Where nursing meets its deepest questions

“In a hospital room, there is rarely time to pause. A patient dies; another needs to be discharged. Machines beep. Decisions stack up. Nursing moves forward. And nurses are left with questions that don’t fit neatly into charts or clinical protocols: Was that a good death? What did that patient need that we couldn’t give? What does it mean to care well? At UC Irvine, those questions are not pushed aside. Sometimes they’re the point. The Center for Nursing Philosophy in the Sue & Bill Gross School of Nursing is carving out space for something increasingly rare in modern healthcare: reflection – not as an abstract exercise but as a necessary part of understanding what constitutes nursing and what it could become. The philosophical study of nursing is not new. For decades, an international community of scholars has explored the ethical, epistemological and human foundations of care. Organizations like the International Philosophy of Nursing Society have advanced this work globally, and leading scholars across institutions have shaped the field. What’s different at UC Irvine is the creation of an academic center – a sustained, visible home for this kind of inquiry. Founded in 2019 by Miriam Bender, professor of nursing, the Center for Nursing Philosophy brings together nurses, scholars and students to examine the questions that sit beneath everyday practice – not about the mechanics of care but about what makes for “good” care. Miriam Bender, professor of nursing and founding director of the Center for Nursing Philosophy, is facilitating a global community to explore the deeper questions at the heart of care. Debra Curran / UC Irvine “Philosophy helps us interrogate the assumptions behind practice,” says Bender, who directs the center. “To move nursing forward in meaningful and lasting ways, we have to examine how we define it – and how those definitions shape what we do and determine what nursing is meant to accomplish.” Bender’s path to this work began with a simple frustration. Before she became a second-career nurse, she would ask nurses a straightforward question: What is nursing? She never got a straightforward answer. “I would always get told a story,” Bender says. “Never a definition.” At first, that felt insufficient. But over time, it became revealing. Nursing, she realized, cannot be reduced to a formula. It is situational, relational, unfolding in real time. It requires an attentiveness to what hasn’t happened yet – to the possibility of easing pain and restoring dignity … or simply being present. “How can ‘not pain’ happen in a context of pain?” she asks. “That’s not something you can think through empirically very well.” To make sense of that complexity, Bender turned to philosophy, from feminist theory to ethics to process philosophy. She discovered she wasn’t alone. Nurses across the world were grappling with the same questions, often without enough training or vocabulary to fully articulate them. The center grew out of that shared need: to define nursing once and for all and create a community where its meanings could be examined, debated and expanded. Nursing has always carried a philosophical dimension, says Mark Lazenby, dean of the Sue & Bill Gross School of Nursing and a professor of nursing and philosophy. From its professional origins in the 19 th century with Florence Nightingale, whose Notes on Nursing reads as much like philosophy as instruction, the field has been intertwined with questions about life, suffering and meaning. “As long as there have been people, there has been a nurse,” Lazenby says. “Someone to care for the sick, someone to keep the healthy well, and someone to provide peaceful passage to the dying.” That proximity to life’s most vulnerable moments makes philosophical reflection unavoidable. “The world acts on a nurse,” Lazenby says. “You don’t get to choose whether to face those questions. You walk into the room, and they’re there.” And yet, in today’s healthcare system, those questions are often crowded out. As care becomes more fast-paced and technology-driven, the time and space to reflect – once found in conversations among colleagues, in break rooms or at the bedside – have diminished. “We don’t have time to pause and ask, ‘What just happened? And was it right?’” Lazenby says. The Center for Nursing Philosophy is, in part, an effort to restore that pause. It doesn’t teach nurses how to care; it helps them make sense of what they already experience. “Nurses see,” Bender says. “They see what’s happening in their practice every day. What they often lack is the vocabulary and the support to say what they’re seeing in a rigorous way.” Through virtual workshops, global conferences, fellowships and a growing curriculum, the center equips nurses to think conceptually and to write about their insights in ways that can shape the field. Its writing workshop, now offered both as a Ph.D. course and through continuing education, responds to a widespread gap in nursing education: the lack of training in conceptual and philosophical writing. The goal is not to replace empirical research or clinical expertise but to complement it – to step back and ask what lies beneath the data. Questions explored through the center’s programming range widely: How do nurses navigate ethical conflicts in high-pressure environments? What responsibilities do they hold within legal, social and institutional systems? How does nursing practice intersect with issues like racism, disability or homelessness? What does “good care” actually mean and do? These are not abstract concerns. They shape decisions made every day at the bedside. What began as a small initiative has grown into an international hub. The center hosts global conferences, including the International Philosophy of Nursing Society meeting, drawing scholars from around the world. Its virtual format, accelerated by the COVID-19 pandemic, has made participation possible across borders. It’s also continuing and expanding its fellowship program, offering structured training and mentorship to nurses seeking to develop their philosophical work. At its core, the center functions as a gathering place for individuals who might otherwise be isolated in their questions. For Lazenby, the work of the center points to something fundamental about nursing itself. “Nursing is a profession, but it’s also an identity,” he says. “When you say, ‘I am a nurse,’ you’re making a claim about who you are as a moral person.” That identity is shaped not just by skills or knowledge but by reflection – by the willingness to ask difficult questions about care, responsibility and meaning. The Center for Nursing Philosophy doesn’t provide easy answers. Instead, it insists that the questions matter. And in a healthcare system increasingly defined by speed, efficiency and data, that insistence may be one of its most important contributions. Because behind every chart, every diagnosis and every outcome is something harder to measure and impossible to ignore: why and how we care.

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