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The Practice of Nursing: A Vocation with Axiological
and Humanist Sense
Author: Rubén Eliut Hernández
Ortega
Universidad
Latinoamericana y del Caribe, ULAC
Caracas, Venezuela
Abstract
The purpose of this essay is to approach nursing praxis from an
axiological and humanistic perspective, based on the philosophy of humanized
care described by Watson Jean, in a dialogical discussion with Katherine Núñez
(2017), where he understands the phenomenological and spiritual existential
care; including for this a moral and ethical human action, typical of the
nursing profession, also reaching a primordial therapeutic relationship between
humans, based on respect and intersubjectivity. And the theory of moral
development of Lawrence Kohlberg (1997), considering that psychological
maturity and moral action do not necessarily parallel the biological maturation
of the human being, so that the moral conscience follows a process of growth or
maturity throughout of people's lives. Based on this, professional praxis
should be framed with the demands and transformations of the world's health
systems, therefore, training, continuous training, reflexivity and
interreflexivity on the action of its practicality should be systematic,
continuous and deep, aware that their action and interaction in a changing
sociocultural environment is crucial to offer therapeutic help, in addition to
restoring health and protecting life.
Keywords: aptitude; humanism;
paramedical personnel.
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Date Received: 10-01-2018 |
Date Acceptance: 05-03-2018 |
La Praxis de
Enfermería: Una Vocación con Sentido Axiológico y Humanista
Resumen
El presente ensayo
tiene como propósito abordar la praxis de enfermería desde una visión
axiológica y humanista, basado en la filosofía del cuidado humanizado descrito
por Watson Jean, en tertulia dialógica con Katherine Núñez (2017), donde
comprende al cuidado desde lo existencial fenomenológico y espiritual;
incluyendo para ello una acción humana moral y ética, propia de la profesión de
enfermería, alcanzando además una relación terapéutica primordial entre
humanos, basada en el respeto y la intersubjetividad. Y la teoría del
desarrollo moral de Lawrence Kohlberg (1997), considerando que la madurez psicológica
y acción moral no necesariamente van paralela a la maduración biológica del ser
humano, por lo que la conciencia moral sigue un proceso de crecimiento o de
madurez a lo largo de la vida de las personas. En base a ello, la praxis
profesional debe ir enmarcada con las exigencias y las transformaciones de los
sistemas de salud del mundo, por tanto, la formación, la capacitación continua,
la reflexividad e interreflexividad sobre el accionar de su practicidad debe
ser sistemático, continuo y profundo, consciente de que su actuación e
interacción en un ámbito sociocultural cambiante es determinante para ofrecer
ayuda terapéutica, además de restaurar la salud y proteger la vida.
Palabras clave: aptitud; humanismo; personal paramédico.
|
Fecha de Recepción: 10-01-2018 |
Fecha de Aceptación: 05-03-2018 |
1. Introduction
Based on the precepts of education, it is essential to
assume the supports that govern it worldwide and that also include the principles
and values described in the Constitution of the Bolivarian Republic of
Venezuela (1999), and the Organic Law of Education (2009).
Based on the aforementioned, the respective
considerations are created to address the issue of nursing praxis linked to
education, since this science is based on philosophical principles present in
the curricular conception and which also include a close relationship between
the vocation, skills, human values and humanistic practicality.
Therefore, the present essay aims to address the
practice of nursing from an axiological vision with a humanistic sense,
sustained in the theory of human care by Jean Watson, cited by (Guillaumet,
García, Casacuberta and Serra, 2005, p.128), where he argues that nursing care
focuses on philosophical (existential-phenomenological) approaches from the
spiritual; In addition, he sees care as a moral and ethical action
characteristic of the nursing profession, that is to say; considers human care
as a primordial therapeutic relationship between human beings, visualizing it
as relational, transpersonal and intersubjective.
In the same sense, it is important to analyze,
understand and explain the cause-effect relationship of human behavior,
according to the aspects pointed out by Kohlberg (1997a), in the theory of
moral development; cited by (Reluz and Cajachahua, 2011a, p.103), which
emphasizes the process of growth and maturity of moral conscience, reflection
and reasoning that determines the way people act.
In accordance with the aforementioned, the moral
development of Nursing professionals is basically in the knowledge of social
type in relation to the praxis-society conjugation and that must be constantly
reinforced with axiological principles and based on the reflexivity of the action
before the interaction environment, society and praxis.
It means, then, that the nursing professional has the
tools to perform a praxis in accordance with the demands and transformations of
the health systems of the world, therefore, training, continuous training,
reflexivity and interreflexivity on the action that each one performs, it will
undoubtedly help to internalize, improve and deepen the performance and
interaction of its practicality in a changing sociocultural environment.
Based on the above considerations, as nursing
professionals perform their functions optimally, society will benefit from care
based on models of quality and excellence typical of state policies enshrined
in the legal texts of the Bolivarian Republic. of Venezuela, in terms of health
promotion and recovery, through human care based on competencies and values.
In the same sense we talk about the meaning of
professional skills from the know-how and knowing how to live together, where
it must be taken into account that they become the object of the profession and
of nursing care to the healthy or sick individual in their reciprocal
relationship with the social environment in which it operates, taking into
account human needs as a fundamental basis in this interaction between praxis,
society and the environment.
2. Development
2.1. Vocation
as the essence of nursing praxis
According to Agrazal (2016), the essence of being a
nurse (or) attracts an "inspirational force called vocation", where there
is not only an effusive desire for work and the achievement of the well-being
of other people, but also framed in the benefit granted by the praxis of
nursing in the care of human life. The author also states that the development
of the vocation of nursing is built by means of the factors, conditions and
elements that emerge from the interior of each person who chooses to be a nurse
(or), and is linked to the development of skills and competencies to promote
health, prevent diseases and provide human care to the person, family and
community.
So, when the vocation to be a nurse (or), is part of
life, is to perform the praxis with an optimal social responsibility, providing
care with human quality, where beyond the requirement of the health system,
this It leads to recognize what, why and what for the profession.
Due to this, it is important to emphasize that the
vocation focuses its purposes on that inner voice that leads the person to
perform actions that are intertwined with the ontological being of the
profession, and that are complemented with professional training and training.
In concise terms, the vocation of nursing is linked to
the practice carried out daily by these professions and that leads to an internalization
of the procedure and the fundamental action as a rationale for human care.
For this reason, the vocation of nursing becomes an
individual precept, rooted in the conception of the human being and
complemented by the highest standards of training, to assume and practice a
practice consistent with that established in the professional practice.
It is appropriate to emphasize that the nursing
professional's training includes a series of axiological, theoretical and
humanistic elements that build the nursing knowledge and allow the constant
critical reflection of the care provided, thus highlighting the vocation as an
indispensable factor in the essence of that human action.
In relation to this, a qualitative study conducted by
(Camejo, 2017, p.242), highlights that "as a main finding it was known
that most nursing students do not know the future of the career".
Undoubtedly, starting from the precepts of this
author, it is evident that the vocation in nursing is a human foundation that
begins in training and that also carries a real conception of what the
professional future will assume as a principle to base its practice on the
social context.
2.2. Nursing Praxis from the humanist conception
Based on the definition
used by Paulo Freire in the pedagogy of the oppressed (1979), praxis is a
"reflection and action of men on the world to transform it". Quoted
by (Masi, 2008, p.78).
In relation to this
concept, it is important to assume the nursing praxis from a human vision, full
of fundamental moral, ethical and axiological essence, which leads to a
continuous reflexivity on the professional performance and in this way to
achieve social transformation through care human.
So, the praxis combines the
ability to understand, reflect and act on the structural and traditional
effects that society conceives on nursing care, having as a fundamental basis
the interaction between knowledge, doing, living and being; guiding the action
and the willingness to act morally and correctly.
In relation to the term
"nursing praxis" (López and Torres, 2009a, p.37), they point out that
the nursing professional bases his action on analyzing, understanding and
interpreting the activities of the discipline, in any of the functions that
perform (assistance, teaching, administrative and research); through scientific
knowledge, techniques, skills and axiological foundations, from a humanistic
perspective; that is, praxis must have with it the disposition to apprehend by
means of reflexivity and discover the essence of the art of caring from the
human.
Therefore, it is important
that the nursing professional understands, apprehends and internalizes that
this conception is intrinsically related to their human actions towards society
as they point out (López and Torres, 2009b):
Praxis
must be apprehended as a function of philosophy and this is not part of
categories, not part of general and comprehensive concepts, but of men; analyze
what he does, ask why he does it, teach what he does (p.38).
Based on what has been described above, it can be pointed out that
nursing praxis bases its principles on axiology and humanism, for this reason
it is important to incorporate fundamental aspects that direct nursing action
in Jean Watson's theory of human care, where the existence of a risk of
dehumanization in patient care, due to the restructuring of health care systems
worldwide; for which this author emphasizes the rescue of the human, spiritual
and transpersonal aspect, applicable in all functions (nursing, administrative,
educational and research) of nursing. Quoted by (Guerrero, Meneses, De La Cruz,
2015a, p.131).
From this precept, it is conceived that the ontological meaning of
nursing is undoubtedly granted from the training, structured in the competencies
of knowledge, know-how, living together and being, the philosophical models of
human care, the deontological code and the law of exercise; However, the lack
of knowledge management, capitalism and the commercialization of health
policies have caused an automation in the way of providing human care, as well
as the dehumanization and little practicality of social values in the
exercise of the field of health. The infirmary.
It is appropriate to consider that the foundations of nursing care
create their foundations in understanding health processes and those of
illness, through human experience. Therefore, the philosophy of the science of
care is the definition of the results in the purely scientific activity,
related to the humanistic aspects of life, in addition to the interrelation of
the quality of life, including death and the postponement of life.
In this same order of ideas we could consider that human care based on
values, should be the fundamental pillar in all health systems of today's world,
therefore, it is necessary to train and train professionals to form and conform
a system of humanistic health, where they strive to provide altruistic care,
cultivating sensitivity for those who perform the care and for those who
receive them, with the purpose of generating changes in nursing practice.
As a summary, it can be said that nursing praxis epistemologically
includes a connection between the way of carrying out the practice, including
human action and axiology as an essential foundation in the act of human and
humanized care, in order to achieve an activity Reflective, scientifically
developed and independent.
2.3. Nursing praxis and axiology as a fundamental axis
According to the assumptions and values described in Jean Watson's
theory of human care, it is evident that the vocation of the nursing
professional is an internal conception that leads the subject to comply with
axiological principles, guided by the spiritual dimension of life, the capacity
for growth and change, the value and affection for the person being cared for
and human life, the freedom to make decisions adjusted to the clinic and
science, as well as the importance of an interpersonal and intersubjective
relationship based on in respect and love of neighbor.
After the above considerations, it is important to emphasize that
nursing praxis has another axis in which it bases its essential principles such
as axiology, whose links are strengthened with the adherence to norms,
principles and the moral essence itself described in the deontological code and
the law of the professional practice of nursing.
It should be added that the praxis of nursing emphasizes providing human
and humanized care, valuing above all life and the person from its integrality;
but at the same time reflecting and raising awareness of the human action that
leads to the realization of that praxis; where the professional must
incorporate elements that favor care from the technical, scientific and
humanistic; conjugating fully the skills of knowing, doing, living and being.
In the same sense, as has been pointed out, the significance of
professional skills include vocational, axiological and humanistic aspects
raised methodologically in the curriculum from know-how and knowing how to live
together, however, the importance of assuming, interpreting and applying This
practicality is undoubtedly the great challenge that nursing professionals
have, since the integration of these competencies forms the object of the
profession and of the human nursing care, in favor of the humanization of
nursing, as it is pointed out by Watson, "The moral ideal of nursing is
the protection, improvement and preservation of human dignity. Human care
involves values, will and a commitment to care, knowledge, care actions and
consequences ". Quoted by (Guerrero, Meneses, De La Cruz, 2015b, p.133).
In the same way, mention should be made of the theory of moral
development of Kohlberg (1997b), in which he considers that "psychological
and moral maturity does not necessarily go hand in hand with the biological
maturation of the human being". So "the moral conscience follows a
process of growth or maturity", cited by (Reluz and Cajachahua, 2011b,
p.103).
Based on this author, it can be emphasized that the moral conscience is
denoted as an unalterable learning process, in which new knowledge structures
are acquired, so it is not considered reasonable that once learned and put into
operation by the subject stop acting substantially. That is to say; that
according to the stages of moral development proposed by this theorist, a field
of action, assessment and knowledge that is in the mental structure of the
nursing professional can be evidenced, however, it is important to specify that
there could be considerable phenomena of imbalance in some that could influence
in a different way to act in front of the problems of labor cause.
In concrete terms, from the educational precepts is committed to the
performance of nursing professionals who substantially assume their role as
caregivers, according to the requirements of training and training, capable of
managing human care to transform society and man in its essence human,
internalize within their philosophical conception the moral performance, as a
fundamental element in the application of their daily praxis, based on the
vocation of service and the axiological and humanistic foundations.
Therefore, it is considered that nursing praxis includes an absolute
performance of the vocational sense, an integral impregnation of social values and
a high humanistic sense.
3. Conclusions
The philosophical conception of the practice of
nursing is framed in a legal support established in the laws of the Bolivarian
Republic of Venezuela, however, it is important that the nursing professional understands,
apprehends and internalizes that this conception is intrinsically related to
his actions human facing society.
In such a way that, this human action must help to
perfect, internalize and understand from the spiritual, the reason of being of
nursing, which leads to the reflexivity of the action carried out, based on the
characterization of the primordial element of the praxis; The vocation.
For this reason, nursing professionals have the
challenge and the fundamental capacity to restructure administratively health
systems, through the application of praxiological principles and under the
humanized care approach.
However, it is essential that nursing professionals
can perform their praxis under care models that encompass theory, practice,
skills, skills, constant and continuous research in each area of performance,
continuous reflection on the plans of care, methods and ways of caring,
techniques that incorporate the management of real knowledge of the values of
the profession and those of the caring subject, as well as the development of
coexistence skills that interconnect why care and what to care for; based on a
humanized care. That is to say; Nursing practice should strive to humanize care
substantially.
According to the above, it is evident that the nursing
professional has a series of tools that from their formation are combined to
perform a praxis in accordance with the demands and transformations of the
health systems of the world, therefore, training, the continuous training, the
reflexivity and interreflexivity on the action of its practicality must be
systematic, continuous and deep, aware that its action and interaction in a
changing sociocultural environment is crucial to offer therapeutic help, in
addition to restoring health and protecting life .
Finally, it is important to emphasize that the nursing
practice is linked to the vocation, the axiology and the humanistic precepts;
and that self-reflection and interreflexivity are necessary to improve daily
nursing action in our health facilities.
4.
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Rubén Eliut Hernández Ortega
e-mail: rubenho1977@gmail.com
Born in the Güiria state Sucre, Venezuela.
Licentiate in Nursing (Universidad Nacional Experimental Rómulo Gallegos)
UNERG, Magister Scientiarum in Higher Education (Universidad Latinoamericana y
del Caribe) CIU, Student of the Doctoral Program in Educational Sciences (Latin
American and Caribbean University) ULAC, Coordinator of the Nursing PNF of the
District Capital (2012-2016), Professor of Nursing PNF (Universidad Politécnica
Territorial de Los Altos Mirandinos “Cecilio Acosta”), Teaching Coordinator of
the National Nursing Department of the Ministry of Popular Power for Health
(MPPS), Post Graduate Coordinator of Nursing from the Universidad Ciencias de
la Salud. Nursing Supervisor at the Hospital Psiquiátrico
Dr. Jesús Mata de Gregorio of the Instituto Venezolano de los Seguros Sociales
(IVSS).
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- Original Version in
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DOI: https://doi.org/10.29394/Scientific.issn.2542-2987.2018.3.9.19.348-361