This article is about nursing theories, the development of nursing knowledge and the underlying, hidden epistemology. The current technical-economical rationality in society and health care calls for a specific kind of knowledge based on a traditional Western, Socratic view of science. This has an immense influence on the development of nursing knowledge. The purpose of the article was therefore to discuss the hidden epistemology of nursing knowledge and theories seen in a broad historical context and point to an alternative epistemology for a future context. It is a question about which nursing theories and what nursing knowledge should be developed in order to benefit patients and relatives of the future. We suggest that future knowledge development in nursing be developed in an interchange between theory and practice and guided by philosophy like a kind of pendulum where all three elements are treated as equals. We suggest a framework for the development of nursing knowledge based on a caring-ethical practice, a theory on life phenomena in suffering and relationship-based nursing, and thereby, we may be able to help patients to be cured, to recover, to be alleviated or comforted when suffering.