ABSTRACTIn 2016, Bowen and Prentice published a dialogue on Benner's model ‘From Novice to Expert’. Their main concern was to explore the development of expertise in nursing and the evolution of this expertise when domains of practice change. In this contribution, this dialogue by Bowen and Prentice (2016) is the starting point to consider Advanced Practice Nurses (APN). The argument will propose that Benner's model can help perceive APN skill (and knowledge) acquisition. For this purpose, Benner's original works, the philosophical bases on knowing that and knowing how, as well as the concept of APN, which was developed by Ann Hamric (2014; Tracy et al. 2023), are consulted. Eventually, it will be demonstrated that Benner's model can be employed in conjunction with APN and can provide valuable insight into skill and knowledge acquisition and career development. Therefore, APN can reinvigorate Benner's model and render it again very valid for today. This contribution will conclude with suggestions for supporting APNs' skill and knowledge development and indications for the evolvement of Benner's model.

ABSTRACTBetween 1997 and 2009 Derek Sellman published a series of articles that explore the question: what makes a good nurse. To answer this question, Sellman engaged at length with the virtue ethics of Alisdair MacIntyre. Sellman contends that modern nursing is a professional practice, in the sense of practice described by MacIntyre. Based on nursing's ends and moral tradition, therefore, certain professional virtues can be collectively discerned and then nurtured in developing nurses. Contemporary bioethics approaches, including consequentialism, which tend to dominate ethics in nursing, are largely dismissive of virtue ethics. Sellman offers a corrective, proposing MacIntyrean virtue ethics as a solution to the loss of attention to a nurse's character in current ethical theorising within nursing. He proposes the virtues of open‐mindedness and trustworthiness as required for nurses to respond to patients and their families or carers; patients, Sellman argues, who are more‐than‐ordinarily vulnerable. In revisiting Sellman's work, I consider its importance, reflect on the profession's engagement with it, and examine a few of the challenges it presents. Throughout the analysis, I explore MacIntyre's approach in the context of philosophical shifts in the mid‐20th century, specifically in relation to moral philosophy and the aretaic turn, and social sciences. The value of contextualising nursing scholars' work in philosophy, and specifically moral philosophy, is presented, with a call to more explicit integration of moral theorising and cognitive science.

ABSTRACTThis essay builds upon the dialogue with Missel and Birkelund's reflections on the contributions of contemporary hermeneutics—particularly the work of Paul Ricoeur—to health research. While endorsing these authors’ central thesis, the present discussion seeks to extend the argument by advocating for hermeneutics’ relevance to clinical practice as well. Drawing on the ideas of Gadamer, Ricoeur, and Habermas, the text critiques the excessive hegemony of techno‐scientific knowledge over clinical practice and its harmful consequences for outcomes. It argues that revisiting Aristotle's distinction between theoria, techne, and praxis and fostering a genuine synergy among these spheres of rationality represents a potential hermeneutic contribution to the emancipatory reconstruction of health practices. The concept of Care is adopted as the philosophical horizon for this critical‐hermeneutic reconstruction.

ABSTRACTWhile social justice is widely upheld as a foundational value and responsibility within nursing, this concept remains poorly articulated and lacking in a clear and cohesive definition. In particular, prior conceptualizations of social justice within nursing have been critiqued as lacking a strong theoretical foundation and being insufficiently critical in orientation. Resultantly, guidance for nurses in engaging in social justice action is scant, and ultimately, the profession is challenged in truly taking up social justice as a central aim. As such, this critical interpretive synthesis aims to explore and synthesize how social justice is conceptualized within the nursing literature, and apply critical theoretical approaches to re‐conceptualize social justice to guide nursing theory, research, and practice. To comprehensively review the literature on social justice (and the related concept of equity) in nursing, CINAHL and Medline (Ovid) databases were searched using nursing, social justice, and equity keywords. Following title/abstract and full text screening of 1428 references, N = 216 were retained for analysis, utilizing critical interpretive synthesis approaches through a critical social theory lens. Through a critical thematic analysis of the nursing literature, this review identifies that concepts of social justice and equity were often conflated in the nursing literature, and that dominant conceptualizations advance notions of social justice as distributive justice and as fairness. Engaging with these dominant conceptualizations through a critical lens illustrates that a re‐conceptualization of social justice is necessary to establish conceptual clarity and more meaningfully support nurses in engaging with social justice through theory and practice. As such, this review presents the following re‐conceptualized definition of social justice: As a guiding principle for nursing, social justice is a process of recognizing and remediating inequities at individual and structural levels towards a state of equity.

ABSTRACTThis paper advances a critical, multidisciplinary argument that nursing's persistent subordination is not the result of historical accident, but of institutionalized power/knowledge asymmetries deliberately embedded within healthcare systems. Rather than offering an exhaustive literature review, this paper develops a theoretically informed synthesis of historical, spatial, feminist and policy scholarship. The analysis draws on comparative evidence from Canada, the United States, Australia and the United Kingdom, while also incorporating emerging insights from healthcare systems in Pakistan, Brazil, Sri Lanka, Turkey, Ireland, Finland, Portugal and New Zealand. The analysis traces how patriarchal norms, architectural arrangements, credentialing hierarchies and governance structures have systematically constrained nursing's authority, visibility and epistemic legitimacy, even amidst professionalization. To counter this structural injustice, the paper proposes six interlocking domains as foundations for genuine autonomy: clinical authority, governance integration, control over working conditions, spatial equity, independent advancement pathways and epistemic recognition. Each domain is situated within broader philosophical concerns about moral agency, institutional ethics and epistemic justice. Through critical synthesis across disciplines, the paper offers not only a conceptual critique but also a normative framework for reimagining healthcare design. It positions nursing as a full epistemic and strategic partner in leadership and system transformation, arguing that such recognition is both a professional necessity and a philosophical imperative for building just, resilient and inclusive health systems.

ABSTRACTChantal Mouffe and Ernesto Laclau made significant developments in discourse theory, based on the premise that all practices and objects are discursive, deriving meaning through existence in a wider context. This paper introduces the work of Laclau and Mouffe, explicating the main tenets of discourse theory through an example chosen from the nursing discourse, ‘professionalism’, and exploring how this serves as an empty signifier. The construction of a discourse is explored, from the building blocks of individual signs and moments to the totality established when each sign is fixed in relation to other signs and all other possible meanings excluded. The empty signifier represents a lack or absence, stabilising the discourse in a move towards hegemony. The question is posed as to whether, as an empty signifier, professionalism has resulted in a successful hegemonic formulation. Nursing has always struggled to be ‘fully constituted’ with an antagonistic frontier delineating ‘women's work’ of caring and nurturance from the cost‐effectiveness of evidence‐based practice. However, the lack of a coherent identity for nursing is highlighted as the empty signifier defines us merely as ‘not unprofessional’. Identification of the empty signifier ‘professionalism’ and exploration of the ensuing hegemonic formation of ‘professional’ nursing identity demonstrates that the work of Laclau and Mouffe has significant relevance to nursing. Exploration of further areas of the nursing discourse through the lens of discourse theory is encouraged.

Informed consent is ethically incomplete and should be redefined as empowered consent. This essay challenges theoretical assumptions of the value of informed consent in light of substantial evidence of its failure in clinical practice and questions the continued emphasis on autonomy as the primary ethical justification for the practice of consent in health care. Human dignity-rather than autonomy-is advanced from a nursing ethics perspective as a preferred justification for consent practices in health care. The adequacy of an ethic of obligation (namely, principlism) as the dominant theoretical lens for recognising and responding to persistent problems in consent practices is also reconsidered. A feminist empowerment framework is adopted as an alternative ethical theory to principlism and is advanced as a more practical and complete lens for examining the concept and context of consent in health care. To accomplish this, the three leading conceptions of informed consent are overviewed, followed by a feminist critique to reveal practical problems with each of them. The need for a language change from informed to empowered consent is strongly considered. Implications for consent activities in clinical practice are reviewed with focused discussion on the need for greater role clarity for all involved in consent-beyond and inclusive of the patient-physician dyad, as the practice and improvement of consent is necessarily a transdisciplinary endeavour. Specific concrete and practical recommendations for leveraging nursing expertise in this space are presented. Perhaps what is most needed in the discourse and practice of consent in health care is nursing.

Globally, healthcare has become dominated by women nurses. Gender is also known to impact the way people are cared for in various healthcare systems. Considering gender from the perspective of how lived bodies are positioned through the structural relations of institutions and processes, this systematic review aims to explore the meaning of gender in the caring relationship between the nurse and the older person through a synthesis of available empirical data published from 1993 to 2022. CINAHL, PUBMED, EMBASE and Web of Science were searched from the beginning of each database's temporal range, and PRISMA guidelines were used for the screening, reviewing and selection processes of available records. A thematic synthesis of the available data resulted in three analytical themes: (i) vulnerability of the gendered body, (ii) norms and values related to gender and sexuality and (iii) balancing closeness and distance in the nurse-patient relationship. These themes are intertwined and represent different aspects of gender meaning in the nurse-patient relationship. This research shows that gender, through its influence on the gendered body, its relationship with power dynamics in the caring process, and its intersection with dimensions of identity, has a significant meaning for the experienced vulnerability in the nurse-patient relationship. This has implications for the well-being and sense of dignity of the older person as well as the nurse.