TEXT A　Modern Views on Nursing

The Definitions of Nursing

Nursing has been defined differently in the literature depending on the historical era.The most influential definitions about nursing were introduced by the following nursing scholars and nursing organizations.

Florence Nightingale，the founder of modern nursing，is probably the first one to formally define nursing.In the well-known publication Notes on Nursing:What It Is and What It Is Not，Nightingale wrote，“Nature alone cures … and what nursing has to do is to put the patient in the best condition for nature to act upon him.Nursing ought to signify the proper use of fresh air，light，warmth，cleanliness，quiet，and the proper selection of administration of diet—all at the expense of vital power of the patient.Nursing creates the environment most conducive to body's reparative processes”.

The best known definition of nursing is probably the one developed by Virginia Henderson who wrote，“the unique function of the nurse is to assist the individual，sick or well，in the performance of those activities contributing to health or its recovery （or to peaceful death）that he would perform unaided if he had the necessary strength，will or knowledge”.This definition was adopted by the International Council of Nurses （ICN）in 1960 and is still the most widely and internationally used definition of nursing.

Another well-known definition of nursing was developed by the American Nurses Association （ANA），which stated that “nursing is the protection，promotion，and optimization of health and abilities； prevention of illness and injury； alleviation of suffering through the diagnosis and treatment of human responses； and advocacy in health care for individuals，families，communities，and populations”.

In 2002，ICN offers a definition of nursing similar to that of ANA.According to the ICN，“nursing encompasses autonomous and collaborative care of individuals of all ages，families，groups and communities，sick or well and in all settings.Nursing includes the promotion of health，prevention of illness，and the care of ill，disabled and dying people.Advocacy，promotion of a safe environment，research，participation in shaping health policy and in patient and health systems management，and education are also key nursing roles”.

The Nature of Nursing

Nursing has been recognized as both an art and a science.Nursing has also been considered a young profession，a practice discipline.

Nursing as an Art.When we talk about the art of nursing，we emphasize the intuitive，creative，and imaginative aspect of nursing.As Donahue wrote，“Nursing is not merely a technique but a process that incorporates the elements of soul，mind，and imagination.Its very essence lies in the creative imagination，the sensitive spirit，and the intelligent understanding that provide the very foundation for effective nursing care”.

Art is also the reflection of feelings and perceptions.Because the core and essence of nursing is caring and personal interaction，the art of nursing finds expression in many ways:for example，in a nurse's sensitivity and perception of a client's thoughts and feelings and the nurse's expression of thoughts and feelings to the client.

Traditional nursing as art was predominate in the first half of the 20th century when nursing was largely the care of the ill in the hospital.Nursing was primarily the art of caring，based on intuition and skill training rather than on science.As nursing has continued to evolve as a profession，the scientific aspect of nursing has been gradually recognized without devaluing the art of nursing.

Nursing as a Science.Science is concerned with causality （cause and effect）.Parse defines science as the “theoretical explanation of the subject of inquiry and the methodological process of sustaining knowledge in a discipline”.Science is both a process and product.As a process，science is characterized by systematic inquiry that relies heavily on empirical observations of the natural world.As a product，it has been defined as empirical knowledge that is grounded and tested in experience.Science can be classified as pure or basic science，natural science，human or social science，and applied or practical science.

In general，nursing science refers to the system of relationships of human responses in health and illness addressing biologic，behavioral，social，and cultural domains.Florence Nightingale identified nursing as a scientific discipline separated from medicine，emphasizing the idea of creating freestanding nursing schools where nurses （rather than doctors）assumed responsibility for nursing education.The integration of science and art in nursing，consequently，has been facilitated.

The shift of nursing education from hospitals to universities has advanced the science of nursing.University-based nursing education provides nurses the educational foundation necessary to make scientific applications in nursing practice.Graduate nursing education prepares nurses with advanced research and critical thinking skills，and a working knowledge of theories from other scientific disciplines，which contribute to further advancements in nursing science.

Nursing as a Profession.In the past，there has been considerable discussion about whether nursing is a profession or an occupation.It is necessary to differentiate these two terms here.An occupation is a job or a career，whereas a profession is a learned vocation or occupation that has a status of superiority within a division of work.All professions are occupations，but not all occupations are professions.

To answer whether nursing is a profession，we need to know the characteristics of a profession.In general，all professions have the following features:

1）A body of knowledge on which skills and services are based

2）Ability to deliver a unique service to society

3）Education that is standardized and based in colleges and universities

4）Control of standards for practice through professional registration and licensing

5）Responsibility and accountability of members for their own actions

6）Career commitment by members

7）Autonomy

Traditionally，nursing was viewed as an occupation rather than a profession.Nursing has had difficulty being deemed a profession because the services provided by nurses have been perceived as an extension of those offered by wives and mothers.Additionally，historically nursing has been seen as subservient to medicine，and nurses have delayed identifying their unique body of knowledge.Furthermore，autonomy in practice is in question because nursing is still dependent on medicine to direct some of its practice.

However，many of the characteristics of a profession can be observed in modern nursing.Nurses provide services to meet health care needs for clients at different points in the health-illness continuum.There is a growing knowledge base，authority over education，a code of ethics，and registration requirements for practice.Hence，many nurses believe that nursing is an aspiring，evolving profession.

New Words

signify ［ˈsɪɡnɪfaɪ］ vt.　表示；意味；预示

optimization ［ˌɒptɪmaɪˈzeɪʃən］ n.　最佳化，最优化

alleviation ［əˌliːviˈeɪʃn］ n.　减轻，缓解；镇痛剂

advocacy ［ˈædvəkəsɪ］ n.　主张；拥护；辩护

encompass ［ɪnˈkʌmpəs］ vt.　包含；包围，环绕

collaborative ［kəˈlæbəretɪv］ adj.　合作的，协作的

perception ［pəˈsepʃn］ n.　知觉；看法；洞察力

intuition ［ˌɪntjuˈɪʃn］ n.　直觉

empirical ［ɪmˈpɪrɪkl］ adj.　经验主义的，完全根据经验的

accountability ［əˌkaʊntəˈbɪləti］ n.　有义务；有责任

autonomy ［ɔːˈtɒnəmi］ n.　自治，自治权

subservient ［səbˈsɜːvɪənt］ adj.　屈从的

authority ［ɔːˈθɒrəti］ n.　权威；权力；当局

ethics ［ˈeθɪks］ n.　伦理学；伦理观；道德标准