and substance to nursing in the context of COVID-19.

Exploring the relationship between compassion, the practice environment, and quality of care as perceived by paediatric nurses

PurposeTo (1) explore associations between paediatric nurses' perceptions of their own compassion, the practice environment, and quality of care, and (2) identify factors that influence perceived quality of care. Design and methodsCross-sectional survey of paediatric nurses (n = 113) from a hospital network in Melbourne, Australia. The survey included the Compassion Scale, Practice Environment Scale of the Nurse Work Index (PES-NWI), a single quality of care item, and demographic items. Hierarchical regression was used to explore factors that predicted perceived care quality. ResultsThere were moderate positive correlations between perceived care quality and both compassion (rho = 0.36, p < .001) and practice environment (i.e., total PES-NWI: rho = 0.45, p < .001). There were significant differences in perceived care quality based on nurses' work area (i.e., critical care vs medical/surgical wards). The final hierarchical regression analysis included compassion (Step 2) and four of five PES-NWI subscales (Step 3), controlling for work area (Step 1). The model was statistically significant and explained 44% of variance in perceived quality; compassion and PES-NWI subscale 2 (Nursing foundations for quality of care) were statistically significant predictors. ConclusionsPaediatric nurses' perceptions of quality were influenced by their own compassion for others and elements of the practice environment, particularly nursing foundations for care quality, which is characterised by a clear nursing philosophy and model of care, with programs and processes to support practice. Practice implicationsThe findings offer insights into potentially modifiable individual and workplace factors that contribute to paediatric nurses' perceptions of care quality.

Doctor of Nursing Practice and Its Application to School Nursing.

School nurses who are considering a terminal degree in nursing have two options, a Doctor of Nursing Practice (DNP) or a Doctor of Philosophy in Nursing (PhD). There are several factors for school nurses to consider when determining which terminal degree is best suited for them. This article focuses on the relevance of a DNP degree to school nursing, by first reviewing the evolution of DNP programs and then pivoting to discussions by three school nurses on why they chose this terminal degree and the projects completed during their courses of study. A main focus of a DNP project is to gather, analyze, synthesize, and translate research into practice, often operationalized as quality improvement (QI) in clinical settings. School nurses, practicing independently from other healthcare professionals while often managing large workloads, stand to benefit from obtaining or working with a nurse prepared at this level.

Application of evidence‐based nursing in postoperative radiotherapy care for breast cancer

AbstractTo investigate the effect of evidence‐based nursing on breast cancer patients during postoperative radiotherapy care. In the sample selection, 100 breast cancer patients who received postoperative radiotherapy in our hospital from January 2020 to January 2022 were selected to participate in this study. Patients in the control group received routine nursing program, while patients in the study group applied the intervention of evidence‐based nursing philosophy, the nursing effect was compared between the two groups. According to the nursing effect of the two groups, there was a significant difference under the intervention of different protocols. The patients in the study group showed significant improvements in Self‐Rating Depression Scale and Self‐Rating Anxiety Scale scores under the evidence‐based care intervention, superior to those of the control group, and the difference was significant (p &lt; .05); from the scores of shoulder and elbow functions, the patients in the study group showed more significant intervention effects, superior to that of the control group, and the difference was significant (p &lt; .05); from the skin injury degree of the two groups, the skin injury grade of the study group was significantly superior to that of the control group, with a significant difference (p &lt; .05); from the patient satisfaction indexes, after the evidence‐based nursing intervention, the satisfaction indexes of the study group and the control group were 98% and 82%, respectively, and the difference was significant (p &lt; .05). In the current nursing intervention of postoperative radiotherapy for breast cancer patients, evidence‐based nursing models can effectively relieve the adverse emotions of patients, improve patients' shoulder joint and elbow joint function, reduce the skin damage, and improve patient satisfaction, which has an important clinical spread value.

Workplace violence against cardiovascular nurses during Covid-19 pandemic

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): The National Federation of Orders for Nursing Professions (FNOPI - Italia) Background Workplace violence (WPV) impacts negatively both healthcare workers and healthcare organizations. Nurses are the most exposed healthcare workers to vertical WPV, also during the COVID-19 pandemic. Purpose Describing the WPV against nurses and its predictive factors in cardiovascular settings during COVID-19 pandemic in Italy. Methods This is a secondary analysis conducted in cardiovascular hospital settings from a larger national study between January and April 2021. Data were collected through the Practice Environment Scale of the Nursing Work Index (PES-NWI; Likert scale 1 to 4) and the adapted version of the Violence in Emergency Nursing and Triage (VENT) Questionnaire. Descriptive and logistic regression analyses were conducted. Results The analysis was conducted on 360 cardiovascular nurses (76.7% female; mean age 42.6 years, SD 10.8). Thirty per cent (n=108) of them reported WPV in last year and/or last week and 14.2% (n=51) only in last week. The number of patients was higher for nurses with WPV (mean difference [MD] +1.9; p = .030). The work environment was significantly worse for nurses with WPV: mean PES-NWI composite score (MD -0.2; p&amp;lt;.001); PES-NWI subscales: staffing and resource adequacy (MD -0.3; p&amp;lt;.001); nursing foundations for quality of care (MD -0.2; p = .005); nurse participation in hospital affairs (MD -0.3; p&amp;lt;.001); physician-nurse relationship (MD -0.2; p = .004). Multiple linear regression demonstrated that the risk of WPV increases when a clear nursing philosophy was not completely implemented in cardiovascular setting (odds ratio [OR] 5.29; 95% confidence interval [CI], 1.07-26.05; p = .040) and the nurses restrain patients (OR 2.49; 95% CI, 1.04-5.97, p = .041). The risk of WPV decreases when protectives glasses were present (OR 0.36; 95% CI 0.19-0.70, p = .003). Conclusion Public healthcare services should reduce WPV by investing in improving the nurse work environment. Integrated and multimodal programs of prevention and management of WPV are useful to address it.

Mattering: Per/forming nursing philosophy in the Chthulucene.

This paper presents an overview of the process of entanglement at the 25th International Philosophy of Nursing Conference (IPNC) at University of California at Irvine held on August 18, 2022. Representing collective work from the US, Canada, UK and Germany, our panel entitled 'What can critical posthuman philosophies do for nursing?' examined critical posthumanism and its operations and potential in nursing. Critical posthumanism offers an antifascist, feminist, material, affective, and ecologically entangled approach to nursing and healthcare. Rather than focusing on the arguments of each of the three distinct but interrelated panel presentation pieces, this paper instead focuses on process and performance (per/formance) and performativity as relational, connected and situated, with connections to nursing philosophy. Building upon critical feminist and new materialist philosophies, we describe intra-activity and performativity as ways to dehierarchise knowledge making practices within traditional academic conference spaces. Creating critical cartographies of thinking and being are actions of possibility for building more just and equitable futures for nursing, nurses, and those they accompany-including all humans, nonhumans, and more than human matter.

The Science of Nursing Practice Originating From the Philosophy of Nursing.

In this article, the author introduces Reed and Crawford Shearer's second edition of Nursing Knowledge and Theory Innovation: Advancing the Science of Practice, envisioning the expanded meaning of nursing theory and knowledge development from the perspective of the science of nursing practice originating from the philosophy of nursing.

Reflections on an interactive posthumanist panel: A model for future nursing philosophy conference engagement?

Reflections on an interactive posthumanist panel: A model for future nursing philosophy conference engagement?

Whither nursing philosophy: Past, present and future.

A version of this paper was given as the Inaugural Steven Edwards Memorial Lecture at the 25th conference of the International Philosophy of Nursing Society 16th August 2022. Using the literary meaning of 'whither', that is 'to what place', this paper will explore the role of philosophy in nursing, past, present, and future. The paper will begin with some thoughts on the history of nursing philosophy, its development as a subject and the scholarly activities that have led to where it sits today. The establishment of the journal Nursing Philosophy, the Annual Nursing Philosophy Conference, the International Philosophy of Nursing Society (IPONS) and their influence on nursing both in the academy and in practice will be discussed. The concept of nursing philosophy as a discipline will be considered, and how this fits with nursing theory, and nursing knowledge. Philosophical questions central to understanding contemporary nursing in a globalised world will be explored and the use of analytical philosophy and philosophical method in addressing such questions. The paper will conclude by looking to the future; what the role of philosophy might be in shaping nursing as a discipline and in the preparation of future practitioners.

How Advanced Practice Holistic Nurses Meet International Criteria for Advanced Practice.

Much has been written about the inclusion of holistic nursing philosophy and practices in undergraduate nursing education, but their inclusion and influence in advanced practice nursing education have not been fully explored. Supporting a holistic paradigm and model of care founded on evidenced-based clinical theory allows for expanded nursing practice and health care options for patients. Holistic nursing aligns with culturally competent, patient-centered care and is consistent with how our current health care landscape has evolved in recent years. Health care reform highlights a new direction in practice toward self-transformation, accountability, natural treatment options, and a patient's active role in health care decisions. To demonstrate the role, this article will address how advanced practice holistic nurses meet the International Council of Nurses Criteria for Advanced Practice and is substantially equivalent and exceeds current APRN competencies.