Philosophical Foundations of Nursing

Nursing isn’t just a set of tasks—it’s a way of thinking, a way of being. The philosophical foundations of nursing provide the deep roots that support everything we do in healthcare. These foundations explore the “why” behind the “what”—shaping how nurses view human beings, health, illness, care, and even life itself. Understanding these philosophical bases helps students and professionals alike ground their practice in purpose, clarity, and compassion. Whether you’re preparing for exams, exploring nursing theory, or reflecting on your own values, this topic equips you with the mental tools to connect deeper with your role as a nurse.

Philosophy in nursing isn’t abstract fluff—it’s the inner compass that guides clinical reasoning, ethical decisions, and empathetic actions. From human dignity to holistic care, from the nature of truth to the meaning of healing, this journey invites you to think deeply, feel fully, and care wisely.

Ontological Assumptions

What It Means

Ontology is the study of being—it asks, “What is the nature of existence?” In nursing, ontological assumptions are the beliefs we hold about what it means to be human, to be a nurse, and to experience health or illness. These foundational ideas shape how nurses see patients—not just as medical cases, but as unique people with feelings, stories, and identities.

Relatable Example

Consider two approaches: One nurse views a patient as “just a pneumonia case,” while another recognizes the same person as “Ms. Reyes, a grandmother who’s anxious about missing her grandson’s birthday.” The second nurse’s view is shaped by ontological assumptions that value the patient’s whole being, not just their illness.

Why It Matters

• Influences care: Guides nurses to treat patients as whole persons, not just symptoms.
• Supports empathy: Helps nurses understand patient experiences beyond the physical body.
• Shapes relationships: Builds trust by honoring the individuality of each person.

Memory Trick

O.N.T.O. = “Observe Not The Obvious”—reminding nurses to look beyond the surface and consider the deeper nature of each patient.

Simple Worksheet

1. Ontology in nursing focuses on:
A. How care is organized
B. The nature of being and existence
C. Moral rules
D. Methods for gathering data

2. Which statement reflects an ontological assumption?
A. Nurses should always document accurately
B. Patients are unique beings with their own lived experiences
C. Medication errors are common
D. Health is measured only by lab results

Epistemological Assumptions

What It Means

Epistemology is the branch of philosophy that explores how we know what we know. In nursing, epistemological assumptions are the beliefs about the nature, sources, and limits of knowledge in practice. This includes understanding where nursing knowledge comes from (like research, experience, intuition, or tradition), and how nurses decide what information is trustworthy for making care decisions.

Relatable Example

Imagine you’re learning a new wound care technique. One nurse insists, “We do it this way because research studies show better healing.” Another says, “I’ve always done it this way and my patients do fine.” The first nurse is using scientific evidence (formal knowledge), while the second relies on personal experience (informal knowledge). Both are drawing from different epistemological assumptions.

Why It Matters

• Guides practice: Helps nurses choose what information to trust—whether it’s from textbooks, clinical guidelines, or personal experience.
• Supports critical thinking: Encourages questioning, not just following routines blindly.
• Shapes lifelong learning: Inspires nurses to keep asking, “How do I know this is best?”

Memory Trick

EPISTEMOLOGY = “EPIStemic: Evidence, Practice, Intuition, Science”—reminding you that nursing knowledge comes from many sources.

Simple Worksheet

1. Epistemology in nursing is mainly concerned with:
A. The meaning of health
B. The nature and sources of knowledge
C. The value of caring
D. The process of documentation

2. Which is an example of epistemological thinking?
A. Deciding to use a new technique after reading research
B. Labeling medication bottles correctly
C. Setting up IV fluids
D. Taking a lunch break

Axiological Assumptions

What It Means

Axiology is the branch of philosophy that deals with values and ethics—it asks, “What is good? What is valuable? What matters most?” In nursing, axiological assumptions are the beliefs about what is right, important, and worthy in care. These assumptions shape the ethical standards, priorities, and attitudes that guide nurses’ choices every day, such as respecting patient dignity, promoting justice, or valuing compassion.

Relatable Example

Imagine a nurse faced with a patient who refuses life-saving treatment due to cultural beliefs. The nurse must weigh the value of patient autonomy against the value of preserving life. Their response reflects their underlying axiological assumptions about what is most important in that situation.

Why It Matters

• Shapes ethical behavior: Guides nurses in making tough decisions, especially when values or beliefs clash.
• Clarifies priorities: Helps set what matters most—like patient safety, confidentiality, or respect.
• Promotes caring culture: Encourages a practice environment where kindness and justice are valued.

Memory Trick

A.X.I.O. = “Act Xtra In Others’ interest”—reminding nurses that axiology is about values and acting for the good of others.

Simple Worksheet

1. Axiology in nursing is mainly concerned with:
A. The nature of knowledge
B. The physical health of patients
C. Values and ethics in care
D. Methods for research

2. Which statement shows an axiological assumption?
A. Patients must fast before surgery
B. Compassion is essential in nursing
C. IV fluids must be clear
D. Dosages are calculated per weight

Ethical Principles in Nursing

What It Means

Ethical principles are the core values and moral rules that guide nurses in making decisions and providing care. These principles help nurses handle complex situations where the “right” action may not always be clear. By applying these principles, nurses protect patient rights, support safe care, and maintain public trust in the profession.

Key Principles Explained

Autonomy:
Respecting each patient’s right to make their own choices, even if the nurse disagrees.
Example: Supporting a patient’s decision to refuse treatment.

Beneficence:
Doing good and promoting the well-being of patients.
Example: Providing pain relief and comfort.

Nonmaleficence:
Doing no harm—avoiding actions that could hurt patients.
Example: Double-checking medications to prevent errors.

Justice:
Treating all patients fairly and equally, no matter their background or circumstances.
Example: Providing the same quality care to every patient.

Fidelity:
Being loyal, truthful, and keeping promises to patients.
Example: Maintaining patient confidentiality.

Veracity:
Being honest and transparent with patients about their condition and care.
Example: Explaining all risks and benefits before a procedure.

Relatable Example

Imagine you’re caring for a patient who wants to leave the hospital against medical advice. You respect their autonomy (right to choose), but you also want to practice beneficence (help them heal) and nonmaleficence (avoid harm). Balancing these principles guides your ethical response.

Why It Matters

• Supports patient rights: Ensures patients are treated with dignity and respect.
• Guides difficult decisions: Offers a clear moral compass in challenging situations.
• Builds trust: Patients feel safer when nurses act ethically and transparently.

Memory Trick

“A Big Nurse Just Feels Virtuous”
(A = Autonomy, B = Beneficence, N = Nonmaleficence, J = Justice, F = Fidelity, V = Veracity)

Simple Worksheet

1. Which principle involves telling the truth to patients?
A. Beneficence
B. Justice
C. Veracity
D. Fidelity

2. Treating all patients equally is an example of:
A. Autonomy
B. Nonmaleficence
C. Justice
D. Beneficence

Professional Nursing Values

What It Means

Professional nursing values are the core beliefs and standards that guide how nurses think, act, and interact with patients and colleagues. These values form the foundation of nursing practice and reflect what the profession stands for—shaping everything from bedside care to advocacy and leadership. When nurses uphold these values, they help create a positive, ethical, and trustworthy healthcare environment.

Key Values Explained

Caring:
Showing compassion and concern for patients’ well-being.
Example: Sitting with a patient who feels anxious or lonely.

Integrity:
Being honest, accountable, and doing the right thing even when no one is watching.
Example: Admitting to a medication error promptly.

Respect:
Valuing each person’s dignity, beliefs, and choices, regardless of background.
Example: Listening without judgment to a patient’s cultural or religious needs.

Advocacy:
Actively supporting patients’ rights and speaking up for their best interests.
Example: Ensuring a patient’s wishes are honored during treatment planning.

Excellence:
Striving for the highest quality in care, learning, and improvement.
Example: Pursuing continuing education to keep skills up to date.

Altruism:
Putting patients’ needs above personal gain or convenience.
Example: Volunteering time to educate patients or support health initiatives.

Relatable Example

Imagine a nurse who finds a patient’s religious practice unfamiliar but takes the time to learn about it and makes accommodations in their care. This demonstrates respect, caring, and advocacy—key nursing values in action.

Why It Matters

• Builds trust: Patients and families feel safe and respected.
• Promotes ethical care: Decisions are guided by strong values, not just rules.
• Strengthens teamwork: Values create a positive and professional work culture.

Memory Trick

“CRIARE” (pronounced: kree-ARE)
(Caring, Respect, Integrity, Advocacy, Responsibility, Excellence)
Tip: Imagine a nurse “creating” trust and quality care!

Simple Worksheet

1. Which value is shown by being honest about a mistake?
A. Caring
B. Integrity
C. Altruism
D. Advocacy

2. Speaking up for a patient’s needs demonstrates:
A. Advocacy
B. Excellence
C. Respect
D. Responsibility

Comprehensive & Interactive Worksheet

1. Ontological assumptions in nursing focus mainly on:
A. The meaning of knowledge
B. The nature of being and existence
C. The process of ethical decision-making
D. The best research methods

2. A nurse deciding on care by relying on scientific research is using which type of assumption?
A. Ontological
B. Epistemological
C. Axiological
D. Practical

3. Believing that patient dignity must always be respected reflects which philosophical area?
A. Ontological
B. Epistemological
C. Axiological
D. Technical

4. The ethical principle that means “do no harm” is called:
A. Autonomy
B. Beneficence
C. Nonmaleficence
D. Justice

5. Which of the following is NOT a core professional nursing value?
A. Advocacy
B. Integrity
C. Compassion
D. Profit

6. A nurse values patient choice above all else. This demonstrates which ethical principle?
A. Autonomy
B. Fidelity
C. Justice
D. Beneficence

7. When a nurse treats all patients equally regardless of background, which principle is being practiced?
A. Veracity
B. Justice
C. Altruism
D. Excellence

8. Which is an example of epistemological thinking in nursing?
A. Deciding to use a new wound care method because a trusted nurse said so
B. Choosing a practice based on clinical guidelines and studies
C. Refusing to care for certain patients
D. Believing only personal experience matters

Memory Trick Recap

• Ontological:
  O.N.T.O. – “Observe Not The Obvious” (Look deeper into what it means to be a person)
• Epistemological:
  EPIStemic: Evidence, Practice, Intuition, Science (Nursing knowledge comes from many sources)
• Axiological:
  A.X.I.O. – “Act Xtra In Others’ interest” (Axiology = values and ethics)
• Ethical Principles:
  “A Big Nurse Just Feels Virtuous”
  (Autonomy, Beneficence, Nonmaleficence, Justice, Fidelity, Veracity)
• Professional Values:
  “CRIARE”
  (Caring, Respect, Integrity, Advocacy, Responsibility, Excellence)

FAQ Section

Q: What is the difference between ontology, epistemology, and axiology in nursing?
A: Ontology is about what exists or what it means to be (e.g., what is a person?). Epistemology is about how we know things (sources and limits of nursing knowledge). Axiology is about values and ethics (what is good or important in nursing care).

Q: Why are ethical principles important in nursing?
A: They guide nurses in making difficult choices, protect patient rights, and ensure consistent, safe, and fair care.

Q: How do nursing values impact patient care?
A: Nursing values influence every interaction—encouraging respect, honesty, compassion, and advocacy, which improve patient trust and satisfaction.

Q: Can personal beliefs conflict with professional nursing values?
A: Yes, but nurses are expected to uphold professional values and ethical standards even if they differ from personal opinions.

Q: Where does nursing knowledge come from?
A: Nursing knowledge comes from scientific research, experience, patient preferences, tradition, and intuition.

References

• Berman, A., Snyder, S., & Frandsen, G. (2020). Kozier & Erb’s Fundamentals of Nursing (11th ed.). Pearson.
• Potter, P. A., & Perry, A. G. (2022). Fundamentals of Nursing (10th ed.). Mosby/Elsevier.
• American Nurses Association (ANA). (2015). Code of Ethics for Nurses with Interpretive Statements.
• Chitty, K. K., & Black, B. P. (2019). Professional Nursing: Concepts & Challenges (8th ed.). Saunders.
• McEwen, M., & Wills, E. M. (2022). Theoretical Basis for Nursing (6th ed.). Elsevier.
• Butts, J. B., & Rich, K. L. (2018). Philosophies and Theories for Advanced Nursing Practice (3rd ed.). Jones & Bartlett Learning.