Nursing Knowledge Science Practice And Philosophy Pdf


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Too often we dismiss philosophy as something obscure that has nothing to do with our practice. It is true that much contemporary academic philosophy is criticised for being very technical, narrowly focused and detached from human concerns Norris But this is not how we understand philosophy in Careful Nursing.

Nursing Knowledge in the 21st Century: Domain-Derived and Basic Science Practice-Shaped

Susan A. This article addresses wisdom-in-action for nursing practice. We briefly describe nursing theory , review the wisdom literature as presented in various disciplines, and identify characteristics of wisdom by analyzing four models of wisdom from other disciplines.

We also present the ten antecedents of wisdom and the ten characteristics of wisdom identified in our analysis of the wisdom literature, discuss and summarize these antecedents, and conclude that understanding these ten antecedents and the ten characteristics of wisdom-in-action can both help nurses demonstrate wisdom as they provide nursing care and teach new nurses the process of becoming wise in nursing practice. Citation: Matney, S. Keywords: wisdom, knowledge, informatics, concept analysis, antecedents of wisdom, characteristics of wisdom, wisdom-in-action.

Where is the wisdom we have lost in knowledge? Thomas Stearns Eliot , p. Few could imagine the technological advances that would occur after T. Eliot wrote this poetic line in , relating wisdom to knowledge and suggesting a distinct relationship between the concepts.

In , the American Nurses Association ANA released the revised Nursing Informatics: Scope and Standards of Practice adding the concept of wisdom to the accepted framework of data, information, and knowledge concepts in nursing informatics. Wisdom is defined in the Merriam-Webster Dictionary as a knowledge gained through life experiences, b the innate ability to understand things that others cannot understand, and c judgment or good sense.

Because nurses have a desire to apply wisdom within their practice and nurse informaticists need to understand how to support the use of wisdom in practice see discussion below , a clearer understanding of the concept is needed. This article describes a deliberate study to identify characteristics of nursing wisdom by examining four theories in other disciplines.

Theory is used in all aspects of nursing care and assists the practicing nurse in organizing, understanding and analyzing patient data. Nursing theory facilitates the development of nursing knowledge and provides principles to support nursing practice. Nursing theory is developed from groups of concepts and describes their interrelationships, thus presenting a systematic view of nursing-related events. Essentially, theory provides a systematic, consistent way of thinking about nursing care to guide the decision-making process.

Theory-based, clinical practice occurs when nurses intentionally structure their practice around a particular theory to guide them in their care of the patient.

One of the greatest contributions grand theories Different levels of nursing theory exist; these levels include metatheory, grand theory, and mid-range theories. Metatheories focus on theory about theory.

These theories develop through asking philosophical and methodological questions to form a nursing foundation. One of the greatest contributions grand theories, largely developed between the s and the s, provide for nursing is the differentiation between nursing practice and the practice of medicine.

They offer the specificity needed for usefulness in research and practice, usually focusing on one specific topic or area of care and often beginning with a concept analysis and the development of a larger conceptual model often called a construct.

Wisdom is an abstract ideal, an end-point or characteristic, something applied in, yet separate from practice. Today, we have a large body of literature about wisdom, although much of it does not relate to wisdom in nursing practice.

To support this exploration, definitions of wisdom from the early classic philosophy and psychology literature, and the alignment of these definitions with nursing, as well as definitions from the nursing literature are presented.

Classical philosophers began defining wisdom as early as B. Plato wrote that wisdom is the knowledge about the good between all that exists Truglio-Londrigan, while according to Aristotle, wisdom is knowledge of the first causes and principles of things Rice, Aristotle differentiated wisdom into five states of mind: episteme or scientific knowledge; theoretikes or theoretical knowledge devoted to truth; techne or technical skill; phronesis or practical wisdom, which enables ethical action that contributes to the common good; and sophia which is concerned with truth towards a practical end McKie et al.

All five of these wisdom states could define the art and science of nursing practice. The nursing profession is built upon scientific knowledge episteme and nursing practice is grounded with theory theoretikes ANA, Nurses must understand and stay abreast of current technology techne. One of the nursing standards of practice is ethics; hence, nurses integrate ethics phronesis into all areas of their practice.

Finally, the art of nursing practice is based on a framework of caring sophia. Personal wisdom comes into play after experienced nurses reflect on their own practice, and learn from their experiences, thereby increasing their personal knowledge. General wisdom is directed toward other individuals from a third-person perspective. It is a personal trait manifested by caring for others.

Personal wisdom is about one's own life and problems seen from a first-person perspective. These are both important to understand because nursing pertains to both general and personal wisdom. Afterwards, learning from the caring experience can be applied personally. Results demonstrated that all age groups were able to change negative life experiences into positive ones when wisdom was used.

Resulting themes included morality, integrity, overcoming risk or adversity, searching for insight, and striving toward individual improvement.

Wisdom is assumed to be intrinsically associated with age and experience Wisdom is assumed to be intrinsically associated with age and experience. Although older people have more experiences, age is not the only characteristic associated with wisdom. This is important for nursing because it means that age is not necessarily a factor in being a wise nurse. Sternberg and his team hypothesized that the key leadership components of wisdom are intelligence, creativity, and knowledge, as well as being able to use these characteristics to make good decisions.

His team presented difficult life problem vignettes along with possible solutions to study participants. The participants rated the solutions. Then, their solutions were compared against ratings from psychological experts. The findings from psychology illustrate that important wisdom-character precursors include morality, integrity, creativity, intelligence, knowledge and insight, as well as concepts used during the application of wisdom, such as judgment and thinking of others.

All of these concepts align with the practice of nursing. Few authors have explored or attempted to define wisdom in a nursing context. Benner wrote that nursing wisdom is based on clinical judgment and a thinking-in-action approach encompassing intuition, emotions, and senses. Benner and colleagues described clinically wise nurses as both proficient and expert. Matney, et al. These definitions link wisdom to performance, or nursing practice, leading one to recognize that wisdom must be tied to actions using skills and knowledge.

Haggerty and Grace evaluated the psychology and philosophical wisdom literature to determine the key components of clinical wisdom. Two concepts from the field of philosophy, praxis and phronesis, are associated with wisdom in nursing. Praxis is defined as the act of putting theory into practice Rolfe, Praxis is developed from moral, experiential, and practice-related situations and changes over time with increased experience Connor, Litchfield illustrated a nursing-praxis framework, merging theory, practice, and research.

Phronesis is indicative of morality in that nurses need to be ready to determine the most appropriate response in particular circumstances Chen, Characteristics of wisdom found in praxis and phronesis e.

Clinical nursing is a process requiring a practice-based theory of wisdom rooted in action. Understanding wisdom from a nursing context will leverage the ability of both practicing nurses and nursing informaticists as they facilitate the development and use of wisdom.

This article focuses on identifying wisdom concepts that pertain to clinical nursing and that are derived from wisdom theories in other disciplines. As authors, we made three assumptions pertinent to the identification of wisdom characteristics and the development of a theory for nursing. First, wisdom is defined in other disciplines. Therefore, these existing theories of wisdom likely contain characteristics useful for wisdom in clinical nursing even though these theories from other disciplines have not yet been collected into a single whole.

Second, nurses provide care for patients in clinical situations using wisdom. Third, nurses use both general and personal wisdom as described above. The process of derivation as defined by Walker and Avant was used in the identification of wisdom characteristics. Derivation implies that the concepts are obtained from another source. The method entails examining existing models or theories; selecting a core model, or models, from which to create a new theory; and specifying how existing models are adapted.

This derivation process included three steps: a identification of potential theories that may contribute to or overlap with nursing wisdom; b selection of the theories from which the characteristics could be derived; and c analysis of the characteristics of the parent theories needed for the new nursing theory. We followed this process to produce a list of wisdom antecedents and characteristics that describe and can support wisdom in nursing practice.

These models were chosen because they focus on knowledge as the core of wisdom, a central component in the application of wisdom to any actions. Each is described below.

The initial model evaluated was the DIKW framework that originated in computer and information sciences, particularly in knowledge management Blum, All rights reserved. Wisdom is using knowledge correctly to handle or explain human problems. The components consist of four overlapping concepts: data, information, knowledge, and wisdom Figure 1.

Data are symbols that represent properties of objects, events, and their environments that alone have little meaning. Information is data given structure.

Knowledge is derived by discovering patterns and relationships between types of information Nelson, The ANA describes wisdom as the ability to evaluate the information and knowledge within the context of caring, and use judgment to make care decisions ANA, ; Matney, et al.

Metaheuristics are high level strategies that organize lower level rules within individuals to assist in planning, managing and evaluating life issues. A metaheuristic pragmatic to orchestrate mind and virtue toward excellence. The American Psychologist, 55 1 , The sections include wisdom antecedent factor precursors and process concepts.

Wisdom involves using good judgment, insight, emotional regulation, and empathy and is found in all areas of life including family interactions, writing, and personal relations. The third section portrays qualitative criteria for solving problems. The authors' first study was conducted using autobiographical narratives of people who thought they were wise.

The second was a qualitative study of people nominated as wise; open interview questions were used in this study. Figure 3. Challenges are managed head-on or through adaptation, and individuals do not feel victimized when events are beyond their control, giving individuals a sense of mastery.

Mark Risjord, Nursing knowledge, science, practice and philosophy

Nurses when assisting a patient in an emergency situation, or in any other circumstances, act putting into action, learned knowledge and experienced, personal skills such as intuition and scientific principles resulting from the research. They do it, according to the person, the situation and the context, considering the best way to do this and the possibility of implementation within an ethical perspective. When these nurses find solutions to problems that arise in a process of reflection in an action and reflection on the action, are acquiring own nursing knowledge that when systematized - in a process of reflection on the reflection in an action - shared and validated by their peers turns into nursing science. Nursing being a human science, is a discipline oriented to the practice, established on the development of a care relationship between nurses and users, in a perspective of health and wellness 1. A practical human science with a practical-reflexive rationality distinguished from a technical rationality , within an epistemology of practice as distinct from a classical epistemology , whose specific knowledge turns into hermeneutical spiral processes 2. Recursive processes, between theory and practice, which are developed in a context of high complexity, the environments where the nursing action takes place, the relationship established between caregivers and users, and the characteristics of these interventions. What nurses do in their action, it is to use a package of knowledge that recreate while they work, and recreating, they are able to find new solutions, new processes, or to create new knowledge.


Nursing Knowledge: Science, Practice, and Philosophy Mark W. Risjord · Publisher: Wiley-Blackwell Release Date: · ISBN: Author.


Toward an Understanding of Wisdom in Nursing

Skip to search form Skip to main content You are currently offline. Some features of the site may not work correctly. Preface Foreword. Introduction to Part I. Nursing knowledge.

As nurses, we seek to better understand how to apply nursing knowledge in our daily practice. Nowadays, the term philosophy is widening used in many areas, including nursing. However, there is existence of unclear understanding about nursing knowledge development derived from standpoint of philosophical and methodological perspectives. This article discusses about this issue and mainly focus on empiricism, post positivistic view, the philosophy of Buddhism and an example related to asthma. Bruce, A.

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Nursing Knowledge: Science, Practice, and Philosophy. Author(s). Mark Risjord. First published October Print ISBN |Online.

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