Philosophy and science are essential for a practice discipline such as nursing to define it as a profession and distinguish it from a mere occupation. For example, nursing philosophy describes a worldview that lies at the base of nursing science and guides nursing research (McEwin & Wills, 2019). Meleis (2012) postulated that nursing incorporates postmodernism as a dominant view of science with broader perspectives on reality and truth (as cited in McEwin & Wills, 2019). Therefore, nurses understand that a perceived fact for one patient may not be accurate for another. For instance, a person with chronic lower back pain cannot be a candidate for vigorous exercise programs even if they may benefit another patient.
Science, in turn, brings to the profession a framework of theories and methodologies. Nursing is a complex synthesized science that incorporates multiple disciplines such as biology, chemistry, psychology, social studies, and business (McEwin & Wills, 2019). However, nursing also includes broader aspects of knowledge, including human interaction, compassion, and intuition. For example, the second nurse in the scenario provided by Dr. Patty Schweickert in Week 1 of Class Discussion responded to the patient in distress by recalling her experience with a different patient, not by merely noticing the fever. The nurse’s “knowing” comes from her training, experience, and intuition.
McEwin and Wills (2019) describe Carper’s four patterns of knowing in nursing, such as empirics, esthetics, personal knowledge, and ethics. I agree with Bender and Elias (2017) that esthetics are fundamental to nursing practice due to the dynamic nature of health phenomena. For example, during the COVID-19 pandemic, nurses must assess the patients’ mental health because even previously healthy people have increased stressors currently. Besides, esthetics focus more on different patterns than on claims. For example, inability to sleep, poor appetite, and increased alcohol consumption can point nurses to increased psychological stress even if the patients consider themselves relatively healthy.
Esthetic knowing is still understood poorly and considered an inappropriate scientific research object (Bender & Elias, 2017). However, Benner’s work on clinical expertise is one of the best-known examples of describing knowing (as cited in Bender & Elias, 2017). Using this theory, nurses can place themselves in the continuum of nursing expertise from novice to expert. This theory can be used in nursing education and for introspection for nurses when they evaluate their progress.
In opposition to the esthetic pattern of knowing, empirical science lies at the base of evidence-based practice guidelines and is considered to be the most robust research (Burns & Grove, 2009). An example of incorporating empirical research in practice is prescribing ICS-containing inhalers to treat mild asthma according to the new Guidelines developed by Global Initiative for Asthma (2020). In conclusion, the scientific method incorporates methodologies that lead the nursing practice to new knowledge and refine nursing traditions.
Bender, M. & Elias, D. (2017). Reorienting esthetic knowing as an appropriate “object” of scientific inquiry to advance understanding of a critical pattern of nursing knowledge in practice. Advances in Nursing Science,40(1), 24-36.
Burns, N., & Grove, S. (2009). The practice of nursing research: Appraisal, synthesis, and generation of evidence (6th ed.). St. Louis, MO: Saunders Elsevier
McEwin, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.) Philadelphia, PA: Wolters Kluwer Health.
Philosophy and Science in a Practice Discipline
Importance of Philosophy and Science
Whether it be bedside patient care, management, or research prospects, all aspects of nursing are founded on nursing philosophy and theory. Even as student nurses, philosophical and theoretical principles are taught in order to make students more conscious of the intricacy of human health issues. According to Rega, Telaretti, Alvaro, and Kangasniemi (2017), the philosophical and theoretical content is a curriculum requirement incorporated in order to empower the nurse’s skills for reflection, analysis, and thinking about the profession. The skills carry over into daily patient care. When nurses further their education, the nurse starts to build on these principles to make meaningful changes in patient care and the care environment at a different level.
The nursing profession is a legitimate scientific process with roots, in theory, continuing research, and evidence-based practice. Gray, Grove, and Sutherland (2017) state that nursing research is a scientific process that authenticates and enhances existing knowledge while generating new knowledge that directly and indirectly influences evidence-based practice delivery. Nursing is easily legitimized because so much research goes into every aspect of their academia and practice after licensure. It is a process that can be replicated with good results. Although nursing has changed vastly over the year with new technology, the result is always the best and safest patient outcome. These outcomes are documented in peer-reviewed articles and results in our basis of practice. With Evidence-based practice, empirical knowledge is preferred over other forms of knowledge because Evidence can be tangibly measured, documented, and compared (Bender, & Elias, 2017). Evidence-based practice is just one of the many reasons why nursing is a stable scientific profession.
Scientific Method in Nurse Practice
The scientific method is based on the process of stating hypotheses, testing them, and then either disproving them or pushing them more fully to gain more information (Gray, Grove, and Sutherland, 2017). Research studies are conducted to obtain observed and measured data in order to form what we use as evidenced-based practice. The research results determine the way nurses perform nursing skills, the medications are given, and the interventions patient receive based on data of best patient outcomes. As far as using the method in everyday practice, nurses utilize critical thinking and knowledge to make prudent judgments. It may not be something spelled out for them in a policy, but it is gained through their own experiences. When I practice as a Post Anesthesia Care Unit (PACU) Nurse, I have basic nursing skills, focused PACU assessment skills, and a working knowledge of the protocols. You receive the necessary details of the patient’s history but are never sure of their metabolic capabilities or history of medication abuse/use. When giving medications, you have to practice what interventions will relieve their pain while not affecting their respiratory drive or substantially decreasing their mentation. It is a trial and error as it is with the scientific method. Nurses must use one side of their brain to act sympathetically and be responsive to patients’ needs while using their knowledge of the sciences for medical interventions.
Bender, M., & Elias, D. (2017). Reorienting esthetic knowing as an appropriate “object” of scientific inquiry to advance understanding of a critical pattern of nursing knowledge in practice. Advances in Nursing Science, 40(1), 24-36.
Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier.
Rega, M. L., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and theoretical content of the nursing discipline in academic education: A critical interpretive synthesis. Nurse education today, 57, 74–81. https://doi.org/10.1016/j.nedt.2017.07.001
EXAMPLE OF HOW THE REPLY NEEDS TO BE DONE.
Nursing should not rely solely on biological science. “Science is concerned with causality” (McEwen & Wills, 2019, p. 5). The scientific method is to gain a better understanding of reality, which is exemplified by observing, verifying, and experience; hypothesis testing and experimentation is considered a scientific approach (McEwen & Wills, 2019). In contrast, philosophy is concerned with the dedication of human life, the nature of existence and reality, and the theory and limits of knowledge; examples of this are instinct, reflection, and reasoning (McEwen & Wills, 2019). Nursing is the act of caring for the whole patient including physically, mentally, and spiritually. Each registered nurse has their own philosophy of nursing and provided care holistically. Multiple nursing experiences assist the nurse in making decisions every day about their patient’s physical, mental, and spiritual wellbeing. Through clinical experiences and the use of intuition, nurses can recognize patterns of deviations from the normal clinical course and know when action is needed (Gray, Grove & Sutherland, 2017). Activities such as being able to make a decision based on the assessment of the environment when you walk in the door, being able to recognize communication skills, i.e. verbal and non-verbal, and able to respond to either one or recognizing changes in the patient’s condition without touching the patient. These examples can be described as intuition. Science and philosophy share the common purpose of increasing knowledge (McEwen & Wills, 2019).
In the late 1980s and early 1990s, the science for wound care was less evolved. The common practice for pressure ulcers was Maalox liquid and a heat lamp. This applied direct heat to the wound hoping to increase blood flow to the area to promote healing, In fact, the Maalox dried out the wound bed, the heat lamp caused 2nd and 3rd degree burns, and there was a larger problem than when first started. The application of wound care and science has greatly influenced the way wounds, no matter how large or small, are treated today. In fact, there are whole teams of nurses who are certified in wound care and provide wound care in the facilities, thus reducing the number of tasks to be performed by registered nurses.
Gray, J. R., Grove, S. K., & Sutherland, S. (2017). Burns and Grove’s The practice of nursing research (8th ed.). Elsevier.
McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.). LWW.