Page 138 - Nursing: The Philosophy and Science of Caring

Fr om carative Fa c t o r 6 t o C ar it as ProC e s s 6
Processes seek information, knowledge, understanding, and wisdom
(Watson 2005).
The ultimate goals of nursing care, Caring Science, and research
are to deliver quality, humane care. The method for delivering quality,
humane scientific and artistic caring-healing requires the formal use
of a creative problem-solving process and the systematic use of cog-
nitive, rational logic, along with all ways of knowing. Caring Science
honors diverse sources of knowledge, multiple methodologies, and
expanded views of a relational ontology. It includes caring ethics as
well as empirical evidence: the art and science of caring, healing, and
health. The development and practices of nursing and Caring Science
are sophisticated and complex. Nursing is constantly maturing, advanc-
ing, and developing in its scholarly orientation toward caring practices
and research.

reConsidering evidenCe-Based PraCtiCe
Earlier in nursing’s history, there was strict adherence to a linear view
of the nursing process; today, there is a great focus on “evidence-based
practice.” Evidence remains an ambiguous term and phenomenon,
in that “medical evidence differs from reflection from a phenomeno-
logical concept of evidence gleaned from personal story” (Martinsen
2006:11). Kari Martinsen (2006), in her latest theoretical work from
Norway, draws on Logstrup’s view of evidence as “the evident”: the
insights and existential questions emerging from within the narrative
expression of one’s life philosophy, that which can be trusted.
Evidence-based medicine (EBM), which has influenced evidence-
based nursing (EBN), is derived from clinically controlled studies and
statistical concepts as the empirical-technical basis for a system of
knowledge. The origin is in epidemiological and general statistical
population-based research. As Martinsen (2006:123) put it: “How does
this kind of evidence relate to judgment [wisdom], which is so impor-
tant in all research and practical work?”
In other words, we are invited to reflect upon and analyze, as well
as critique, issues. It is important to ask questions, such as how and
where do a philosophy of caring and healing and a philosophical ori-
entation toward what Martinsen (2006:123) calls “life possibilities in

110