What characterises nursing care? A hermeneutical philosophical inquiry

Abstract

The aim of this study was to identify some common characteristics associated with nursing care based on the historical text by the nursing pioneer, Rikke Nissen, and the modern philosophy of care, principally that of Kari M. Martinsen. The hermeneutic approach has been inspired by Gadamer's thinking. His philosophy influenced interpretation and reflection on the content of historical and modern text. Typical basic characteristics associated with nursing care can be grouped into three mutually reinforcing areas: (i) the notion of excellence in nursing care, (ii) the relationship between nursing care and moral values, and (iii) caring as an interpretational exercise. The most significant core element was the strong relationship between care and professional judgement (or clinical judgement), and the requirement of analytic cognition on different levels of abstraction in context with the patient. In the early days of nursing, care was a concept deeply rooted in Christian philosophy. Within modern nursing philosophy, care is conceptualized in a number of ways, depending on philosophical stance and world view. What seems absolutely necessary is to differentiate between the concept of care on the superordinate level and each individual philosopher's unique perspective on care. As a superordinate term, nursing care encompasses the patient's fundamental needs, as well as the patient's values and experience. Nursing care is characterized by the holistic view and the moral inherent in excellent nursing. Excluding the patient as a unique human being, should be regarded as noncaring and amoral practice. Whether nursing care represents a specific domain of knowledge is still an unanswered question, and something which has consequences for the application of a caring philosophy in nursing practice and the state of caring knowledge in nursing.