Philosophy of nursing is defined by each nurse’s own belief, values and ethics to apply to nursing. Nursing is both an academic discipline and a practice profession. Supporting theories and personal philosophy are essential guides in the advancement of nursing practice. Providing an optimal level of client wellness in diverse nursing settings is dependent on the nurses' critical thinking and clinical judgment. As such, clinical judgment is a key pillar in professional nursing practice.
Autobiography
I chose nursing out of compassion and strong desire to make a positive contribution to people’s wellness. This is my 5 th year in my professional career. Compassion, honesty, care, understanding, and integrity are the core values that have shaped my practice as a nurse. These values guide the decisions I make, and I always do my best to ensure that the results of my work are reflective of the values. My guiding philosophy is founded on the alignment of my principles and the fundamentals of nursing. According to the American Nurses Association (2017), nursing is defined as "the protection, promotion, and optimization of health and abilities, prevention of illness and injury, facilitation of healing, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, groups, communities, and populations." The holistic nature of nursing makes it more than a job but rather, it is a calling. In my years of practice, I have drawn great satisfaction, not from the paycheck received at the end of the month but from being a part of a patient's recovery.
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Metaparadigm Concepts
Fawcett (1985) established the four-domain metaparadigm as the base upon which nurses center their practice. The metaparadigm comprises of four components: person, health, environment, and nursing. These components are critical in the development of a nurse and the advancement of good care.
Person
Patients are people first. A patient deserves respect and has the authority to choose. The holistic nature of nursing encompasses the person's spiritual and social needs, including healthcare needs. The person component is based on the premise of empowerment; one's ability to make a choice on his/her health and well-being with dignity and self-preservation.
Environment
The surroundings that affect a patient make up the environment. A person's health and wellness are affected by internal and external influences upon which one interacts. The nursing environment comprises of the factors that affect growth, health, and progress of a patient. One can modify environmental influences to improve health status.
Health
Health refers to the extent of wellness and health care access available to a patient. The health component focuses on the entire nature of the client in physical, social, aesthetic, and moral realms. A patient's state of well being is influenced by factors such as genetic makeup, social, physical, and economic environment, and a person's characteristics and behaviors.
Nursing
This is the delivery of optimal health outcomes for the patient through holistic care guided by the value of human freedom, choice, and responsibility. The American Nurses Association Code of Ethics describes nursing duties as "…responsibility to promote health and safety, preserve the character of wholeness and integrity, maintain competence, and continue personal and professional growth." According to Benjamin and Curtis (2010), nurses are tasked with the responsibility of helping patients through nurse-patient relations and therapeutic management of their environment to advance health and well-being.
Personal Guiding Principles
Nursing as an attitude
My decision to pursue a career in nursing was informed by the desire to help heal and alienate the suffering of others. According to Edwards (1997), nursing is an attitude towards life, and reality stemming from a nurse's core beliefs and values. The well being of a patient extends beyond the medical aspect of nursing to include emotional wellness. Care requires empathy, compassion, and respect. It intrigues me just how much difference I can make in other people's lives. A positive attitude on its own is has a significant impact on a patient's recovery process. I want my personal n ursing to revolve around building a trusting and caring relationship with patients because “to establish a trusting relationship is necessary in order to see the situation from the patient’s perspective and an absolute prerequisite for acknowledging and realizing a patient’s values,” (Austgard, 2006, p.16). I believe in establishing good relationships, interacting, and connecting with my patients as a valuable means of getting a unique perspective pertaining to the meaning of the patient's illness, beliefs, and preferences.
Ethical practice
Besides my core values and principles, basic ethical principles drive and guide all my actions. I understand that to every patient that I care to; I must do what I firmly believe is the best for the patient at that specific moment. Instances where my personal beliefs conflict with those of the patient, I always endeavor to find a solution worthy of the patient's needs without compromising my own beliefs. Nurses have the autonomy to make independent decisions and are accountable for their actions (Creasia & Parker, 2007). The autonomy to make decisions on my own is to me a reminder of the trust and confidence bestowed upon me. My judgment must, therefore, be always guided by critical thinking, mastery of scope, and intuition.
Commitment
Working under sometimes incredibly difficult conditions requires strong will, commitment, and understanding. "The nurses' primary commitment is to the patient, whether an individual, family, group, community or population" (American Nurses Association Code of Ethics, 2015). I am a committed nurse, always willing to work an extra hour when called upon, and always cooperative with my fellow nurses. Sometimes in the line of work, nurses have found it challenging to work with others owing to factors such as level of experience and the general lack of cooperation. I believe every nurse possesses a particular skills set or unique knowledge and such; there is always something new to learn. As a relatively new nurse, I believe that collaboration with senior experienced nurses will benefit me advice and guidance. The working relationships can sometimes be complicated. I have witnessed the indifference of many senior nurses towards the mismanagement of new nurses. Incidences of bullying with the nursing profession have been documented by Lewis (2005), who studies the micro-sociological perspective and the interactive mechanisms that give rise and continuity to the bully culture.
Clinical Example
One of my patients, a young 12, suffered from severe needle phobia. Additionally, the young girl also had Down's syndrome. On one of my many interactions with her, I discovered that she was a huge fan of comedian Kevin Hart. The next morning after her admission, I brought her my iPad loaded with Kevin's performances. We had a lot to chat about, and in the process, the girl was distracted from her needle fear. Nurses, by nature are concerned with a patient’s comfort, for “ comfort remains a substantiveneed throughout life and, as such, should be considered anindispensable constituent of holistic nursing care,” ( Malinowski& Stamler, 2002 ).
Conclusion
My strength to achieve my professional goal stems from maintain positive attitude. Nursing as profession can be very stressful, negative thinking can lead to wrong decision making and wrong patient outcome. Developing a personal philosophy should be guided by one's values, beliefs, ethics, and a holistic view of nursing. Through this philosophy paper, I have explored what nursing truly means to me, and have become more aware of principles I value for clinical practice. I value holistic nursing and want to value each patient as an individual with varying needs. Respect for every patient is essential in preserving a patient’s dignity. My goal is for the patient to always be the focus of care and to make sure the patient’s values are understood. I desire to work in a healthy working environment in which open communication is encouraged.
Assumptions
The essence of nursing is to care
Cure is dependent on the giving and receiving of care
A positive attitude can change a patient's perception of their illness and coping skills.
Nursing is a call to serve people
Care requires empathy, compassion, and respect.
Nursing care involves the patient as a person and not just the health problem
References
American Nurse Association. (2015, January). Code of Ethic for Nurses with Interpretive (2020). Retrieved 5 March 2020, from https://www.nursingworld.org/~4aef79/globalassets/docs/ana/ethics/anastatement- ethicshumanrights-january2017.pdf
American Nurses Association. (2017). Retrieved from What is Nursing:
Retrieved 5 March 2020, from
http://www.nursingworld.org/EspeciallyForYou/What-is-Nursing
Austgard, K. (2006). The aesthetic experience of nursing. Nursing Philosophy 7, 11-19.
Benjamin, M., & Curtis, J. (2010). Ethics in nursing: cases, principles, and reasoning . Oxford University Press, USA.
Creasia, J. L., & Parker, B. J. (2007). Analysis and evaluation of contemporary nursing knowledge: nursing models and theories. Philadelphia: FA Davis Co , 217-19.
Edwards, S. (1997). What is philosophy of nursing? Journal of Advanced Nursing, 1088-1092.
Fawcett, J. (1984). The metaparadigm of nursing: Present status and future refinements. Image: the journal of nursing scholarship , 16 (3), 84-87.
Lewis, M. A. (2006). Nurse bullying: organizational considerations in the maintenance and perpetration of health care bullying cultures. Journal of nursing management , 14 (1), 52 58. Statements . Retrieved from https://www.nursingworld.org/coe-view-only
Malinowski, A., &Stamler, L.L.(2002). Comfort: exploration of the concept in nursing. Journal of Advanced Nursing 39 (6), 599–606.
