Alasdair Maclntyre and the Professional Practice of Nursing
29
hand and on the other hand an as yet undefined
category.
If it is appropriate to accept that nursing is a practice
in the MacIntyrean sense then it is a practice that
remains clearly distinguishable from chess in a number
of significant ways. The most important perhaps is
related to the part that the practice plays in the life of
a given individual. For the chess player chess is likely
to be an important aspect of their lives and also may be
part of the array of practices that MacIntyre identifies
as contributing to the good life, yet for most chess
players chess remains a practice with which the indi-
vidual will engage by inclination rather than necessity,
and further it is a requirement of this type of practice
that sufficient leisure time is available. While this will
not be the case for the professional chess player whose
playing of chess may be their livelihood, the fact
remains that the majority of players engage with the
practice of chess in their spare time.
Nursing is substantively different not least because
the kind of practice that nursing represents is not one
with which a nurse can engage merely as the inclina-
tion dictates, indeed nursing is the kind of practice
that demands a degree of commitment not necessary
for the game of chess. Leaving aside competition
matches and the chess player whose livelihood is
chess, the general chess player can start a game of
chess at a moment of his or her choosing, can play a
game of chess without the actual presence of an oppo-
nent, can interrupt a game for varying periods, can
contemplate a move with leisure, and can abandon a
particular game at a whim.
This contrasts with the activity that is nursing
where the individual engaged with the practice of
nursing is committed to the care of a given individual
or group of individuals. To start a particular task in
nursing is to commit to its completion, or at least to
its completion as far as is possible in a given set of cir-
cumstances. It requires a continuing engagement to a
point at which it is safe to interrupt.To abandon a task
at a whim would be to court censure at best and to
inflict harm at worst.
In this respect nursing is in the same species of
practice as those which in MacIntyre’s list includes
farming and ‘... the making and sustaining of family
life ...’ (1984, p. 188). It is this species that I have
provisionally termed a professional practice and I
use professional here in the absence of a term that is
sufficiently descriptive for my purposes.
While it is necessary to have a commitment to chess
if it is to be undertaken as a practice, the nature of
that commitment is different to the commitment
required of a professional practice. The commitment
to the practice of chess lies in a commitment to the
nature of what it means to be a practice; that is, if I
am to engage with chess as a practice then I am bound
to accept a commitment to the rules and traditions of
chess in the knowledge that I can only achieve the
goods internal to chess by remaining committed to
those traditions and rules. At the risk of repetition, to
win by cheating is to relinquish those internal goods.
This commitment does not of itself preclude innova-
tion; as MacIntyre points out, a practice in good
order can and does develop within the traditions of
that practice as a response to internal tensions, and as
a result of the pursuit of excellence by individuals
engaged in the practice.
To engage with nursing as a practice requires the
same type of commitment, namely a commitment to
the rules and traditions of nursing, but in the case
of nursing such a commitment represents a minimum
requirement. The additional commitment is explained
in part by the promise implicit in the expectations
held both by patients∕clients and by healthcare
professionals that the best interests of any given
individual in receipt of care are paramount; and in
part by the fact that nursing as a practice requires a
physical, emotional, and intellectual presence. A pres-
ence that encompasses a commitment to the tradi-
tions of nursing, a commitment to the well-being
of the individual or group of individuals in receipt
of care, and a commitment to the development of
the practice of nursing. It is within these different
commitments that the virtues can be identified as
having specific purposes in helping to maintain the
practice.
A professional practice, then, may be characterized
as having two elements: the first being that it consti-
tutes a practice in the MacIntyrean sense and the
second that engagement with the practice requires a
commitment that transcends the commitment to a
practice as such.
© Blackwell Science Ltd 2000 Nursing Philosophy, I, pp. 26-33
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