Practical nursing judgment: a moderate realist conception

Under the influence of idealist mainstream thinking that reality is mind-dependent, many nurses are dismissing the possibility of attaining objectively true judgments. A worrisome trend that has emerged from such thinking is to recommend that nursing practice decisions ultimately be based solely on subjective judgments. We present a conception of practical nursing judgment based on the common-sense philosophy of moderate realism, which has the potential to help offset the trend. It allows for nursing decision making in which nursing principles and rules are modified in light of the contingent circumstances of a nursing situation, resulting in decisions which have both a subjective and an objective aspect to them. This feature, plus the fact that the nursing principles are grounded in common natural needs, rights, and obligations, provides nurses with a basis for nursing care which is individualized, just, benevolent, and sensible, a means requisite to making our lives good.