Learning for holistic care: addressing practical wisdom (phronesis) and the spiritual sphere

This paper is a discussion of practical wisdom (phronesis) and spirituality in holistic caring and strategies to facilitate their application in nurse education.

Phronesis, with its inherent spiritual qualities, is an established aspect of the persona of excellent clinical leaders. There is a strong case for recognizing the value of this characteristic in all nurses, and a strategy is required for engendering the development of phronesis during nurse education.

Electronic searches of Google Scholar and CINAHL were conducted for English language publications in the period 1996-2008. Search terms included combinations of phronesis, spirituality, health, education, pharmacology, medicines and medication education, holistic care and spiritual care. Selection of items for inclusion was based on their pertinence to the arguments being developed and their value as leads to earlier material.

The links between the attributes of effective clinical leaders and those required for holistic caring are explicated and related to phronesis, the acquisition of which involves spiritual development. An explanatory account of phronesis and its applicability to nursing leads to an explanation of how its spiritual aspects in particular might be incorporated into learning for holistic care. Reference to research in medicines-related education illustrates how the principles can be applied in nurse education.

Nursing quality could be enhanced if adequate opportunities for acquiring phronesis through experiential learning were provided in nursing curricula. Phronesis and spiritual care could be incorporated into existing models of nursing care or new models devised to use these critical concepts.