Practical nursing judgment: a moderate realist conception.

Under the influence of idealist mainstream thinking that reality is mind-dependent, many nurses are dismissing the possibility of attaining objectively true judgments. A worrisome trend that has emerged from such thinking is to recommend that nursing practice decisions ultimately be based solely on subjective judgments. We present a conception of practical nursing judgment based on the common-sense philosophy of moderate realism, which has the potential to help offset the trend. It allows for nursing decision making in which nursing principles and rules are modified in light of the contingent circumstances of a nursing situation, resulting in decisions which have both a subjective and an objective aspect to them. This feature, plus the fact that the nursing principles are grounded in common natural needs, rights, and obligations, provides nurses with a basis for nursing care which is individualized, just, benevolent, and sensible, a means requisite to making our lives good.

Children and adolescents of parents undergoing dialysis therapy: their reported quality of life.

OBJECTIVE: The objective of this study was to describe one aspect of the reported quality of life (QOL) (according to the Aristotelian-Thomistic philosophical theory of the good life) of a selected group of children and adolescents whose parents were being treated by dialysis therapy for renal failure. DESIGN: An exploratory descriptive design was used. SAMPLE/SETTING: Twenty-five children and adolescents ranging in age from 8 to 16 years, selected on a convenience basis, participated in the study. The setting was a major renal treatment program in Western Canada. METHODS: Semi-structured interviews were held with children and adolescents privately, in their homes, once a week for two to three weeks. The interview data were subjected to content analysis. RESULTS: Generally, the children and adolescents seemed to possess the real goods necessary for a good life. However, they appeared to need more goods of the mind: (a) an intellective good--more information about how their various family members were feeling, and (b) decreased fear in relation to their parents' condition and treatments. Also, they discussed the need for carefree family vacations, an instrumental means to sensory pleasure--a bodily good. CONCLUSION: Overall, the QOL of this group of children and adolescents seemed to be good. The parents' renal disease and dialysis therapy had an impact on the children's lives in that sometimes it interfered with and sometimes it facilitated attainment of real goods. Further study is required to examine the effects on the QOL of children and adolescents regarding dialysis modality, age/gender of the child or adolescent, and stage of treatment.

Clarifying the nature of conceptualizations about nursing.

This discipline of nursing is at a crucial point in its development. Conceptualizations about nursing are being developed and tested without benefit of a clear conception as to their nature. Consequently, the nursing literature on the topic tends to confuse rather than clarify thought. The purpose of this philosophic treatise is to show that greater clarity could be achieved by acknowledging the fact that questions addressed in conceptions about nursing are philosophic in nature. The influential thought of Jacqueline Fawcett is critiqued with reference to how acknowledging and acting in terms of this fact would also lend parsimony to thought on the matter.

Multicultural ethics in nursing education: a potential threat to responsible practice.

If nurses are to make the kind of contribution they are capable of making to the betterment of human health, then they must critically examine the moral injunctions and tenets of multicultural ethics that are being widely promulgated in nursing education. Such an examination, undertaken in this article, shows that responsible nursing practice cannot be realized under multicultural ethics. An alternate ethical basis for practice, a transcultural ethics grounded in moderate realism, is described and recommended because it provides principles that permit the realization of responsible practice.