It is fundamental assumption in nursing theory that it is important for nurses to understand how patients experience states of ill health. This assumption is often related to aims of empathic understanding, but normative principles of social interpretation can have an important action‐guiding role whenever nurses seek to understand patients’ subjective horizons on the basis of active or passive expressions of meaning. The aim of this article is to present a philosophical theory of concept possession and to argue that it (...) can shed light on how nurses should seek to understand patients’ subjective perspectives on the meaning of illness. The two basic ideas in the theory are that patients’ beliefs and thoughts about their experiences involve concepts and that concepts can be communicated on the basis of shared implicit conceptions of what they mean. These conditions of understanding have a striking application: nurse‐patient communication is limited by many contextual factors, but it is often possible for nurses to detect shared implicit conceptions of the meaning of concepts of disease and illness. Furthermore, by acting as sympathetic linguistic experts and creating an atmosphere for dialogue, nurses can make patients feel comfortable about deferring to medical explanations of meaning that can constitute a communicative platform. The last part of the article uses a number of cases studies to show how these implications can be implemented as conceptual tools for securing meaningful communication about illness experiences in patient dialogue. (shrink)

In this article, a poetical and performative narrative is shared to examine how the use of stories to critically self‐reflect on oppression facilitates an understanding of critical social theory in nursing education and impacts social justice. A fusion of prose with a poetical narrative is employed; the latter is reserved to capture the immediacy of personal, emotive, and embodied storied experiences. This deeply intimate and dialogical story begins with a pedagogical experiment created to facilitate nursing students' understanding of critical social (...) theory. Drawing upon Paulo Freire's work, the nursing teacher in a professional development course attempted to deconstruct power relations and cultivate an open and safe learning environment by sharing a poem that depicts her oppression. Students then anonymously wrote a word/statement about their oppression. The teacher created a composite poem from students' words and shared it with the class; it was a powerful moment that highlighted their shared humanity. As a way to further explore stories and consider how to preserve these words, a small group of students and the teacher formed the ‘the oppression group’. Towards the end, we conclude an unfinished story by realizing that the chains of oppression are loosening and humanity is surfacing. There is still a camouflaging of an authentic self. There are still stories to be told. The group is not yet certain if a social representation of an authentic self is possible and if all stories can be told. It has become apparent that the personal can play out in social justice as enacted in the classroom between teacher and students and provides an entry point into the development of the capacity to be social agents in nursing. The group simultaneously concludes the story with both an ending and a threshold of social justice. (shrink)

Technology is fundamental to and embedded in the way practice is conceptualized and institutionalized in social service work. Many scholars assume and expect that good practices of care are achieved with the correct application of theory produced by rigorous scientific research. However, there are significant critiques of this viewpoint. We examine the work of Donald Schön and Martin Heidegger and agree with these authors' suggestions that technical rationality and modern technology are not the way to achieve good practice in the (...) human services. At the same time, we are not convinced that the alternatives offered by Schön and Heidegger provide what good practice requires. We draw on Aristotle's account of the intellectual virtues and make the case for phronesis and praxis as other possibilities for inspiring new kinds of social welfare practice in the twenty-first century. (shrink)

One element of the American Society for Bioethics and Humanities’ recently-piloted quality attestation portfolio for clinical ethics consultants is a “philosophy of clinical ethics consultation statement” describing the candidate’s approach to clinical ethics consultation. To date, these statements have been under-explored in the literature, in contrast to philosophy statements in other fields such as academic teaching. In this article, I argue there is merit in expanding the content of these statements beyond clinical ethics consultation alone to describe the author’s approach (...) to other important “domains” of healthcare ethics practice. I also claim such statements have at least three additional uses outside quality attestation: as a reflective practice learning tool to increase role clarity among practicing healthcare ethicists and bioethics fellows; assisting practicing healthcare ethicists in clarifying role expectations with those they work with; and helping inform developing professional practice standards. (shrink)