Nursing Concepts: Health, Ontologies, and Ethics Essay

This essay provides a comprehensive overview of key nursing concepts, beginning with a definition of health and its evolution. It explores various ontological traditions, including critical theory, complexity theory, and positivism, analyzing their influence on nursing practice. The essay delves into ethical issues frequently encountered by nurses, such as patient autonomy, beneficence, justice, and non-maleficence. It examines controversies and intersections between different ontological perspectives, ultimately arguing for the relevance of complexity theory in nursing. The essay highlights the importance of understanding how various factors impact health and the need for nurses to navigate ambiguity effectively. The analysis concludes with a systematic inquiry that enhances the quality of patient care and underscores the evolution of the health concept into a multidimensional format.

Running head: NURSING CONCEPTS
Nursing Assignment
Name of the Student
Name of the University
Author Note

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Introduction
Nursing concept is usually defined as a rigorous and creative structuring of a range of
ideas that are found to project in a purposeful, tentative, and systematic observation of
phenomena. Although there was lack of formal nursing related knowledge in the early years,
with a development of nursing education, the requirement of categorising knowledge helped
in the development of different nursing theories that allowed the nurses to critically evaluate
complex situations that are encountered while caring for patients. Health has been identified
as a basic concept in nursing theory that is continually evolving over time (Cook & Peden,
2017). Traditional paradigms that are related to health, have disorders or illness as the
primary focus and have gradually emerged into multifaceted multidimensional models that
centre on a holistic and positive approach towards the phenomenon, commonly referred to as
health. This essay will elaborate on the health concept, in relation to different ontological
lenses, besides identifying ethical issues related to it.
Health: the nursing concept
Traditionally, the concept of health has had different meanings, depending on the
person, circumstances and time, during its definition. The word health was found to first
appear around 1000 AD, and denoted the condition or state being whole or sound. The
concept of mind-body dichotomy considered the body to function in the form of a system,
based on chemical and mechanical laws that could be distinguished from the mind. The onset
of the conception of disease or illness during the time of Hippocrates made people embark on
a journey that focused on unravelling the different causes of disorders (Lee et al., 2017). This
was followed by the conception of the germ theory of disease by Pasteur and Koch in 1800s.
However, in the words of Larsen (2017) it was argued in 1941 by Sigerist that health did not
just mean the absence of any illness, but represented presence of a positive attitude and
acceptance of life. This was followed by the formulation of different paradigms such as, the

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ecological model and psychosocial model that placed a due focus on the interaction of the
body, society, and mind, for attaining good health. In other words, the concept of health is
fundamental to nursing and comprises of both physiological and mental wellbeing of a
person, the service user.
3 ontological traditions
The critical theory was established by several professors from the Institute of Social
Research during the 1920s and was supported well by the Marxist philosophical base. Marx
defined it in the form of a self-clarification that needs to be gained through the present time
of the desires and struggles. Considering nursing as a major discipline of dialectic nature,
upon imparting the theory, it should immediately be put to practice for accomplishing better
learning, via feedbacks (Gathercoal, Gathercoal, Seegobin & Hadley, 2017). Thus, the critical
theory provides for novel and broader exploration questions and holds the potential to
encompass the information base of nursing discipline. In the words of Mill, Allen and
Morrow (2016) the critical theory holds the potential of advancing the understanding of a
nursing professional of the collective organization of commonplace practice situations and
the ways by which they can be reorganized.
Nursing professionals who are found to adhere to the critical theory have often
elaborated on the necessity to advance the building of knowledge with an unshackling and
liberating determination, which allows the delivery of responses in a manner that helps in
approaching reality through a dialectic and global vision. The complexity theory refers to a
manner of understanding the communities and organisation that have been considered as a
method, existing within the healthcare management, in place of a nursing tool (Mitchell,
Jonas-Simpson & Cross, 2012). The term complexity theory is most commonly used
interchangeably with different terms, most particularly complex adaptive systems. It has been
defined by Plsek in the form of a gathering of discrete agents who are allowed to act in means

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that are not completely foreseeable and whose activities are consistent. According to
Thompson, Fazio, Kustra, Patrick and Stanley (2016 each group of persons who work
together in a clinical team, have discrete pattern of behaviours that arise over time and
progress within the practice environment. Thus, the complexity ontology facilitates
development of a sound understanding of the role that organisations and communities have,
in relation to healthcare management.
Thus, the nursing professionals must engage in the work and behaviour complexity
leadership, in addition to the awareness that change and interconnectedness are normal
functioning conditions (Beuthin, 2015). Nursing has also been found to be influenced by the
ontology of positivism, the primary feature of which relies on the scientific explanation of
contrasting the outcomes with several favourable events. Gortner and Schultz (1988) stated
that positivism goes back to the year 1907, during the formation of the Vienna Circle. The
nursing conception related to positivism dates back to Nightingale during the end of 19th
century when due focus was placed on the principles of space, cleanness, air, and light.
Positivism has also been found to exert a direct influence on the clinical capacity that is
reflected in most nursing practice where the approach of ontology is used by professionals via
inductive reasoning.
Ethical issues
Nursing professionals encounter ethical dilemmas on a regular basis, while
maintaining and enhancing the health and wellbeing of their service users. Ethical issues
encompass the practice of providing care that is correct, good and rational. The patients
should also be provided with the opportunity of expressing their freedom of choice, in
relation to the procurement of services and the way by which they want to be cared for. Some
of the common ethical issues that might arise in professional nursing practice, while taking
into consideration of the concept of health are the respect for autonomy of patients,

4NURSING CONCEPT
beneficence, justice, and non-maleficence (Grace & DRN, 2017). According to Cherry and
Jacob (2016) perspective of the essence of nursing ontologies often drive the ethical
behaviour that is demonstrated by nurses towards the clients. Under situations where a nurse
perceives the service user as a means to a culmination, the patient becomes objectified and
ends to have significance as an individual. On the other hand, considering the patient as an
end-in-themselves, the nurses are subjected to a dramatic change in scenario. By observing
others as ends foreshadows that the nurses grip the exclusive and subjective kind of each
client.
Controversies and intersections
The definitions of complexity theory are often indefinable in nursing practice and
there is an absence of consensus statement on how complicated and multifaceted an entity
must be, in relation to the theory. Chandler, Rycroft‐Malone, Hawkes and Noyes (2016)
opined that complexity theory is able to deliver a standpoint to reviewing complex systems in
a method that does not lessen the system to discrete constituents. From a perspective of the
complexity theory, the communications between constituents of a system are significant for
reading a system. Furthermore, it is the exchanges of system elements that result in the
general performance. Hence, the complexity theory is able to acknowledge that elements
existing within the nursing system interact with one another, to produce certain behaviour, in
relation to the concept of health. In other words, complexity theory is able to offers a set of
conceptual tools for explaining the assortment in contemporary modernity experiencing
globalisation. This is in stark contrast to the ontology of critical theory that emphasises on the
critique and reflective assessment of the society, which is facilitated by application of
knowledge from humanities and social sciences (Dallaire & Krol, 2018).
Thus, in contrast to the other ontologies that are oriented towards explaining and
understanding the society, this theory is directed towards changing and critiquing the entire

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society (Alligood, 2017). Conversely, positivism is often not used as an ontological approach
by nurses since it presents arbitrary practice and confines the nurses to one science. Upon the
implementation of positivism, advanced practice nurses reach a position where they can
assess their practice via a particular method, thus eradicating the certainty that the domain of
nursing also comprises of art (Williams, Rycroft‐Malone & Burton, 2017). Additionally,
“logical positivism” has been found to exert serious impacts for theology and ethics.
Best ontological tradition
The ontological tradition that focuses on complexity theory can be considered best for
nursing practice. This can be accredited to the fact that ambiguity is inherent in the practice.
As the healthcare becomes progressively multifaceted, nurses must endure to efficaciously
deal with larger expanses of clinical ambiguity (Kitson et al., 2018). Though uncertainty is
often debated in nursing, negligible concept modification occurs to capture the circumstantial
complexities. Perception of nurses on an equivocal clinical occasion, in amalgamation with
tolerance level for complexity, can influence the nurse response. Furthermore, there are a
range of external and internal context that are associated with the skill of capturing social
variations, besides rapid reaction.
Conclusion
A comprehensive systematic inquiry in nursing practice allows nursing professionals
to develop their knowledge and awareness on enhancing the quality of care that is delivered
to patients. Recent trends show an evolution of the health concept into a multidimensional
format. The concept of disease has been the dominant focus in the inspection of the spectacle
of health. Application of the critical theory to nursing helped in the establishment of a
dialectic vision of health. Conversely, positivism is primarily characterized by the
explanations or particular involvements processes that facilitate arrival at a generalised result.
Complexity theory has become progressively prevalent in healthcare research over few

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decades. Thus, the complexity theory is able to offer an exhaustive approach to nursing
practice that elaborates on the concept of health.

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