Philosophical foundations of nursing practice

This chapter examined how nursing has conceived itself historically and how this conception has changed. It is our contention, along with some of the authors discussed, that this issue is of paramount importance in structuring how a nurse responds to a moral dilemma and which obligations have primary or greater weighting. The empirical studies contained or referred to in Holfing et al. and Murphy substantiate that these conceptions do make a determinative difference in how nurses make ethical decisions. How nursing is viewed and its role relationships defined has been variously referred to as model, role conception, or philosophy of nursing. The significant point is that this forms the philosophical foundation of nursing and has profound ethical implications. The now dominant philosophy is that of client advocacy. However, as the articles indicate, ambiguity about just what advocacy entails and misgivings about the direction nursing has taken by those within and outside of nursing do exist. The next chapter presents still more conceptions of client advocacy and problems associated with it.