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Running head: PHILOSOPHY OF NURSING 1

Philosophy of Nursing

Katlyn Romero

Professor Christine Turner, PhD, RN

Bon Secours Memorial College of Nursing

NUR 4142 Synthesis for Nursing Practice

March 15, 2018

“I have neither given nor received aid, other than acknowledged, on this assignment or test, nor

have I seen anyone else do so.”


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Nurses must have certain qualities in order to offer the best care to their patients. The first

step to this is being self-aware; this self-awareness can be achieved when one is able to identify

their personal values and beliefs. I have reflected on my values and beliefs to create my personal

philosophy of nursing. This paper will discuss what this philosophy is, my personal experiences,

and my professional development.

Nursing Defined

The tenets of our program’s philosophy statement include nursing, nursing education,

caring, health, and service. When I think of how I define nursing personally, I believe these

topics form the foundation of nursing. My definition of nursing has been created over my years

in nursing school. Each experience I have had has influenced how I view this profession.

Nursing is a profession that provides patients compassionate care and support. Personally, I

believe nursing is defined as promoting healing in all aspects through the use of therapeutic

interventions. I will address the tenets of nursing, caring, and health in relation to my personal

definition of nursing.

Nursing

The first tenet, nursing, focuses on the importance of collaboration, learning, and

creativity. Evidence-based practice is also vital; this is what therapeutic interventions are based

upon. The interventions we offer as nurses must be backed by research in order to optimize

healing and safety. Creativity is necessary in order to maintain flexibility and excel in problem

solving. In nursing, learning is something that must be sought out to offer quality care.

Caring
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Another tenet, caring, is very closely linked to my definition of nursing. I believe

compassionate care is core to the profession of nursing. This tenet emphasizes the application of

safe nursing interventions to meet realistic outcomes, as well as holistic care. My definition, to

offer healing in all aspects, is achieved through the use of holistic care. My program of nursing

has influenced me greatly in this area.

Health

The tenet of health describes the ultimate goal for our patients. Health is a self-defined

definition, as it is unique to each patient and their needs. Those that are ill or dying can all

achieve health. This also ties into the use of holistic care. We must care for the patient as a

whole, not simply their illness. Holistic care includes the mind, body, and spirit.

Personal Philosophy in Nursing Practice

I practice my personal philosophy in all aspects of my nursing practice. Compassionate

care and healing are things I strive towards in my interactions with patients. My therapeutic

interventions are evidence-based and tailored specifically for each patient. I recognize the

importance of a specialized care plan formed to the individual needs that a patient may have. In

my practice, I always conduct a thorough assessment to identify these needs.

I also provide non-judgmental care; this is a necessary piece of compassion. I show

compassion by practicing empathy; I try to look at things from the patients’ perspective. In order

to care for others, I also practice self-care to remain present. Practicing presence and empathy

takes energy; by ensuring I get enough sleep and maintain my own health I can offer these things

to my patients.
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Another part of my practice is being an advocate for my patients. I do this by helping

them maintain their autonomy and providing education. Nurses are educators in addition to their

other responsibilities. By educating patients we help them take ownership of their health, which

in turn can increase compliance with medications and other interventions. Empowering patients

can improve health outcomes.

My nursing practice is focused on cultivating a healing environment in which patients

can have their specific needs met. As a nursing student, I have worked continuously on

improving my practice. I am sure this will continue to evolve as I progress through my career.

Example Encounter

During my time in clinical I have had many patient encounters that helped to form and

solidify my personal philosophy of nursing. One specific example occurred during my pediatrics

rotation. I was caring for a young patient with a behavioral disorder; the patient’s mother was

also present. This was my first experience caring for a pediatric patient, and I was nervous at the

prospect of a parent being present during care. During my initial assessment I worked on

establishing a trusting relationship with both my patient and her mother. Through this I was able

to identify certain needs related to my patient’s developmental stage and education opportunities.

My patient was a school-aged child with high energy. I interacted with her in an

individualized way by making a “game” out of certain activities. I let her participate in her care

as appropriate as well. For example, I let her take her own temperature, take off her own blood

pressure cuff, and choose her own snacks. The latter was especially important, as she had been

refusing to eat. Offering choices enabled her to feel a sense of control and empowerment. All of
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these things kept her engaged; children in the industry vs. inferiority stage need to feel involved

and active.

After developing a trusting relationship with the mother, she expressed a lack of support

system and feelings of being overwhelmed. I used therapeutic listening and presence to show

empathy and compassionate care. With this knowledge, I offered to stay in the room and play

with my patient while she could leave for lunch. Such a simple task allowed her the respite that

she needed. Before I left for the day, she thanked me for all that I did with her and her daughter.

This experience illustrated to me perfectly what compassionate care is all about. Every

step of care that I planned out helped me successfully care for my patient and her mother. I used

therapeutic interventions that were evidence-based and unique to my patient. I also practiced

empathy and creativity in this specific situation. I would say this is just one of many encounters

that portray the use of my personal philosophy in practice.

My Values and Beliefs

At the start of my nursing school career, my values and beliefs centered on equality,

empathy, holistic care, and education. In my previous philosophy of nursing I also stated the

importance of collaboration and freedom of choice. My values and beliefs have not changed

through school; they have simply been reinforced by my experiences. I now have more clinical

experience to base my beliefs off of. This has created a better understanding of what my role is

as a nurse. These fundamentals have remained important to me over the past three years.

Skill Acquisition

According to the Benner’s application of the Dreyfus Model to nursing, there are

different skill levels at which a nurse can be (Benner, 2001). The progression goes from novice,
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advanced beginner, competent, proficient, to expert (Benner, 2001). A certain level of

knowledge and skilled performance as a clinical nurse characterizes each level. In order to

identify one’s level of proficiency, one must first understand what defines the levels.

Novice is the first stage at which nursing students “enter a new clinical area” (Benner,

2001, pg. 21). The skills of a novice nurse are limited and they have little to not experience.

Basic skills are taught and rules guide most actions. The next stage is advanced beginner; these

nurses or nursing students have real situation experiences gained from the hospital (Benner,

2001). The advanced beginner can start to improve on assessment skills and recognition of

important signs. Following advanced beginner is competent. Competence is reached once the

nurse can develop long-term goals think further in the future about her patients’ care. For

example, care plans that have long-term outcomes.

Once decision-making and time management improves one can move into the proficient

stage. Proficiency can be exemplified by the “experience-based ability to recognize when the

expected normal picture does not materialize” (Benner, 2001, pg. 29). The final stage is expert.

Expert nurses are described as “fluid and flexible” and do not rely as much on rules as much as

the previous stages (Benner, 2001, pg. 34). An expert nurse is more comfortable using their own

judgment and managing more acute or complex patients and situations.

Current Professional Development

Based on the definition of each skill level, I identify most with the advanced beginner. I

began at the novice stage when I first entered nursing school and progressed through my clinical

rotations. I then progressed to the advanced beginner with my experience in different clinical

sites and simulations. I have had two and half years of clinical, which have allowed me to learn
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from real life situations. I would say I have not reached the competent stage because I have not

been on a job for two to three years. I have not had the opportunity to be in a similar situation

for more than one semester.

According to Benner’s theory, the new graduate nurse is in the advanced beginner stage

(Benner, 2001, pg. 23). We require specific instructions and guidance from a preceptor.

Prioritization is a skill that is being developed, and is by no means something I have mastered at

this stage. My time management skills are also a big learning opportunity. When there are

multiple acute patients, I still consult my preceptor when it comes to prioritization. My preceptor

is a great resource for any questions I have. I feel once I begin my career I will be able to

improve on these aspects of nursing and work on progressing to the competent stage.

Moving to the Next Stage

In order to improve and progress to the next level, competent, I will take certain actions.

I need to improve on my assessment skills to improve on recognition. “Aspect recognition” is a

common goal for new graduate nurses in order to identify changes in patient status and acuity

(Benner, 2001, pg. 22). I believe this skill is essential to offering quality care. I must be able to

recognize any worsening condition or emergency situation. This also will help me improve my

prioritization. Learning how to effectively prioritize increases the safety of my patients.

Another action I will take to move towards competence is to be proactive and practice as

many hands on skills as I can. I need to seek out new opportunities to learn and become more

confident in the clinical setting. A characteristic of the competent stage is more experience and

efficient organization skills (Benner, 2001). My goal is to take advantage of my resources

around me as well and ask many questions to increase my knowledge.


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Lastly, I am going to continue my education even past graduation. While education is

built into most orientation programs, I also am striving to participate in committees and other

professional meetings to increase my knowledge base. There is very valuable knowledge that is

taught in these environments and it will be helpful for me to draw on when I am practicing as a

registered nurse.

All of these efforts will aid me in increasing my practical knowledge. I have learned the

theoretical piece in my lectures and written assignments. However, the greatest amount of

learning I will now go through will be real world experience. If I can get to the point where I feel

comfortable referencing my experiential knowledge and connect them to present situations I will

be a much more competent nurse.

Conclusion

In conclusion, my philosophy of nursing has remained the same fundamentally. I truly

believe compassionate, holistic care is our responsibility in order to facilitate healing. This care

must be evidence-based to ensure patient safety. My experiences over the years in nursing

school have formed my values and beliefs in this area. I hope to progress from advanced

beginner to competent as I graduate and begin my new career. Nursing is a profession in which

you are constantly learning new things every day. It is my intention to offer the best care I can to

my patients; furthering my education on a day-to-day basis and seeking out more experiences is

how I will achieve this. I believe as I gain this experience I will increase in my confidence,

speed, and clinical judgment.


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References

Benner, P. (2001). From novice to expert: Excellence and power in clinical nursing practice

(commemorative ed.). Upper Saddle River, NJ: Prentice Hall.