Care as Choice, Care as Destiny
Written by Linn
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Written by Linn 〰️
To speak of nursing is to speak of paradox. At first glance, the profession presents itself as a practical decision: a secure career, the promise of employability, a role with visible social value. Yet the narratives of nurses across history and today reveal that the decision rarely feels purely rational. Nursing is frequently described as a calling, something that pulls with an inevitability difficult to resist. This tension between agency and inevitability, between a deliberate choice and an unfolding destiny, is central to the identity of nursing. It is also what makes the profession endure as more than occupation.
Florence Nightingale articulated her own path as a call from God, describing her life as incapable of being lived otherwise. Mary Seacole, excluded from official channels during the Crimean War, nonetheless traveled at her own expense to serve those neglected by formal medical structures. Their words and actions suggest that nursing has always carried with it a dimension beyond pragmatism. It is difficult to imagine either Nightingale or Seacole describing their work as simply a professional calculation. Their decisions were rational in part, but they were also compelled by forces larger than logic: faith, duty, and moral urgency. This duality continues to shape how nursing is understood today.
For the student who enters nursing now, the process often begins with choice. Courses are considered, career trajectories compared, and nursing emerges as a path that blends science with human connection. To commit to nursing is to embrace rigor in physiology, chemistry, and pharmacology, while also accepting that the essence of the role lies in proximity to human vulnerability. It is not only about learning the structure of the lung but about listening to a patient’s shallow breath. This decision marks a statement of values: that knowledge is incomplete until it is joined with care. Choice, then, is present and deliberate. Yet it cannot explain the whole story.
Many who pursue nursing describe the decision as something that felt inevitable, as though their lives had already been oriented toward this work. The word vocation captures this pull. Derived from the Latin vocare, to call, vocation acknowledges that some decisions feel less like invention and more like recognition. Jean Watson’s theory of human caring emphasizes this by describing nursing as both intentional practice and moral orientation. Nurses do not simply carry out tasks; they embody an ethic that transcends choice. The sense of being called does not negate agency, but it complicates it, suggesting that one’s biography, values, and experiences converge into a trajectory that feels destined.
For first-generation students, this convergence is even sharper. Entering higher education without family precedent requires carrying the weight of inheritance while also creating something new. Nursing provides both reassurance and innovation. It signals stability to families, a promise of security, while also allowing students to construct a tradition not yet written in their histories. In this way, care becomes collective destiny: the student’s choice is personal, but it reverberates through families and communities who see their sacrifices transformed into future service. The profession becomes a site where inheritance and innovation meet.
Destiny also manifests through responsibility. Emmanuel Levinas wrote that ethics begins with the face of the other, that responsibility arises before choice. Nursing exemplifies this principle with clarity. The nurse is often the first to notice a subtle shift in a patient’s condition, the first to respond to anxiety that words cannot capture, the first to advocate when structures fail to listen. This responsibility is not abstract; it is lived in twelve-hour shifts, in documentation that stretches into fatigue, in the residue of another’s suffering that follows home. Responsibility in nursing clarifies destiny because it reveals a life oriented not inward but outward, committed to the well-being of others.
The paradox of choice and destiny thus cannot be separated. To describe nursing only as choice is to reduce it to employment, a matter of salaries and scheduling. To describe it only as destiny is to risk exploitation, demanding endless sacrifice under the guise of vocation. The profession survives in the balance between the two. Choice acknowledges agency and deliberation. Destiny acknowledges inevitability and moral orientation. Together, they form the synthesis that defines nursing as both sustainable practice and enduring philosophy.
This synthesis has shaped not only the identity of individual nurses but the trajectory of the profession itself. Henderson defined nursing as assisting individuals in activities that contribute to health and independence. Her formulation highlights the deliberate practice of enabling autonomy. Watson expanded this into a philosophy of care that is at once technical and transcendent. Both theories recognize that nursing cannot be reduced to tasks. It is the deliberate exercise of skill combined with the acceptance of responsibility that feels larger than the self. It is both chosen and compelled.
To care is therefore to live in paradox. It is to make a decision and to recognize a destiny. It is to stand at the intersection of autonomy and surrender, science and philosophy, stability and risk. Florence Nightingale once described nursing as the act of placing the patient in the best condition for nature to act upon them. Her definition captures the essence of this paradox: it acknowledges the technical arrangement of conditions while recognizing forces beyond human control. Nursing is both what one does and what one is compelled to do.
Care as choice. Care as destiny. The two are inseparable, and it is in their entanglement that the meaning of nursing endures.
