Constructing adequate conceptualisations of spirituality and religion for clinical practice entails grounding them in the wealth of centuries of philosophical and theological thinking, ensuring that they represent the diverse society that nursing serves and anchoring them within a moral view of practice.

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The tremendous growth in nursing literature about spirituality has garnered proportionately little critique. Part of the reason may be that the broad generalizing claims typical of this literature have not been sufficiently explicated so that their particular implications for a practice discipline could be evaluated. Further, conceptualizations that attempt to encompass all possible views are difficult to challenge outside of a particular location. However, once one assumes a particular location in relation to spirituality, then the question becomes how one resolves the tension between what are essentially theological or philosophical commitments and professional commitments. In this study, we discuss the tension between these perspectives using the idea of a responsible nursing response to spiritual pluralism. We then problematize three claims about spirituality in nursing discourse based upon our location as scholars influenced by Christian theological understandings: (i) the claim that all individuals are spiritual; (ii) the claim that human spirituality can be assessed and evaluated; and (iii) the claim that spirituality is a proper domain of nursing's concern and intervention. We conclude by suggesting that the widely shared values of social justice, compassion and human dignity may well serve as a grounding for the critique of spiritual discourses in nursing across particularized positions.

Modern American nursing arose during the Civil War and subsequently adopted the Nightingale educational model in the 1870s. By 1889, the journal Trained Nurse and Hospital Review had been established. It published a six‐part series on ethics in nursing. With the establishment of the American Nurses Association in 1893, the articles of incorporation gave the organization its first charge: “to establish and maintain a code of ethics.” While the rich and enduring tradition of nursing's ethics has been concerned about individual patients and their relational nexus, nursing ethics has from the beginning been a social ethics, intimately concerned both for the shape of society and for social change. This concern has been for health, conceived broadly and not focused specifically on disease and its treatment, but including the social causes of disease. Nightingale herself was an ardent social reformer, instituting a wide range of types of army sanitation reform, sanitation reform in India, and hospital and nursing reform. Despite her gender, her wealth and privilege granted her access to men in power who furthered her policy and reform agenda. From the start, then, modern nursing was imbued with a social reformist bias.

The place of scholarly research in nursing has not been well studied. Ethical inquiry, as scholarly research, has been included in this neglect. The concept of ethics research is defended and new research approaches to ethics are outlined. Forms of ethics research identified are scholarly, empirical, and dual mode. Questions considered are: Is ethics research research? What are the forms of ethics research? What is the role of empiricism in ethics research? And what is the relationship of ethics research to the moral concerns of nursing? Ethics research explores the basic moral norms undergirding nursing research, practice, and education.

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The overcrowding of Emergency Departments (EDs) is a well-known problem that has been analyzed on multiple occasions. Queuing theory and simulation have been applied extensively to specific ED situations, such as staff planning, waiting time reduction and capacity investment. However, there are remaining problems in the EDs that need more study. One of them is the ambulance diversion, which may cause a delay in the treatment of urgent patients therefore jeopardizing their welfare. Since ED are complex system and setting the diversion state in EDs is a subjective decision, a detailed modeling and analysis of cause and effects of such a decision is beneficial. In this research, we build a case-study and analyze the impact of diversion policies in various performance measures of the ED through a designed experiment using a discrete-event simulation model.

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