Monthly Archives: February 2009

Postmodernism seems to be a catch-all term these days that among the public refers to moral relativism, pluralism, “tolerance”, and obliteration of objective truth. Taken to its extremes these things can be true (modernity wasn’t any less oppressive, though for different reasons), but postmodernism has much to offer nursing philosophy.

Postmodernism’s esteem of holism dovetails seamlessly into nursing’s prime value of holistic care. The time is ripe for capitalizing on this as we seek further understanding of how intangible factors impact health. My opinion is that there is a gold mine of information for holism to be found at an anthropological level in the concept of desire. More on that later.

On the flip side, I don’t expect much advancement in nursing philosophy this decade. That may seem contradictory to the above paragraph. But nursing’s (and medicine’s) currrent emphasis is on “evidence-based practice” (EBP), which has the potential to be a throw-back to modernity’s slogan, “if it’s not measurable, it can’t be true”. This has huge ramifications for nationalized health care as the federal government has indicated it intends to mandate “outcomes”.

Nursing research targeted to EBP leaves little room for development and progression of nursing philosophy. It’s an economic problem whereby research funds are preferentially given to EBP models. It’s an educational problem as nurses are not philosophers, though graduate and post-graduate programs offer perhaps 2-3 classes in nursing theory/philosophy.

The influence of postmodernism has so far resulted in many narrative reports of patients’ experiences, the conclusions of which are philosophically fragmented for several reasons. One reason is that nurses typically pick one aspect of either a secular or nurse philosopher to guide their study without a philosophical application in the end. I may be too critical here because nurses are not philosophers. (Neither am I , but I’m learning…) I assert that if the end result is isolated stories, of what benefit is that to nursing as a whole if there is no working, coherent philosophy as its foundation? What’s the bigger picture we’re after? I’m not sure as a profession we have an answer to that.

Prognosis: The theory-practice gap will widen to a chasm that will take decades to bridge.

What can we do? I believe nursing should commit funding to philosophical development to further the profession’s historical ideals of holistic care. Without a sound philosophical foundation there can be no substantial development of a global nursing initiative. Perhaps nursing needs to partner with professional philosophers to clarify the issues.

Postmodernism has opened a door for me to write nursing philosophy from a trinitarian viewpoint, thanks to the recognition of the value of diverse viewpoints and the recognition that truth is not always quantifiable (in fact, most truth is not quantifiable, even in physics).

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