Personal Nursing Philosophy

Jasmin Smith, RN

College of Central Florida

April 17, 2016

Personal Nursing Philosophy

         Nursing is an interactive phenomenon supported by active, caring, interpersonal relationships. Nursing can be both complex and pure and one must be able to differentiate which approach is appropriate, or when to implement both simultaneously. Nursing fosters hope, encourages self - sufficiency, and advocates patient centered care. Nursing is not for those opposed to change as it promotes new avenues, backed by trials and evidence based research, to achieve holistic care. Overall, nursing possesses a stable foundation, that has propelled it through times of scrutiny and skepticism, but is adaptable and constantly perfecting it’s approach in efforts to provide patient centered care.

           Jacqueline Fawcett is to be credited with coming up with the four cornerstones, nursing, health, environment, and person, which composes the foundation of all nursing theories today (Alligood, 2014). These facets make up the nursing metaparadigm, which Fawcett identified as “totality of the phenomenon inherent in the discipline in a parsimonious way, as well as being perspective-neutral and international in scope” (Alligood, 2014, pg., 32). I interpret Fawcett’s definition of the metaparadigm to mean that while we all may have our different approaches to providing care, they all trace back to a mutual foundation encompassing person(s), health, environment and nursing.

           In my mind, I see nursing as a calling not merely a profession. For this reason from the get-go in my nursing career I have always voiced that nursing should be patient centered and not paycheck centered. Too many individuals are in this profession for the job security, and while there is nothing wrong with job security nursing should be a selfless profession and not solely focused on personal gain. A nurse is a detective, caregiver, listening ear, and sometimes the backbone for their patients. Nursing requires looking further into the patient’s symptoms, reading between the lines, and connecting the dots. When patients are the most vulnerable nurses step in and care, sometimes through words but most often with actions, which are carried out in such a way that the patient feels thankful but not embarrassed. Nurses realize that patients do not care how much we know until they know how much we care and the best way to show this is to take the time to listen to what the patient has to say. And nurses, though respectful of doctors and other medical personnel, have an obligation to stick up for the patient and cannot be afraid to be a voice for them when needed.

           Individuals are just that: individual. For this reason nurses must approach the facet of the “person,” understanding that each is unique and although similar characteristics may be present patients differ in their needs and priorities. Persons identify themselves based upon spiritual, cultural and social experiences, or lack thereof. Individuals seek purpose and strive for recognition, meaningful relationships, respect, happiness, and love. At anytime a person’s identity can be altered due to events, transitions, and relationships.

             Interpretation of health is also dependent on spiritual, social, and cultural upbringing. Some see health as a reflection of their character, and lack thereof a punishment for wrongdoing. I see health as a gift that individuals must cultivate and take care of through healthy food choices, exercising, and meaningful relationships; however, I recognize that some individuals are predisposed to illnesses with which they had no way to prevent. Ultimately, to me, good health is a subjective condition but it is when individuals feel fulfilled, satisfied and possess a sense of well-being.

             An environment is composed of the circumstances and events that each individual experiences. Eating, sleeping, relationships, education, transportation, health, financial assets, death, birth, etc., are all examples of factors that could influence an individual’s environment. Environmental factors can either have positive or negative effects on individuals and nurses should try to create a therapeutic environment for their patients. In order to foster a therapeutic environment nurses must be interacting with the patient enough to be able to recognize what factors are seen as positive, and which are acting as negative stressors.

         As Fawcett was aware, there are many different approaches and theories regarding nursing (Alligood, 2014). So far in my nursing career I have not adopted the teaching of a single theorist but rather gleaned from multiple sources. This may change over time, as I am still a relatively new nurse, and based upon future experiences and learning my theory may expand or become more finite. I have already seen personal change occurring in how I approach nursing based upon my knowledge gained from my BSN program. According to Benner’s theory I would place myself in the Competent category, and as Benner identified this is a crucial time for nurses as they are now in the stage where they have to prioritize relevant from irrelevant data (Alligood, 2014). Benner believed that competent nurses could not become proficient until they undergo active teaching and learning (Alligood, 2014), and with active teaching and learning comes new thoughts and ideas, which could influence how I see nursing.

           For my perspective regarding nursing I found King, Martinsen, and Levine’s theories similar to my thought process. King identifies nursing as an “interpersonal process of action, reaction, interaction, and transaction” (Alligood, 2014, pg., 263). This is similar to my belief that nursing is an active role with the nurse interacting with the patient and other health care providers in an attempt to foster patient centered care. Levine’s thought processes is similar to King’s and myself because she voiced that nurses are active participators in each patient’s care (Alligood, 2014). Martinsen identifies caring as a key component in understanding nursing (Alligood, 2014), which pairs along with my thoughts that patient’s do not care how much we know until they know how much we care. True caring comes from the heart and is done in such a way that the recipient recognizes the genuine act and feels no shame from receiving the care.

           I believe my theory of person is most closely related to King and Leininger. King identifies persons as holistic and unique and differing in needs, desires, goals (Alligood, 2014, pg., 263) which is very similar to my opinion that though similar nurses must recognize each patient is unique and has differing priorities. Leininger is all about cultural based care, which is care that considers the patient’s culture and belief systems (Alliood, 2014). I also recognize that persons identify themselves based upon their heritage and experiences, but I also recognize that not all Jews find it a sin to eat pork, and not all Catholics abstain from birth control, so it is important to not treat all people of the same culture or religious belief system the same but rather use your knowledge to assess their beliefs and practices on an individual basis as it affects care.

           In regards to the environment and health I found my philosophy comparable to Imogene King’s theories regarding these cornerstones. King voiced that health is dynamic and must adjust to factors that disrupt the process (Alligood, 2014). Although I did not use the word dynamic, which upon second thought I wish I would have, I recognize that health is dependent on external and internal factors and that it is subjective in nature. King also speaks of recognizing the need for adjustments within the environment stating, “adjustments to life and health are influenced by [an] individual’s interactions with the environment” (as cited in Alligood, 2014, pg., 263).

         In summary, I am actively implementing my nursing philosophy into the patient care I provide. I listen to my patients and then voice my interpretation of what they are saying and ask them if this is what they mean. I use each patient’s unique feelings and concerns to shape the plan of care I provide them and the level of advocacy I need to implement for them. Ultimately I promote self-sufficiency and look for ways to promote active involvement in their own plan of care. My profession humbles me and I do not take it for granted. I reflect on the words of Florence Nightingale to be ever vigilant, because she warned “if you cannot get the habit of observation one way or other, you had better give up being a nurse, for it is not your calling, however kind and anxious you may be” (as cited in Alligood, 2014, pg., 70). At times nursing can be the most emotionally and physically draining thing that I have ever encountered, but at other times the satisfaction of knowing I helped someone when they could not do for themselves, or worked with them until they could achieve a goal provides the reinforcement that I was meant to be a nurse. Health is not a guarantee and being able to recognize adverse events before they occur is crucial as a nurse; but it is also crucial to realize that not everyone views health with the same perspective and to be open minded to your patient’s beliefs. One must treat each person individually and establish their values, needs, and wants in regards to their health and plan of care and one must realize that a therapeutic environment is needed in order for all these elements to blend together in harmony. As I grow my awareness towards the relationship between nursing, health, person(s), and environment, I can attest that you cannot provide holistic care without consciously incorporating all of these elements into practice.

Reference:

Alligood, M. R. (2014). Nursing theorists and their work (8th ed.). St.Louis, MO: Elsevier Mosby.