SECTION 1.1
What is a philosophy of nursing?
Distinguish an observation from a question about meaning or value, and explain why both matter in nursing.
Learn
Philosophy begins when you stop to ask what a familiar word or action really means. In nursing, ‘good care’ is not self-explanatory: we must say what makes it good, for whom, and on what grounds. You do not need previous philosophy study. Start with the difference between finding a fact and examining the meaning or value of that fact.
Key concepts and topics
From belief to a reasoned position
A philosophy of nursing is a reasoned account of what a person is, what health and care mean, what nurses can know, and what they ought to do. It makes assumptions visible so they can be questioned. Florence Nightingale, for example, connected a nurse’s purpose with conditions such as cleanliness, light and ventilation. The point is to explain why an action serves a person, not merely to list tasks.
In practice · A nurse asks, ‘Does this care plan respect what matters to this patient?’ The answer needs the patient’s perspective as well as clinical findings.
Common misconception · Philosophy is not a substitute for evidence. It helps define goals and examine the assumptions behind how evidence is used.
First order and second order questions
An empirical, first order question asks what happened: ‘How many patients reported pain after the procedure?’ A second order question examines a concept or method: ‘What counts as adequate relief?’ or ‘Whose account of pain carries weight?’ The second question changes what evidence the team looks for. Good nursing reasoning moves between both levels.
In practice · ‘The patient is better’ invites a second question: better in symptoms, function, comfort, or a goal the patient chose?
Common misconception · Second order questions are practical: vague goals can make evaluation of care misleading.
Four questions behind a care plan
Ontology asks what kind of being the patient is: a biological organism alone, or a person with relationships and agency? Epistemology asks how a claim is known and how reliable it is. Ethics asks what ought to be done when values conflict. Logic asks whether the conclusion follows from the reasons offered. Aesthetics considers the skilled, perceptive way care is expressed. These branches work together in practice.
In practice · ‘The patient declined treatment’ is an observation. ‘The patient is incapable of choosing’ is a further claim that needs evidence and careful reasoning.
Common misconception · A philosophical question cannot always be settled by counting or measuring, though observations can inform the discussion.
Key facts to remember
- Observation asks what happened; conceptual enquiry asks what it means.
- A care goal needs both evidence and a reason why it matters.
CONCEPTS IN CONTEXT
Explore the ideas
Select each question. Notice why a measurement alone cannot answer all three.
Observation
Information gathered by measurement, observation or a reported experience.
In this situation · The patient reports less pain but still cannot sleep.
Read full notes
What is a philosophy of nursing?
A first-order enquiry works within an accepted definition: count how many patients met the stated goal. A second-order enquiry examines that definition: why was this counted as success, and who chose the goal? The two enquiries strengthen each other. A clear definition makes data meaningful; observations can expose a definition that leaves out something patients value. Philosophical disagreement is not merely personal preference: participants should explain their terms, give reasons, consider objections and revise weak assumptions. This is why philosophy belongs in everyday handover and care planning as well as in academic writing.
Core concepts defined
- Observation
- Information gathered by measurement, observation or a reported experience.
- Meaning
- The definition behind a word such as health, improvement or independence.
- Value
- A reason for treating an outcome or action as important or worthwhile.
Go deeper · worked example
Reason through the situation
During handover, a student says: ‘Amina is better because her pain score fell.’ Amina says she still cannot rest. Work through the claim before judging the plan.
- Separate observation from conclusion. The changed score is one observation; the report of poor rest is another. Neither should disappear simply because it complicates the account.
- Clarify the concept. ‘Better’ could refer to pain intensity, sleep, ability to move or confidence. Ask Amina what improvement would look like to her, then agree a clear goal with the team.
- Connect the goal to evaluation. Review both the observations and the agreed outcome. A partial improvement may be real while further care is still needed; explain this rather than declaring either total success or total failure.
Use this space or your study notebook. Copy your draft before leaving the page.
Reveal a model explanation
Empirical: ‘How much did Amina sleep?’ Philosophical: ‘What should count as meaningful improvement?’ The first seeks information; the second examines the standard used to judge it.
Check your understanding
Three questions from this section’s bank: one easy, one medium and one hard. If any answer is wrong, review your reasoning below and try the fresh set. Practice stays in this page; it is not a saved grade or competence assessment.
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References and review status
Adapted and expanded from Akumbom Eurice N., Philosophy of Nursing, BNS 401, supplied teaching slides, pages 3–15.
Optional further reading · English · internet required:
Teaching diagrams are conceptual guides. Independent nursing and French-language review is pending. Practice is ungraded and is not a clinical competence assessment.