Virtuous Nursing: More caring than science and more scientific than care

Western nursing has been deeply influenced by Christianity and more latterly by the Nightingale ideal of the good nurse. Both views have, as their foundation, the belief that there is an objectively knowable good way to live. This belief presents problems to the modern nurse and has, in large part, been rejected. However, the rejection of this objective moral foundation for nursing has resulted in a crisis of confidence about the best way to articulate what it is to be a good nurse. Two new ways have emerged in recent times. A scientific approach to nursing has elevated the work of nursing to increasingly complex levels and resulted in significantly improved health outcomes for patients. This scientific approach to nursing has manifested itself in two ways. It has resulted in the development of theories of nursing based on psychological concepts. Parallel to this approach has been the tendency for nursing itself to become increasingly scientific and nurses in turn to be technologists. It was thought that nursing that was increasingly shaped in scientific terms would achieve professional status because it presented a scientifically verifiable knowledge base. At the same time, however, it has resulted in an understanding of what counts as being a good nurse being reduced to the nurse's ability to perform tasks to a high level of clinical precision. Alternatively, nursing as a care-based activity has made a caring attitude the moral centre point of nursing. On this view objective standards of practice are regarded as secondary to the emotional care that the nurse brings to the patient. This belief arose in part because notions of the objectivity of science were challenged as ideological rather than the dispassionate form of knowledge that scientists claimed. It was fostered by the emergence and dominance of phenomenology and the influence of the feminist care ethic.;There was also some anxiety about what had been lost in nursing by the embrace of science. In addition, the care ethic seemed to promise the possibility of defining nursing in its own terms in order to make nursing a distinct professional body. However, the demands of an ethic of care have proven elusive and, in the minds of some, unattainable. Given these criticisms of both these ways of thinking about nursing it is proposed that nursing think of itself as a virtues-based activity. Virtues theory incorporates within it the strengths of the two formerly mentioned ways of describing nursing without being subject to the limitations of each. Virtues such as love friendliness, compassion , courage and conscientiousness and the intellectual virtue of prudence or practical wisdom enable nurses to realise that goal in their practice. In this thesis virtue theory will be analysed and applied to nursing in the following way. Some Aristotelian concepts will be identified and their application t professional ethics by contemporary virtue theorists will be discussed. This involves and explication of some virtues that enhance shared conceptions of the practice of nursing. The significance of the good nurse in the shaping of good nursing practice will be considered alongside a reflection on the place of moral luck in nursing practice. It is argued that when nurses think of themselves as participating in a tradition of health care they find meaning in their work, Finally an understanding of nursing as a virtue-based activity clarifies good practice in such a way that nurses are able to elicit from it the qualities needed for its good practice.