{"title":"Staying With the Trouble in Nursing 12.5 Hours at a Time.","authors":"Jamie Brian Smith","doi":"10.1111/nup.70060","DOIUrl":null,"url":null,"abstract":"<p><p>This paper proposes a reconceptualisation of clinical care as a site from which philosophy is produced, rather than a domain to which it is applied. Centreing on a speculative vignette drawn from emergency nursing, I introduce the concept of the event of nursing to name those moments where relational, material, and institutional forces exceed protocol and call for situated, embodied ethical judgement. Through this lens, nursing practice is not the application of philosophical ethics, but an already-theorising practice; one that enacts, improvises, and sustains a posthuman ethics in real time. Drawing on Spinoza, Barad, Haraway, Braidotti, and Deleuze and Guattari, I argue that nursing's entangled thinking-feeling-doing constitutes a form of knowledge irreducible to either abstraction or procedure. I frame response-ability as the immanent composition of powers (conatus), read diffractively, tracing how care is produced through the navigation of competing temporalities, machinic infrastructures, and affective pressures. With the risks of epistemic violence of algorithmic governance and linear reasoning, I offer three speculative propositions: 'assemblage notes,' 'situated adequacy metrics,' and 'posthuman night rounds.' These gestures aim not to reform systems but to make legible the improvisational labour that sustains care amid constraint. The event of nursing, I suggest, offers philosophy a model of ethics grounded in affective intelligence, situated multiplicity, and infrastructural friction, a way of staying with the trouble, 12 h at a time.</p>","PeriodicalId":49724,"journal":{"name":"Nursing Philosophy","volume":"27 1","pages":"e70060"},"PeriodicalIF":2.0000,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12711605/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nursing Philosophy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/nup.70060","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
This paper proposes a reconceptualisation of clinical care as a site from which philosophy is produced, rather than a domain to which it is applied. Centreing on a speculative vignette drawn from emergency nursing, I introduce the concept of the event of nursing to name those moments where relational, material, and institutional forces exceed protocol and call for situated, embodied ethical judgement. Through this lens, nursing practice is not the application of philosophical ethics, but an already-theorising practice; one that enacts, improvises, and sustains a posthuman ethics in real time. Drawing on Spinoza, Barad, Haraway, Braidotti, and Deleuze and Guattari, I argue that nursing's entangled thinking-feeling-doing constitutes a form of knowledge irreducible to either abstraction or procedure. I frame response-ability as the immanent composition of powers (conatus), read diffractively, tracing how care is produced through the navigation of competing temporalities, machinic infrastructures, and affective pressures. With the risks of epistemic violence of algorithmic governance and linear reasoning, I offer three speculative propositions: 'assemblage notes,' 'situated adequacy metrics,' and 'posthuman night rounds.' These gestures aim not to reform systems but to make legible the improvisational labour that sustains care amid constraint. The event of nursing, I suggest, offers philosophy a model of ethics grounded in affective intelligence, situated multiplicity, and infrastructural friction, a way of staying with the trouble, 12 h at a time.
期刊介绍：
Nursing Philosophy provides a forum for discussion of philosophical issues in nursing. These focus on questions relating to the nature of nursing and to the phenomena of key relevance to it. For example, any understanding of what nursing is presupposes some conception of just what nurses are trying to do when they nurse. But what are the ends of nursing? Are they to promote health, prevent disease, promote well-being, enhance autonomy, relieve suffering, or some combination of these? How are these ends are to be met? What kind of knowledge is needed in order to nurse? Practical, theoretical, aesthetic, moral, political, ''intuitive'' or some other?
Papers that explore other aspects of philosophical enquiry and analysis of relevance to nursing (and any other healthcare or social care activity) are also welcome and might include, but not be limited to, critical discussions of the work of nurse theorists who have advanced philosophical claims (e.g., Benner, Benner and Wrubel, Carper, Schrok, Watson, Parse and so on) as well as critical engagement with philosophers (e.g., Heidegger, Husserl, Kuhn, Polanyi, Taylor, MacIntyre and so on) whose work informs health care in general and nursing in particular.
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