The role that nursing plays in the delivery of healthcare is indeed vital. Nurses work tirelessly to ensure that patients receive the best possible care. The nurses remain dedicated despite the many challenges that they encounter. Given the tremendous effort that nurses commit to their jobs, one is forced to wonder what inspires and pushes these nurses to deliver care at the expense of their own welfare. For most nurses, personal philosophies are the primary source of motivation and insight. The nurses turn to these theories for answers to complex questions and the energy that they need to attend to patients. The purpose of this paper is to outline my personal nursing philosophy. The paper seeks to highlight the impact that my philosophy has on my practice.
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I consider nursing as an engaging profession, which provides one with an opportunity to heal others not only based on one ’s requirement at work, but also from a social point of view. Whenever I interact with patients, I am prompted to create a rapport such that it makes my work easy when administering care. Some patients are known to exhibit resistance, which affects a nurses’ ability to provide efficient and high-quality care services. I began my journey as a nursing assistant in 2013 and since then, I have worked towards becoming better at my work. The years I worked as a nursing assistant provided me with an opportunity to increase my knowledge in this particular field. As an example, I encountered situations where I was required to demonstrate the use of evidence-based practice, but under supervision. This experience enabled me to develop a different outlook towards nursing and providing care to patients in particular. I was able to understand that caring for patients differs as some patients might present comorbid conditions demanding a special approach when administering health care services. In 2017, I graduated and got my Bachelor of Science in Nursing. Currently, I work in the field of dialysis. My experience with both staff and patients has been positive. I have passion for Nephrology, which is a field that focuses on the function of kidneys and associated medical conditions. Being that I cherish providing primary care, this will give me an opportunity to observe patients presenting with kidney problems taking note of key developments such as body changes to certain type of medicine among other things.
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Metaparadigms
The four metaparadigms in nursing are patient, nurse, health, and environment.
Patient
The patient is one of the metaparadigms of nursing. This paradigm is concerned with the populations that receive care. As they design the nursing interventions, nurses need to ensure that these interventions meet the needs of the patients (Denisco, 2015). In my practice, I endeavor to place patients at the center of my actions. For example, there have been numerous instances where I have suffered inconvenience and pain in my quest to deliver care. As in the case of thousands of other nurses, I continue to work long hours with the goal of safeguarding patient wellbeing. While the patient is the focus of care, there are other parties that should be considered when delivering care. The patient’s family is among these parties. As they deliver care, nurses need to involve the patient’s family in all aspects of care (Krenzischek, 2016). For example, the nurse should consult the patient of the family in cases where the patient is unable to provide consent. In my practice, I recognize that the patient’s family and the wider community are critical elements of healthcare delivery. For example, through such initiatives as education and training, I provide the patient’s family with the insights that they need to ensure strict compliance with medication guidelines.
Nurse
The nurse is the provider of care and engages in various roles such as carrying out a diagnosis of the patient’s condition, administering medication, among other activities. The nurse metaparadigm is primarily concerned with the interventions and approaches that nurses apply as part of their mandate (Denisco, 2015). While executing their responsibilities, nurses need to ensure that the solutions that they apply enhance patient wellbeing. As part of my nursing philosophy, I recognize that evidence-based practice is at the heart of effective healthcare delivery. I provide my patients with interventions which hold the promise of enhancing recovery and wellbeing. The nurse paradigm extends beyond the interventions that nurses apply. This paradigm also acknowledges the central role that nurses play in the delivery of medical services. Personally, I think that it is nearly impossible for the healthcare system to function without the involvement of nurses. In addition to serving as the face of the system, nurses also provide essential services to patients, their families and communities. Overall, my personal nursing philosophy recognizes the role of nursing while giving focus to the importance of effective nursing interventions.
Health
According to Stoewen (2015), a scholar, health refers to situation where one has physical, mental, and social wellbeing and is not majorly concentrated on the absence of disease. Basically, Stoewen acknowledges the value of holistic care. Instead of simply attending to the physical needs, nurses and other medical practitioners also need to ensure that the mental, social and spiritual needs of their patients are satisfied fully. Holistic care constitutes an integral component of my nursing philosophy. I am a passionate believer in the power of nurses to heal the body, the mind and the souls of patients. Through compassionate and individualized care, we are able to attend to the varying needs of patients. My personal nursing philosophy inspires me to remain committed to preserving all facets of patient health. Furthermore, thanks to this philosophy, I fully understand that the health of a nurse shapes their ability to deliver care. If a nurse is to effectively offer services to patients, no effort should be spared in safeguarding his/her health.
Environment
In nursing, the environment is described as an abstract conceptualization of the totality of one’s surroundings, which includes spiritual, economic, cultural, political, built as well as natural aspects (O’Connor, 1997). Research has shown that the environment is among the factors that influence patient wellbeing and the effectiveness of care. For example, Renate Kieft (2014) and a group of other scholars established that the environment is a critical force that shapes patient experiences. There are particular elements of the environment that have been shown to aid recovery and promote wellbeing. For example, animal-assisted therapy is among the interventions that have been shown to facilitate patient wellbeing (Altschiller, 2011). This intervention involves providing such animals as dogs to patients with the goal of relieving pain and anxiety. My personal nursing philosophy allows me to imbue the hospital environment with facilities and services which promote wellbeing. For example, I am among the pioneers of a program at my facility through which we offer music therapy to patients who are struggling with anxiety as they await treatment. Moreover, we rid the hospital of any and all hazards that could compromise patient health.
Thus, an understanding of these concepts discussed above reveals that to provide efficient care, a nurse should know their role and how the environment in which they operate promotes or undermine effective execution of their work. While that is the case, it is important for one to realize that their spiritual wellbeing affects their ability to provide quality care. Understandably, one can notice that the four metaparadigms are interconnected in that one cannot disregard any of them. They determine the overall quality of the relationship between a nurse and a patient, which in turn affects the patient’s health outcomes as is influenced by the environment.
Practice Concepts
A specific practice concept in nursing involves an understanding of the nurse-patient relationship, with particular focus on communication. In Peplau’s theory, nursing is considered a fundamental therapeutic and interpersonal process. The theory posits that the nurse-patient relationship comprises of various concepts, one of them being communication (Roussel, n.d). His theory underscores the critical role that open and smooth communication among nurses, patients and other stakeholders plays. For example, through effective communication, nurses are able to understand the concerns, needs and desires of their patients.
Apart from communication, I find that evidence-based practice is another critical concept of nursing practice. Nurses are advised to ensure that the interventions that they apply are backed by solid and credible research findings. It is understood that evidence-based practice goes a long way in improving the quality of services (Gillam & Siriwardena, 2014). In my practice, I have observed firsthand the benefits of evidence-based practice. For example, after establishing that a particular intervention heals patients, we proceed to offer it to our patients. Evidence-based practice has transformed healthcare delivery at my facility. While evidence-based practice facilitates healthcare delivery, it has also been shown to improve nurse education. In their article, April Mackey and Sandra Bassendowski (2017) note that evidence-based practice has a long and complex history in nursing education. Today, educational institutions are challenging nurse students to adopt evidence-based practice as part of routine healthcare delivery. I have responded to this challenge in my practice. I seek opportunities for learning and acquiring skills that allow me to apply relevant, recent and credible evidence to my practice. Every day, I continue to witness the tremendous impact that evidence-based practice has on my competence and the wellbeing of my patients.
Propositions
The various assumptions or propositions which can be made from the two concepts are:
Effective communication promotes accuracy during nursing diagnosis.
Communication barriers limit nurses’ knowledge of patient’s presenting health issues.
Evidence-based practice is the key to effective healthcare delivery.
Nurses need to engage in lifelong learning through which they acquire new knowledge and enhance their skills and competencies.
Communication allows a nurse to identify the patient’s needs, which is part of the process of nursing diagnosis.
Evidence is useless unless it is communicated and adopted into practice.
Clinical Example
In order to understand how the propositions listed above manifest in practice, it is helpful to consider a clinical example. I once attended to a patient who presented with an odd ailment. I consulted my colleagues but none of them was able to determine the ailment. The case was referred to another hospital whose nurses were able to accurately diagnose the patient. This case prompted us to reflect on the processes, systems and practices at our facility. After a careful analysis and thorough reflection, we determined that the facility had failed to adopt the latest evidence regarding effective diagnostic procedures. This failure was blamed on the lack of proper communication channels and structures. Thanks to this case, the facility recognized the direct link between effective communication and the adoption of evidence-based practice.
Conclusion
To become effective in the execution of their mandate, nurse practitioners need to develop personal nursing philosophies. As they develop these philosophies, they should incorporate the four main metaparadigms of nursing: nurse, health, patient, and environment. I have ensured that these elements are addressed in my personal philosophy. This philosophy has driven my practice. I attribute the success that I have had to this philosophy. In addition to the four metaparadigms, my philosophy also underscores the significance of communication and evidence-based practice. Since I have witnessed the benefits that they present, I would urge other medical practitioners to embrace effective communication and evidence-based practice.
References
Altschiller, D. (2011). Animal-assisted therapy. Santa Barbara, CA: ABC-CLIO.
Denisco, S. M. (2015). Advanced practice nursing. Burlington, MA: Jones & Bartlett Publishing.
Gillam, S., & Siriwardena, A. N. (2014). Evidence-Based Healthcare and Quality Improvement.
Quality in Primary Care, 22 (3), 125-32.
Kieft, R. A., Brouwer, B., Francke, A. L., & Delnoij, D. M. J. (2014). How nurses and their
Work environment affect patient experiences of the quality of care: A Qualitative
Study. BMC Health Services Research, 14 (249).
DOI: https://doi.org/10.1186/1472-6963-14-249
Krenzischek, S. D. A. (2016). Perianesthesia nursing care. Burlington, MA Jones & Bartlett
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Mackey, A., & Bassendowski, S. (2017). The history of evidence-based practice in nursing
Education and practice. Journal of Professional Nursing, 33 (1), 51-55.
O’Connor, C. (1997). An analysis of the concept environment within nursing theories. Retrieved from http://search.ror.unisa.edu.au/media/researcharchive/open/9915959937701831/53112354380001831
Roussel, L. (n.d.). Concepts and theories guiding professional practice. Retrieved from http://www.jblearning.com/samples/0763757144/57144_ch02_018_049.pdf
Stoewen, D. L. (2015). Health and wellness. The Canadian Veterinary Journal , 56 (9), 983–984.
