Philosophy of Nursing: An environmentally based approach.

A philosophy of nursing should address four things: human beings, the environment they live in, nursing itself, and the interrelation of those three factors.

The author recognizes as human beings all members of our species, from conception to natural death, including those who are unable to speak for themselves such as the unborn, the demented, the disenfranchised homeless or imprisoned, the comatose, and the powerless in any other station of life. It is with this understanding of the term "human being" that the author asserts any human being can, in a given circumstance, be an appropriate client for nursing care.

The environment can be understood in its everyday sense: the earth surrounding us, whether we live in the city, suburbs, or rural areas. The author would seek to employ a broader definition of this term; however, seeking to include in its definition not only the physical space in which we move, but also our mental and emotional surroundings. These can be understood to include the issues we think about, the people we interact with, and the emotions associated with these interactions, and our spiritual state as well.

The nursing process has been defined by the ANA as "the diagnosis and treatment of human responses to actual or potential problems." What precisely this means to a particular nurse at a particular time; however, can be quite confusing. The author would define nursing as any intervention on behalf of a client that is designed to facilitate the client's achievment of a treatment goal. In the usual course, this would be interpreted to mean influencing the client's state of health in a positive manner, but it can also be understood to include interventions that enhance the client's comfort in the face of terminal illness where the goal may be a peaceful death rather than a return to wellness.

Finally, the author recognizes the interactions of client - environment - nursing as dynamic and synergistic. The author firmly believes that until an overwhelming state of illness exists, the client possesses in his or her own body and mind the ability to heal. The nurse's role is to assist the client in placing him or herself in the best possible situation to heal. This often requires a change in the client's environment to remove blocks that are hindering the client's healing process. These can be as simple and obvious as assisting the client to stop smoking, or choose healthier foods, or they can be as complex and involved as lobbying for healthier cities and measures to prevent pollutions that harm the environment at large. The author acknowledges the work of pioneer Florence Nightingale as contributing to her understanding of the interactions of client, environment and nursing.