To be a nurse, practice nursing, and provide nursing care can all be considered an art, a science, and an undeniable tribute to the remarkable innate kindness of the human species. The art of providing nursing care has been around since the dawn of time, not in the formal sense by way of training, education, and insight, but in the informal sense by way of nurturing and providing unconditional care and love in the family unity. This rudimentary form of nursing has been a fundamental requirement for humanity to continue to thrive throughout the ages. To this end, the primordial ability to nurse is indisputably embedded in the very essence of human nature. However, to be a nurse or practice nursing means a lot of different things to a lot of different people in a lot of different contexts. As wildly unique as an individual snowflake is in a blizzard, so are the many philosophies on nursing. This paper details my personal philosophical perspective on nursing; it draws from some of the well known perspectives of famous nurse theorists and pioneers, but more importantly it contains my beliefs, values, and ideals related to the four major nursing metaparadigm concepts of person, environment, health, and nursing.

       My concept of person is wholistic in nature. A person is the culmination of a life’s experiences, or lack thereof, a genetic predisposition and developmental pathway through life’s transitions, a sociocultural environment or upbringing, a prevailing spirituality (what makes one happy), a psychological perspective, and all the actions or behaviors that have brought a person to the present moment in time. Most of my perspective is consistent with Betty Nueman’s Systems Model perspective. She holds that, “the client (person) may be an individual, family, group, community, or social issue. The client system is a dynamic composite of interrelationships among physiological, psychological, sociocultural, developmental, and spiritual factors” (Alligood, 2014).  The person, with regards to the metaparadigm concept, is not always the explicit individual patient being cared for in question, but also the patient’s family and loved ones, the community they live in, the culture that they identify with, or even a prevailing social issue or healthcare concern. Nurses do not always have the luxury of just caring for an individual patient. More times than not, nurses provide care to the patient’s family through emotional support, guidance, and spiritual comfort; they provide education and health promotion to communities when there is a lack of knowledge; and they provide the impetus for societal change in the face of public issues. 

      Furthermore, Jean Watson believes that to be a person means “a unity of mind/body/spirit/nature” (Alligood, 2014). I believe that each person is a unique combination of the aforementioned factors, and the unity of their individual uniqueness cannot be denied by the nurse when interacting with a patient and providing care. Additionally, I find much truth in Dorothy E. Johnson’s perspective on the person “as a behavioral system with patterned, repetitive, and purposeful ways of behaving that link the person with the environment” (Alligood, 2014).  As humans, our singular behaviors, repetitive behaviors, patterns of behaviors, and behavioral experiences throughout life can influence our beliefs of the world; they can positively and negatively affect our health;  they can create our environments, and they without question link a us to a biopsychosociocultural and spiritual perspective.

       Lastly, I hold that each person is a transitional being. As a person grows, develops, and experiences the myriad of life’s trials and tribulations, the end result is that he or she will incite change. Afaf Ibrahim Meleis asserts that, “transitions involve a process of movement and changes in fundamental life patterns, which are manifested in all individuals. Transitions cause changes in identities, roles, relationships, abilities, and patterns of behaviors” (Alligood, 2014). As a nurse, recognizing these transitions is invaluable to understanding a person, their unique health needs, and their environments. Knowing where a person is transitioning developmentally, whether or not they are experiencing multiple major transitions at once, and helping them to understand their transition in relation to their health and environment are important in providing nursing care. The concept of person is a complex matter. The person, or patient, is the reason for nursing. The variability in the human life experience is what makes each of us unique and brings our health into a state of needing intervention by nursing care. I believe that the individual person, as well as society at large, is a culmination of genetics, sociocultural influences, developmental hallmarks and transitions, behavioral patterns, psychological perspectives, and spiritual motivations.

         The concept of environment is interpreted by many as the physical nature, structure, or ecology that a person lives in, is exposed to, or is transitioning through. However, environment is more complex in that it also refers to the internal or intrapersonal atmosphere of the human body, mind, and spirit. In accordance with Betty Neuman, I support the idea of a created environment, which is a protective coping mechanism of the internal or intrapersonal environment that helps to offset a great stressor (Alligood, 2014). Additionally, Marilyn Anne Raye holds that, “environment is a complex spiritual, ethical, ecological, and cultural phenomenon.” Along these lines, environment pertains to the unique biopsychosociocultural and spiritual situation that a person may have been in, is currently in, or will be in. With regards to nursing, environment can be a space of healing physically, emotionally, spiritually and emotionally. Jean Watson states, “healing spaces can be used to help others transcend illness, pain, and suffering. She also speaks about the interpersonal relationship between a nurse and patient by saying that, “When a nurse enters a patient’s room, a magnetic field of expectation is created (Alligood, 2014). A nurse has the unique ability to create a space of healing for a patient through the physical arrangement of the room by detail to cleanliness and amenities, as well as, administration of treatments and interventions. Moreover, a nurse can create a pathway or space for psychological and spiritual healing through unconditional caring, nonjudgmental attitudes, emotional expression, comfort, and reassurance. Marilyn Anne Ray views the environment as “a complex spiritual, ethical, ecological, and cultural phenomenon” (Alligood, 2014). Environment is not just a product of where one resides or what type of structure one calls home, but also the biopsychosociocultural and spiritual atmospheres and ideologies that influence and act upon a person.  The person or patient has their own unique environmental factors to consider when providing care, and a nurse must remember to be aware of this as well as their own personal environmental perspectives as it influences that of the patient.

       The concept of health is related to a person’s biopsychosociocultural and spiritual well being and the ability to functional at a optimum level that allows a person to perform their daily activities in a meaningful and purposeful way. Nursing care aims to minimize the negative aspects of a person’s biopsychosociocultural and spiritual environments and promote the positive aspects. Imogene King states, “Health is a dynamic state in the life cycle, while illness interferes with that process. Health implies continuous adjustment to stress in the internal and external environment through the optimum use of one’s resources to achieve the maximum potential for daily living” (Alligood, 2014). Health is dynamic in that there are fluctuations; everybody has some health issues at one point in a lifetime, some more frequently than others; some rebound quicker and some do not at all. A person can have chronic health issues since birth and still manage to have a happy and productive life, despite what is perceived to be poor health. Each person has a unique perception of what health and illness is and how it impacts their life. Some think it is the absence of illness or disease, while others hold that is the management of their illness and disease in a way that maximizes daily functioning. Sister Callista Roy holds that, “Health is a state and process of being and becoming integrated and a whole person. It is a reflection of adaptation, that is, the interaction of the person and the environment” (Alligood, 2014). I believe that health is the way in which a person adapts to the unique biopsychosociocultural and spiritual hurdles in life and learns to live in a way that promotes their own sense of happiness in daily living. Nursing care should aim to promote the individual’s sense of health and guide them to better understand their unique health perspective in terms of their environment and ways to effectively cope and adapt to maximize the potential for daily functioning.

       At first glance, nursing symbolizes providing care to the ill, injured, and despondent, but upon further investigation and understanding it means establishing therapeutic relationships with others, in essence to be a master of interpersonal relationships. To build a trustworthy nurse-patient relationship requires a working rapport and a therapeutic bond that allows the nurse to see into the life of the patient through self disclosure and honesty. To practice nursing care means to be unconditionally caring and nonjudgmental, compassionate, empathetic, sympathetic, self-sacrificing, and an advocate for the betterment of a patient’s life in the face of medical disagreement or patient indecisiveness.  Being the patient’s greatest supporter when it seems like nobody else is, even the patient himself, shows how unconditional the depth of a nurse’s ability to care truly is.  

       Being a professional nurse means continually learning and advancing one’s education in the field, understanding the need for research and evidence based practice in identifying the best practices in nursing care based on evidence to date.  Moreover, my ideology on being a nurse and providing nursing care means taking the time to understand who I am as a person. Having insight and introspection into my own unique biopsychosociocultural and spiritual perspectives and environment allows me to understand my world thereby affording me the tools to understand another person’s unique perspective on the world. Continually taking interest in the variability and beauty of life and the seemingly endless presentation of cultures of people and practices allows one’s mind to remain open to change, transition, and partial to the knowledge of the world.  Additionally, nursing means knowing that I have been and will be a patient again one day, it reminds me of the overwhelming emotional and spiritual transition that takes place in the face of illness and disease. Remembering to address all the integrated aspects of a person from their mind, body, spirit, and nature in a wholistic fashion speaks to the nurse’s ability to care beyond performing a job or completing a task. Nursing means listening, teaching, loving, advocating, learning, promoting, counseling, adapting, persevering, consoling, relating, reassuring, affirming, enlightening, transitioning, and above all unconditionally caring.  

       Over the course of my BSN educational and experiential journey, I have found that my philosophy is still true to date. However, a new emphasis has been placed on engaging my patients in the conversations and rapport building experiences that create a platform for self-disclosure, trustworthiness, authenticity, and open communication. The interpersonal, interconnectedness and relationship formation of a nurse and patient is without a doubt the most important aspect of being an exceptional nurse. As a human, person, and patient, we all want to feel connected, understood and fought for. We want to know that our darkest, sickest, or lowest points in our lives are being championed by somebody that truly cares to make it better.  My philosophy on nursing has grown by leaps and bounds in this BSN program by simply recognizing the simple power of being true to myself and my patients.

References:

Alligood, M. (2014). Nursing theorists and their work. St. Louis, Missouri: Elsevier