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Derek Sellman
of satisfaction only if the win is achieved in a way that
is consistent with the spirit of the game because only
then are the internal goods available.To win by cheat-
ing brings only external goods. Some of MacIntyre’s
themes are already hinted at in this notion of a prac-
tice - to win in a way that maintains the value of the
internal goods requires certain virtues (MacIntyre
argues that there are three core virtues: those of
truthfulness, justice, and courage [1984, p. 192]); that
while the acceptance of the core virtues may enable
the continuation of a practice this may be at the price
of a failure to obtain external rewards; and to accept
that others have developed strategies that have
brought the game to its present level of sophistication
is to recognize a tradition exists and that the tradition
has much to teach the novice.
It is my contention that nursing could usefully be
considered as a practice in the MacIntyrean sense.
A case will be made to support this contention and
thereafter an outline of nursing as a particular type
of practice will be developed.
Nursing as a practice
The accounts of nursing (at least in the UK), from
Florence Nightingale up to somewhere around the
middle of the 20th century, display concerns regard-
ing the moral character of the nurse (Sellman, 1997).
These accounts finally become mere prescription and
lack the academic rigour required in modern scholar-
ship. Subsequent accounts begin to offer a more
scientific and academic exploration of nursing and
concerns with such items as procedures, technical
skills, organizational approaches, methods of research
together with models and theories of nursing appear
to be valued over and above considerations of what
sort of person the nurse should be. A rider needs to be
added here: it is clear that despite the lack of attention
in the nursing literature given to what sort of person
the nurse should be there is anecdotal evidence to
suggest that nurses will point to those practitioners
and students w,ho do not seem to have the right
attitude. Clearly for practising nurses concerns over
moral character have never gone away.
Nonetheless the accounts of nursing that predomi-
nate in the latter half of the 20th century tend to
marginalize considerations of the moral character of
those who properly call themselves nurses. The notion
of nursing as a practice in the MacIntyrean sense may
be a route by which some of these concerns can be
addressed.
The question now becomes: Ts nursing similar to
chess?’ Do the features that MacIntyre identifies as
constitutive of a practice appear in the activity of
nursing? Sellman (1994) and Wainwright (1997)
believe that that there is a strong case to suggest that
it is appropriate to consider nursing as a practice in
the MacIntyrean sense.
Many of those who enter nursing do so for gener-
ally altruistic reasons. The idea of wishing to help
others is often expressed by candidates seeking entry
to preregistration nursing courses. Students of
nursing do not chase external rewards of large
salaries or high status because for most nurses these
things do not exist relative to other ways of earning
a living. It is reasonable to suggest that the activity
of nursing is perceived as having internal rewards
related directly to the satisfaction of helping others.
It is also reasonable to suggest that other internal
goods become important for those who can be iden-
tified as good nurses and that these internal rewards
become apparent as the student of nursing moves
from mere performance of tasks to a position of
immersion in the wider role of nursing; the equivalent
in MacIntyre’s terms of progressing from an aimless
movement of chess pieces to appreciating the long-
term strategy of a succession of co-ordinated and
planned moves. The latter stages of both represent a
certain perspicacity and an engagement with a prac-
tice. Given these brief considerations it would seem
that nursing can be defined as a practice in the
MacIntyrean sense. MacIntyre does make some
suggestions as to what types of activities should be
considered as practices. He states:
... the range of practices is wide: arts, sciences, games, poli-
tics in the Aristotelian sense, the making and sustaining of
family life, all fall under the concept. (1984, p. 188)
While it is reasonable to accept the range of prac-
tices that MacIntyre identifies there are distinctions
that can be usefully made. The particular distinction
that I want to make is between games on the one
© Blackwell Science Ltd 2000 Nursing Philosophy, I, pp. 26-33
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