Abstract One of the many aspects of nursing that is encouraged is reflection. This paper is a reflection of the current nursing practice, skills, attitudes, and outlining knowledge. Secondly, this paper is an introduction to the authors experiences, attitudes, and personal philosophy of nursing. Lastly this reflection hopes to shed light on nursing and all its different aspects.
REFLECTIONS 3 Reflection of Nursing Practice I am writing this paper about my practice in medical oncology nursing. I have never taken the time to take an outside look at what I have accomplished being a nurse. I look forward to analyzing my everyday routines and training. In this paper, I hope to have some self- discovery. This paper has given me a chance to look at the extensive knowledge, skills, and attitude that are needed in everyday practice. I will talk about the definition of philosophy and my understanding of how it affects my career every day. I will discuss my personal understand of the three nursing concepts. I will explain what I believe effects a person, environment and health. The last section in a short synopsis of the standards of nurse practice and how they effect my role as an oncology nurse. Current Practice The authors current area of practice is in general medical/oncology. I have been a nurse for six months and have loved every second it. In day-to-day interaction there is a variety of different patient with illnesses on the floor ranging from cellulitis to hospice. On the floor, emotions can run high at times, but one must remember that it is all part of this wonderful career we all have chosen. The next sections will talk about the knowledge, skills, and attitude that are needed to be successful on a medical oncology floor. Knowledge The knowledge needed to be successful on my current floor is extensive. Black (2011) outlines that having a basic unique knowledge, though an educational program is one characteristic of a profession (Black 2011, p. 52). As a new graduate, and generalist, I have the basic knowledge needed to care for patients, however, the nurses in this specialty are certified in chemotherapy, reading cardiac telemetry strips, and in hospice care. According to White and REFLECTIONS 4 OSullivan (2012), education is an important standard for professional nursing and my knowledge of respiratory acidosis, oncology crisis, and amputations is essential to perform safe care. The care that we provide on my floor varies greatly from patient to patient. Some of the required knowledge is of peripherally inserted central catheter (PICC or PIC line), Port access, and jejunostomy tubes. This is a wonderful floor for a nurse to start out on because of all the knowledge that one acquires while working there. The next section will discuss the different skills a nurse would acquire while working on a medical/oncology floor. Skills I have many skills that I acquired in nursing school that I use every day. Some of those skills are basic care for a patient; such as someone whom needs a bed bath and/or bed change. I hang blood and blood products on a daily basis, because I deal with a lot of sickle cell patients. I access power ports, peripherally inserted central catheter lines, and perform blood draws each morning. I do wound care on amputations, surgical incisions, and chronic wounds. I deal with patient controlled analgesics pumps and patients with chronic pain everyday. Almost all of my patients are on cardiac telemetry monitoring which means that I must read and analyzing the strips. Some of my ongoing learning is how to do comfort care, hospice and post mortem care. According to Black (2011) nursing technologic development include genetic, biomedical, information and knowledge (p. 45). Attitude I love my job and I love the patients I work with on a daily basis. I enjoy learning new skills and becoming certified in new areas. Some days it is hard to separate myself from my patients. What I find hard is taking care of a patient from when they first get diagnosed with cancer, then when they are on hospice care, and then pass away. I try to leave it at work, but REFLECTIONS 5 sometimes I am lacking in will power. I have patients who want to stuff their faces with food while saying that their pain is at a 24 and get mad when you do not bring them their needed pain meds on time, while the patients family in the next room over is weeping because their dad is 50 years old and dying of brain cancer. Sometimes I need to take a breath between rooms. Overall I try to have a great attitude about work. Black (2011) explains that there are five stages of grieving denial, anger, attempting to gain control, depression and acceptance (p.197). When I work with a cancer patient, I find myself going through the stages of grief for the patient. When I started work I thought that I would be immune to getting attached to my patients, I know now that is the farthest concept from the truth. Philosophy In this paragraph I will outline the nursing concept of philosophy. According to Merriam- Webster (2013) philosophy is an analysis of the grounds of and concepts expressing fundamental beliefs(p.1). Personally I believe that philosophy is your views and beliefs of care and understanding of the patient and their needs. These views can change everyday depending on what situation a person is in. Each person has to have a understanding of what their belief system consist of including their morals and ethical standing. Some nurses never have their beliefs/ of views challenged, however I work with patients that challenge what I believe everyday. After being a nurse for seven months on the medical oncology floor, the authors philosophy of people, health and environment have become stronger. Every nurse has a different philosophy of what nursing is, many nurses believe the American Nursing Association (ANA) definition of nursing, which is close to the authors personal one belief as well. Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering REFLECTIONS 6 through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations(ANA, 2013, p.1). Person I will outline the nursing concept of person. A person is a unique, adaptable being who seeks homeostasis. They are motivated by their hierarchy of needs and influenced by genetics and their environment(Black, 2011, p. 240). A human is a complicated being, their environment changes rapidly and frequently. Some people thrive in a stressful health crisis and others give up the fight. I believe how successful a person is in life depends on support systems, personality and morals. Health In this paragraph I will outline the nursing concept of health. Health is a dynamic, continuum, holistic ever changing beliefs and behaviors that affect a person(Black.2011, p. 240). Personally I define health as a blending of mental and physical health. To be mentally well, I believe there need to be a support system in place whatever "support system" means to an individual including but not limited to proper coping techniques, people they can rely on in times of need and a sense of self confidence in their everyday life. To be physically healthy can range from a women doing yoga everyday to a man running a marathon. People need to start believing that their bodies are beautiful works of art, but just like a priceless piece of art if it not cared for or preserved in the right fashion it will slowly fade away. I believe that physical health is just as important as mental health. Environment In this paragraph I will outline the nursing concept of environment. Environment can affect a person both physically and mentally(Black, 2011, p. 240). A persons environment can REFLECTIONS 7 change on a daily basis. I see this everyday with oncology patients. I have had patient who come is that ten days ago they were up walking around and independent and now they have been diagnosed with stage four lung cancer. This person environment has changed very dramatically since ten days before. I believe we need to be flexible with what the day brings us. We must learn how to adapt and change or we will cease to exist. Nursing Theory Black (2011) discuses how the foundation of nursing are like bones of a human skeleton that work together to hold all the pieces of the body together. There are three essential factors that affect a human being they are person, health and their environment. Each of these factors has sub concepts that help forum the ever-changing philosophy of professional nursing. Each part of a system is a necessary or integral component required to make a complete, meaningful while. These parts are input, throughput, output, evaluation and feedback. (Von Bertalanffy, 1968) Transition When I completed my associates in nursing at Southwestern Michigan College, I did not have a clear picture of what nursing meant to me. I was so busy working on just passing nursing school to think about how the standards of nursing practice affected me. During my first semester at Ferris State University I have learned many aspects of where I stand morally and ethically. I now have a better understanding of nurse practice and how is affects my practice as an oncology nurse. Knowledge The professional standards that have stood out to me this semester are ethics and education. Ethics are a subject most people do not want to discuss, but I have found that it is essential to know where you stand morally to be able to give your patients the best care. During REFLECTIONS 8 this semester I have been forced to think about where I stand on moral issues. I have found this experience to be challenging and enlightening. Education is a very important aspect of professional nurse practice (ANA, 2013, p.1). We must take continuing educational credits during the year to keep our license active. Each state has different requirements for what the continuing education will be every two years. Evidence based practice and research is another aspect of the education nurses must keep current with to be able to give their patients best care and outcome (ANA, 2013, p.1). Most companies encourage their nurses to go back to school to receive a higher level of education. I know personally going back to school for my bachelors in one of the best decisions I have made in the last year. Skills During my transition into my bachelors, I have learned the importance of quality of care I give to me patients daily (ANA, 2013, p.1). Some nurses I work with lack in giving their patients quality care. When I speak with the patient during my assessment, they start to talk about the care they received during the day and how they felt like a burden to the staff. I hope if I am ever complacent with my nursing care that someone pulls me aside and speaks to me about it. Communication is vital for great patient care (ANA, 2013, p.1). At my work, nurses do bedside repost. It has greatly improved the communication between the team and patient. When giving bedside report I always ask the patient if I missed anything or they would like to add anything. Collaboration is working together as a team (ANA, 2013, p.1). This can include the family, doctor, nurse and other multi-disciplinary teams. I find that I must be a leader when asking the patients about their care and concerns at the bedside. I want to be a leader in giving REFLECTIONS 9 the best possible care to my patients. There are many aspects of bedside report that I find to show our dedication to the standards of nurse practice. Attitude As a professional nurse, I must be able to have my practice evaluated by other professionals and be willing to change if necessary. When working in a team setting, we must keep each other accountable to the professional standards (ANA, 2013, p.1). If a nurse is unable to preform the best care for the patient, they must be able to trust another nurse or team member can step in and help with the problem. This is part of using your resources. I enjoy working in a hospital because I have a multi-disciplinary team surrounding me if I need them. As nurses we must provide the best possible care for our patients. We must make curtain that we provide a safe and healthy environment (ANA, 2013, p.1). Reflection This paper has made me discover my personal definitions of a few nursing concepts. I have learned some key feelings I have about the care of my patients. After writing this paper, I will continue to have a personal understanding of how I believe these nursing concepts shape my current practice.
REFLECTIONS 10 References American Nurses Association [ANA]. (2013). Professional Standards. American Nursing Association. Retrieved November 29,2013, From http://www.nursingworld.org/nursingstandards American Nurses Association [ANA]. (2013). What is Nursing. American Nursing Association. Retrieved October 7, 2013, from http://www.nursingworld.org/EspeciallyForYou/What- is-Nursing Black, B. (2011). Professional Nursing Concepts and Challenges (7 ed.). St. Louis: Pearson. Webster. (2013). Philosophy. Merriam-Webster. Retrieved November 10, 2013, from http://www.merriam-webster.com/dictionary/philosophy