Nursing Philosophy最新文献

{"title":"Nursing's Long History of Mutual Aid.","authors":"Sam Porter","doi":"10.1111/nup.70127","DOIUrl":"https://doi.org/10.1111/nup.70127","url":null,"abstract":"<p><p>The doctrine of mutual aid and its application to nursing has recently enjoyed considerable attention in the pages of Nursing Philosophy. However, this is not the first time that nursing theorists have identified its salience to nursing. In 1907, Adelaide Nutting and Lavinia Dock specified mutual aid as the evolutionary impulse upon which the activity of nursing is founded. Nutting and Dock adopted mutual aid from Peter Kropotkin's application of Russian evolutionary theory to anarchism. Russian natural scientists argued that Darwin had overemphasised struggle and under-emphasised cooperation in his theory of natural selection. Just as Kropotkin sought to uncover the mundane relations of mutual support that were the bedrock of species' success, Nutting and Dock aimed to bring to light the unsung history of nursing's crucial contribution to humanity through its enactment of mutual aid in healthcare. They took a gendered approach, which assumed that the ability to engage in mutual aid was a function of the capacity to care which, in turn, was more developed in women. They also took a reformist approach in contrast to their anarchist contemporaries, who advocated revolution. After addressing contemporary dilemmas about the purpose and possibility of mutual aid, the articulation of Nutting and Dock's feminism with difference and neo-Darwinian feminisms are noted. In examining the relationship of their approach with contemporary ecological theory, Nutting and Dock's evolutionary grounding for mutual aid is compared favourably with contemporary anarchism's exclusively political approach, though both are excessively human-centred. It is concluded that the most important message we can take from Nutting and Dock is that survival depends on mutual aid and that nurses have the potential to be key actors in its instantiation.</p>","PeriodicalId":49724,"journal":{"name":"Nursing Philosophy","volume":"27 4","pages":"e70127"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Moral Economy of Nursing Time: Low-Value Nursing Work, Moral Opportunity Cost and Good Nursing.","authors":"Heran Zhang, Ying Shen","doi":"10.1111/nup.70134","DOIUrl":"https://doi.org/10.1111/nup.70134","url":null,"abstract":"<p><p>Nurses work within finite time, competing demands and increasingly auditable systems. This philosophical paper asks what care is lost when organisations and nurses commit scarce time and attention to comparatively lower-value work, and when that loss becomes morally significant. It introduces nursing capacity, the moral economy of nursing time and moral opportunity cost to examine that question. Moral opportunity cost is conditional: it applies only where scarcity is genuine, competing claims differ in moral significance and the work performed plausibly displaces the alternative. We argue that visibility asymmetry-in which auditable work is more easily protected than relational or anticipatory care-can make this loss hard to see. The framework positions de-implementation as ethical reallocation rather than mere reduction: capacity released by removing a practice should be protected for higher-value care or rest and recovery, with safeguards against burden shifting. The paper offers a vocabulary for examining allocation systems, rather than individual nurses alone, as subjects of nursing ethics.</p>","PeriodicalId":49724,"journal":{"name":"Nursing Philosophy","volume":"27 4","pages":"e70134"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking Organisational Justice in Healthcare Through Nurses' Voices: Insights From Nancy Fraser's Theory of Justice.","authors":"Camelia López-Deflory, Margalida Miró-Bonet, Amélie Perron","doi":"10.1111/nup.70123","DOIUrl":"10.1111/nup.70123","url":null,"abstract":"<p><p>Organisational justice has emerged as a key area of interest given the challenges of protecting the health and well-being of nurses in healthcare organisations. Existing research shows significant conceptual and methodological limitations that must be addressed to achieve a more comprehensive and ethically grounded understanding of nurses' needs in the healthcare system. This article explores how nurses experience their working conditions within public healthcare organisations through a theoretical lens of social justice to unveil the systemic injustices embedded within them. Adopting a critical discourse analysis approach, this study draws on 31 semi-structured interviews with nurses working within the public healthcare sector in the Balearic Islands (Spain), informed by Nancy Fraser's feminist theory of justice. The findings illustrate that nurses conceptualised organisational justice as the condition that allows them to practice their profession in accordance with their professional ethos. This novel understanding of organisational justice underscores the economic, social, cultural and political manifestations of gendered injustices nurses face in their daily practice and that prevent them from being considered as peers in the social life of healthcare organisations. This study highlights the imperative to rethink organisational justice through a lens that accounts for the gendered nature of care and nursing work. Nancy Fraser's theory of justice emerges as a groundbreaking framework that offers novel insights to guide this transformative endeavour.</p>","PeriodicalId":49724,"journal":{"name":"Nursing Philosophy","volume":"27 4","pages":"e70123"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caring for the Person's Mirror: The Entrustment of the Data-Person as a Nursing Theory for the Algorithmic Age.","authors":"Katherinne Sáez-Pulgar","doi":"10.1111/nup.70130","DOIUrl":"https://doi.org/10.1111/nup.70130","url":null,"abstract":"<p><p>Health data are born of a person's lived reality and carry that reality with them. They inhabit the systems that receive them, they feed the algorithms that learn from them, and they outlive the encounter in which they were produced. Nursing has begun to theorise its own side of this scene, from technological competency to frameworks for responsible artificial intelligence; the side of the person whose data have departed remains theoretically unattended. This essay proposes the Theory of the Entrustment of the Data-Person. Its founding act is the entrustment. Handing over one's need for care at a stage of vulnerability hands over body, history and data together, and the obligation of care travels with the data wherever they go. From within the relational ethics of care, the essay develops the theory by answering the ontological question (what a data-person is, namely value, origin and biographical bond, belonging to the person and partly constituting her), the metaphysical question (what remains after death, the echoes and the mirror composed of them, a consent that becomes a last will, and a guardian who answers when the source is silent), the epistemic question (what a professional can honestly promise, namely a stepped custody, an organisational duty to disclose, and a duty of awareness in generalisation), the ethical question (why the obligation is enforceable rather than charitable, and why a duty succeeds where new rights would fail, since a right requires a claimant and a duty only an obligated party) and the methodological question (why a theory born at the bedside is legitimate nursing philosophy). The implications propose a three-layer architecture of consent: one may refuse the mirror, not the census. The discipline that manages care, whose object is the person, already occupies the custodian's post in fact. What remained was to name it.</p>","PeriodicalId":49724,"journal":{"name":"Nursing Philosophy","volume":"27 4","pages":"e70130"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Nietzsche's Sickroom: Kafka, the Will to Power, and a Tragic Ontology of Nursing.","authors":"Gharbi Lassad","doi":"10.1111/nup.70132","DOIUrl":"10.1111/nup.70132","url":null,"abstract":"<p><p>Nursing philosophy has drawn on Friedrich Nietzsche before, but almost always to theorise the nurse's professional identity or the profession's political position: his Übermensch as a figure of self-overcoming against managerial instrumentalisation, his genealogy of morals as a lens that unmasks caring itself as a resentful inversion of medicine's authority, his transvaluation of values as a resource against neoliberal capture. Each reading stops at the threshold of the ward's politics. This paper turns instead to the ontological relation between the nurse and a body that cannot be cured, bringing two resources together for the first time in this literature: Franz Kafka's dramatisation of illness as bureaucratic and bodily absurdity, and Nietzsche's philosophy of affirmation and self-overcoming, traced back to its origin in the Dionysian dissolution of individuation first set out in The Birth of Tragedy. Both writers, moreover, tested their thought against their own bodies. Kafka died of laryngeal tuberculosis, unable to speak, communicating in written notes, kept alive at the end by a companion and a medical-student friend who administered his morphine. Nietzsche spent his last decade in a collapse that his philosophy of the sovereign, value-creating individual has no vocabulary to describe-a collapse whose delusional letters, read alongside his early aesthetics, look less like an interruption of his thought than an involuntary literalisation of it-nursed first by his mother and then by a sister who rewrote his intellectual legacy while he could no longer answer for himself. Reading these two deaths together, the paper argues that nursing ontology should rest neither on the presumption that suffering can always be made to mean something, nor on a philosophy of self-sufficient power that cannot survive contact with real dependency, but on a tragic-relational stance that affirms life inside, rather than despite, the vulnerability it cannot resolve.</p>","PeriodicalId":49724,"journal":{"name":"Nursing Philosophy","volume":"27 4","pages":"e70132"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing Werk¹: Camp and Performance in Nursing.","authors":"Jess Dillard-Wright","doi":"10.1111/nup.70129","DOIUrl":"10.1111/nup.70129","url":null,"abstract":"<p><p>The nursing imaginary is populated with a plurality of feminine and feminized archetypes. These images reinforce a particular order of things for nurses and nursing, marching out well-worn stereotypes link gender and sexuality. Less attention has been paid to the productive, affirmative, and playful dimensions of these archetypes and the possibilities they offer. Using feminist theory, queer theory, and lessons from camp, I ask why sometimes it might be useful to be a Madonna or a whore or a battleax. Recognising some potential for misunderstanding, I want to be clear that I am neither dismissing these myths as innocuous or unproblematic nor am I endorsing any particular version as the way, the truth, the life for nurses. Rather than a fixed identity or intractable cage, I want to stay with the trouble to think through what happens when we conceptualise these tropes as personas or characters nurses may don and doff at will like personal protective equipment, stylized to suit the cast with whom they perform, inclusive of patients and colleagues alike. I do this not as a technique to undermine the professionalism of nurses or nursing but rather to recognise this kind of performance as an important piece of emotional triage, acknowledging the skilful affective decision-making that goes into choosing how to occupy a particular role in a particular moment to elicit particular outcomes, conjuring the realities and feelings and ethics. Attending to nursing in this way, I think, can offer some points of entry for thinking about nursing and its work differently: playful, practiced, performative, powerful.</p>","PeriodicalId":49724,"journal":{"name":"Nursing Philosophy","volume":"27 4","pages":"e70129"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Camp Aesthetics as an Ethics of Transnormative Care: Challenging the Seriousness of Nursing From the Perspective of Latin American Travesti-Trans Theory.","authors":"Yeymi Acevedo Ninco, Marcos Venicios de Oliveira Lopes, Viviane Martins da Silva, Reinaldo Gutiérrez Barreiro, Dave Bergeron, Marli T Gimeniz Galvao","doi":"10.1111/nup.70128","DOIUrl":"10.1111/nup.70128","url":null,"abstract":"<p><p>This article argues that the 'politics of seriousness' in nursing operates as a cis-normative control mechanism that imposes sterile professional distances. To address the care of transvestite-trans people, it proposes-drawing on the epistemologies of the Global South and through Latin American Transvestite-Trans Theory (LATTT)-the adoption of an aesthetic of care based on Camp: a form of care that exalts the 'Trava', celebrates Affect and the Art of transvestite-trans self-determination, and replaces the hierarchical clinical protocol with 'Nostredad'. To this end, a critical analysis was conducted using a theoretical framework that integrates Walker and Avant's model with Wayar's Latin American Transvestite-Trans Theory. This contributed to the development of new theoretical concepts applicable to the practice of nursing care for transgender people. We conclude that transnormative care is truly ethical and must therefore be 'unserious': it must be exaggeratedly affective, complicit, and deeply relational to dismantle systemic violence.</p>","PeriodicalId":49724,"journal":{"name":"Nursing Philosophy","volume":"27 4","pages":"e70128"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Complexity Becomes Ordinary: Expertise and the Recognition Paradox in Nursing Practice.","authors":"Chantal Cavatorta, Maria Antonietta Fusco","doi":"10.1111/nup.70126","DOIUrl":"10.1111/nup.70126","url":null,"abstract":"<p><p>This paper develops the recognition paradox in nursing practice: expertise can increase the capacity to manage clinically complex situations while rendering the relational work through which they are managed less available for reflective recognition. Nursing complexity is commonly identified through visible proxies-workload, acuity, care intensity, number or difficulty of interventions. Clancy (2024) has shown how attempts to represent complex practice frequently reduce it to discrete components. Building on that critique, the paper identifies a distinct site of selectivity: complexity may become only partially recognizable to the nurses who enact it, a form of selectivity analytically distinct from that introduced by organizational representation. Drawing on accounts of expertise, tacit knowing and invisible work, it distinguishes experienced complexity (the difficulty, uncertainty or effort perceived by the practitioner) from enacted complexity (the heterogeneity and interdependence of clinically relevant relations on which appropriate performance depends, as established through converging evidence). These can diverge because experience reorganizes attention, allowing multiple cues and contextual relations to be integrated without separate focal inspection. The paper treats possession, exercise, recognition and articulation as analytically distinct sites of possible epistemic loss rather than as stages of a linear process, and shows how selectivity at each site shapes what becomes organizationally visible. The central claim is modest but consequential: representational systems can preserve only those dimensions of complexity that become professionally available for description.</p>","PeriodicalId":49724,"journal":{"name":"Nursing Philosophy","volume":"27 4","pages":"e70126"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critically Exploring Vulnerability in Frail Older Adults Following a Fall.","authors":"Maria Kitsiou","doi":"10.1111/nup.70124","DOIUrl":"10.1111/nup.70124","url":null,"abstract":"<p><p>Vulnerability is widely invoked in healthcare, bioethics, and nursing, yet it remains poorly defined because universal human susceptibility, situational exposure to harm, and clinical frailty are frequently treated as interchangeable. This conceptual ambiguity is particularly significant following a fall, when older adults may be understood predominantly through physical risk, functional decline, and the need for protection. Through an interpretative analysis drawing on nursing philosophy, feminist bioethics, phenomenological accounts of embodiment, and nursing ethics, this paper critically examines the distinction between frailty and vulnerability in older adults following a fall. It argues that frailty describes a multidimensional clinical condition involving reduced physiological reserve, whereas vulnerability also emerges through lived experience, relationships, material resources, and institutional practices. A fall may therefore intensify vulnerability not only through bodily disruption but also through changes in dependence, decision-making authority, and participation in everyday life. Nursing care occupies an ethically ambivalent position within this process: protective interventions may reduce avoidable harm while simultaneously restricting agency or generating pathogenic vulnerability. To address this tension, the paper develops the concept of responsive protection as an ethical orientation for post-fall nursing care. Responsive protection requires protective practices to be negotiated with older adults, proportionate to the risks and burdens involved, and revisable as circumstances and capacities change. The paper concludes that safety, relational autonomy, and dignity should be understood as interdependent dimensions of an ethical nursing response to post-fall vulnerability.</p>","PeriodicalId":49724,"journal":{"name":"Nursing Philosophy","volume":"27 4","pages":"e70124"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Producing Mobility, Withholding Authority: Epistemic Drain and Nursing Sovereignty in Nepal.","authors":"Animesh Ghimire","doi":"10.1111/nup.70093","DOIUrl":"10.1111/nup.70093","url":null,"abstract":"<p><p>Global discussions of nursing in low- and middle-income countries (LMICs) are dominated by the language of shortage, staffing, retention, and migration. Although useful, this technocratic vocabulary obscures a deeper philosophical crisis: nurses may be numerically produced yet institutionally denied authority over knowledge, care, and professional futures. Using Nepal as a theory-generating case, this conceptual article employs critical interpretive synthesis and philosophical analysis of nursing, policy, migration, and interdisciplinary scholarship to argue that the central problem is not workforce scarcity alone but a crisis of 'nursing sovereignty'. The paper introduces three concepts. First, epistemic drain extends the idea of brain drain by naming the erosion of mentorship, pedagogical continuity, professional memory, policy voice, research capacity, and the public credibility of nursing knowledge. Second, professionalised for exit captures a paradox of production in which nursing education expands global mobility more readily than local authority, making migration a morally justified reaction to constrained socioeconomic prospects, rather than a lack of professional dedication. Third, nursing sovereignty names the collective capacity of nurses to shape the ends, authority, knowledge, and institutional conditions of their profession. Drawing together social epistemology, feminist ethics, decolonial lens, political economy, sociology of professions, spatial theory, and digital pedagogy, the article argues that Nepal illuminates a wider LMIC condition in which nurses are essential yet disposable, mobile yet institutionally voiceless, and professionalised yet epistemically diminished. It concludes with a six-domain normative framework for institutional redesign: epistemic authority, educational integrity, governance voice, material justice, spatial and digital parity, and mobility justice. Reframing nursing in this way shifts debate from retention to justice, from labour supply to institutional re-design, and from workforce management to the political philosophy underpinning nursing practice.</p>","PeriodicalId":49724,"journal":{"name":"Nursing Philosophy","volume":"27 3","pages":"e70093"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13271533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}