Newham Roger, Curzio Joan, Carr Graham, Terry Louise
Faculty of Society and Health, Buckinghamshire New University, Uxbridge, UK.
Nurs Philos. 2014 Jan;15(1):50-6. doi: 10.1111/nup.12028. Epub 2013 Oct 31.
This paper's philosophical ideas are developed from a General Nursing Council for England and Wales Trust-funded study to explore nursing knowledge and wisdom and ways in which these can be translated into clinical practice and fostered in junior nurses. Participants using Carper's (1978) ways of knowing as a framework experienced difficulty conceptualizing a link between the empirics and ethics of nursing. The philosophical problem is how to understand praxis as a moral entity with intrinsic value when so much of value seems to be technical and extrinsic depending on desired ends. Using the Aristotelian terms poesis and praxis can articulate the concerns that the participants as well as Carper (1978) and Dreyfus (in Flyvbjerg, 1991) among others share that certain actions or ways of knowing important for nursing are being devalued and deformed by the importance placed on quantitative data and measurable outcomes. The sense of praxis is a moralized one and most of what nurses do is plausibly on any account of normative ethics a morally good thing; the articulation of the idea of praxis can go some way in showing how it is a part of the discipline of nursing. Nursing's acts as poesis can be a part of how practitioners come to have praxis as phronesis or practical wisdom. So to be a wise nurse, one needs be a wise person.
本文的哲学思想源于一项由英格兰和威尔士总护理委员会信托基金资助的研究，该研究旨在探索护理知识与智慧，以及如何将这些知识与智慧转化为临床实践并在初级护士中加以培养。以卡珀（1978）的认知方式为框架的参与者在概念化护理实证与伦理之间的联系时遇到了困难。哲学问题在于，当如此多的价值似乎取决于期望的目的而具有技术性和外在性时，如何将实践理解为具有内在价值的道德实体。使用亚里士多德的术语“创制”和“实践”能够阐明参与者以及卡珀（1978）和德雷福斯（见弗勒贝格，1991）等人共同关注的问题，即对护理至关重要的某些行动或认知方式正因对定量数据和可衡量结果的重视而被贬低和扭曲。实践感是一种道德化的感觉，从任何规范伦理学的角度来看，护士所做的大部分工作都无疑是一件道德上的好事；对实践概念的阐述在某种程度上可以说明它是如何成为护理学科的一部分的。护理作为“创制”的行为可以成为从业者如何将实践转化为实践智慧或实践明智的一部分。所以，要成为一名明智的护士，首先得成为一个明智的人。
