When I heard of the term “nursing philosophy”, I was at first skeptical that nursing should require any other philosophy than that of “Do No Harm”. As I progressed through nursing school however, I found that the idea of a nursing philosophy serves the discipline and profession of nursing and its practitioners by providing a conceptual framework from which to approach the actual practice of nursing (Alligood, 2014). The relationship between nursing philosophy and practice is symbiotic as well and through the process of deductive, inductive or abductive reasoning theories emerge and are either validated or disproven for use by the entire nursing community (Aligood, 2014). My personal philosophy issues forth from a variety of concepts both recently acquired and from wisdoms and insights acquired from more remote periods in my life which I continue to consider having validity and truth. I believe these concepts can be categorized into four generally broad and, for lack of a better term, archetypal categories including: intellectual/cognitive, emotional/psychological, spiritual/religious, and physical/material. These four basic categories will help me to illustrate how my personal view of nursing has been and continues to be constructed through the evolutionary cycle of my life span.

     The intellectual/cognitive aspect of my personal philosophy is derived mostly from the education I have attained professionally and personally. As a student nurse, I was educated with the Neuman Model of nursing which states the human as being a system that responds to inevitably varying forms of input to maintain homeostasis or “negentropy” (Alligood, 2014). Furthermore, thinking of the human body as a system, I think of it as being a system within several other functionally similar systems which are simultaneously different at the superficial level but are all parts of a single system working together towards a common goal. What this means to me is that everything from atoms to people to the entire universe is part of the same system and works towards negentropy and all things interact and even resemble each other in function as microcosms or macrocosms of the others. So, while Neuman’s stressors play a part in the health of our system, we also play a part as stressors ourselves to systems above and below us and can affect the health of the entire System (the universe). Neuman proposes the environment as separate forces “internal and external” that influence us at any point in time (Alligood, 2014). I consider the environment as yet another system in a constant state of flux that has the vast potential to reciprocate the effects of stressors to it in a way that can alter homeostasis to our systems. We are integral and inseparable to all that we come into contact with whether directly or indirectly and it is unavoidable to create cascading reactions with any action we perform. Finally, as nurses we need to remain perpetually aware of the effect our actions have on another person (system) and consider how we can best use our energy to alter that person away from entropy. Our actions will necessarily require the simultaneous manipulation of multiple systems and energies including the patient, environment, family and ourselves in many instances.

     My nursing philosophy also requires an examination of the emotional/psychological category because nursing is a caring profession that requires compassion and patience for its professional practice. Unconditional love, therefore, must be an integral part of nursing philosophy as love without conditions requires remaining non-judgmental towards others and their situation(s). As Eriksson theorizes, love is one of the key components to providing acts of caring (Alligood, 2014). To me, acting out of love is a behavior that not only promotes the health of the patient, but that of the nurse as well and helps to cultivate emotional negentropy in a holistic fashion across both systems. If you dare to “love your neighbor as you would love yourself” then it is at this time that you truly tend to the healing of the patient for, if this is truly practiced, the nurse will see the patient with dignity, equality, respect and extend generosity, hospitality, and charity without exception. Martinssen adds to the discussion of caring in another way suggesting that caring is not only an emotional act of love but “a fundamental precondition of our lives” which to me suggests an inherent psychological need to care as well (Alligood, 2014). To care, it would seem, is not just a necessary criteria for nursing but a necessary function of human existence in total and without providing this, we cannot be totally human.

     Closely tied to the emotional/psychological category of my nursing philosophy is the religious/spiritual category with my views mostly being derived from Judeo-Christian and Buddhist values. From my perspective, nurses should have some spiritual force in their lives in which to derive meaning or inspiration from, or with which to seek solace in times of desperation. This is similarly expressed for patient needs by Jean Watson as she presents us with a series of “carative processes” with one of the top listed of these processes being the installation of faith-hope (Alligood, 2014). We have to be beacons of light our patients can use to navigate their way from their own personal inner darkness when needed and we have to encourage the expression of the spiritual in our patients if we are to provide a truly holistic care. In this fashion then, we have to be the equivalent of the Buddhist bodhisattva who foregoes nirvana (enlightenment) in order to help others to attain it, except instead of helping our patients attain nirvana we are helping them attain negentropy. When we practice nursing, we want to help others because it is impossible to ignore the similarities we share when we look into the face of others; and, when we see ourselves in other people the choice to help them is no longer a choice at all, it is the only thing we can do. As stated earlier, my belief is that we are systems within a Great System and we all share the same spark of the divine; when we serve other equal systems, we serve the Great System. We co-exist with greater and lesser systems without a hierarchy but arranged in a circular manner where the members are constantly transmuted between energy and mass, between spirit and flesh.      

     Moving away from these more esoteric constructs, let us consider the final, but no less important, concept related to the physical/material aspect of nursing philosophy. Physical assessment requires patience, practice, knowledge and discipline. A nurse must strive to become adept at the physical assessment early on in their career for the immediate physical benefit of the patient system. Comprehensive understanding of the nursing process is a necessary aspect of my nursing philosophy and I would personally encourage all other nurses to embrace it as a tool of the trade that can assist a nurse, provide the best care using a critical-thinking process (Jarvis, 2012). Collecting objective data specifically and without putting our own subjective spin on the information that we collect from the patient, perhaps in order to fit the data to our hypotheses, requires, at the time of collection, complete personal disconnection from one’s ego. On the other hand, the collection of subjective data should be performed with an increasingly personal approach as empathy with the patient and their situation is necessary to truly understand the patient’s needs. At the time of hospitalization, the person’s physical needs move towards the forefront of the patient’s list of needs. Abraham Maslow theorized that a person lives life working through a “hierarchy of needs” that begin with basic physiological needs and end with actualization of the self (Townsend, 2011). In agreeance with Maslow’s theory, I think that a patient may revert back to being overly concerned for their physical needs during times of physical illness. So, when hospitalized for a surgery, a person-system’s physical needs become predominant and must therefore be addressed first before attempting to move back up to the need level they were attempting to work towards. If this is true, then it must become the nurse’s first priority to tend to these lower level needs so that the patient does not lose whatever momentum they had built towards attaining their higher level needs.

     In summation, nursing is a caring profession that requires intellect and caring behaviors derived from a recognition of human singularity; the embrace and encouragement of the spiritual with others; and consideration of physical needs so that development is not hindered any longer than it should be. As a nurse and a good person, I believe in the power actions have on the outcome of patient health and negentropy. It is a responsibility and a gift to be able to give of myself so that others may thrive and heal. Through practice and determination, nursing philosophy and practice weave themselves together for each individual into a conceptual tapestry unique to each nurse that tells a story of their concerns and points of view. One day, I hope to look back on the legacy I have constructed and know that differences were, through my nursing practice, made in people’s lives; and, ideally, more often than not for the better.

References
Alligood, M. R. (2014 ). Nursing theorists and their work, 8th Ed. St. Louis, MO: Elsevier.
Jarvis, Carolyn PhD, APN, CNP. (2012). Physical Examination and Health Assessment, 6th Edition. St. Louis, MO: Elsevier Saunders.
Townsend, M. C. (2011). Essentials of psychiatric/mental health nursing: concepts of care in eveidence-based practice, 5th ed. Philadelphia, PA: F.A. Davis Company.