Philosophical Perspectives on Trustworthiness and Open-mindedness as Professional Virtues for the Practice of Nursing: Implications for he Moral Education of Nurses

evidence. The need for judgement in weighing up the evidence for the suitability of
product z for a patient with wound type x remains precisely because of the individual
and contextual factors in the light of which a nurse views that particular patient.

The best dressing for wound type x may well be product type z but if this requires to be
redressed every 8 hours then its use will only be suitable for patients for whom the
dressing can be done three times each day. A patient in hospital might well meet this
criterion but product type z is unlikely to be a good choice for a patient returning home
and for whom a daily visit from a community nurse is the best that can be anticipated,
or for a homeless person whose contact with a nurse is likely to be no more frequent
than once a week. Other factors, such as the nutritional status of the patient and patient
acceptability of the product, need to be considered by the nurse and while protocols may
exist to provide some guidance the final choice of dressing relies on the judgement of
the nurse. The nurse who only ever uses scientific evidence (because she or he holds
nursing to be a science) and always chooses product type z whenever she or he comes
across a patient with wound type x regardless of all other considerations would surely
earn our censure for failing to exercise professional judgement. This is to say, she or he
would have displayed a lack of professional phronesis for it is necessary that
judgements be made in light of a range of available evidence only some of which will
be scientific. So while the use of evidence to guide practice is important it would be an
impoverished view of nursing to suggest that the evidence on which practice is based be
restricted to scientific evidence alone. Further, while it may be true that nursing makes
use of science this is not sufficient to classify nursing as a science.

Nursing as a practice

Thus far I have demonstrated that, despite its seeming prominence, the idea of nursing
as a science is contentious at best. I have suggested that there is some benefit in
understanding nursing as a practice in the technical sense that MacIntyre uses that term
and I will now expand upon this idea. In order to locate this claim within the context of
this thesis it may be helpful to summarise the key components of the argument thus far.
I have argued that the recipients of nursing services are more-than-ordinarily vulnerable
and because of this, the human flourishing of more-than-ordinarily vulnerable persons
is a legitimate aim of nursing. I have also argued that the existing seemingly dominant
view of nursing as a science offers only impoverished account of the nature of nursing.

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