Running Head: Philosophy of Nursing 1

Philosophy of Nursing

Elizabeth Shook

NUR 4144 Synthesis of Nursing Practice

October 16th, 2018

Dr. Christine Turner

“I pledge”
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Definition of Nursing

The definition of nursing is multi-faceted and is defined differently for each nurse..

Nursing is lifelong learning, not only of the medical side but of the personal call to serve for each

nurse. Nursing is being an advocate for the best interest of your patients. The Bon Secours

Memorial College of Nursing clearly states their mission and values include compassion, quality,

and service. Compassion is foundational to not only to our nursing education but to our future

nursing careers. Compassion drives nurses to put other people first. The quality of our nursing

care stems from the lifelong learning, which we have committed to. Our education doesn’t stop

once we graduate. It can be argued that our education will have just begun. After we graduate,

we will spend 3 months or more learning how to adapt our education to real nursing practice, and

continuing advances in medical care require us to learn during our entire careers. In addition, we

will educate our patients. Patients are entitled to informed decision making, and we also educate

them of their conditions and illnesses. Lastly, service is another large part of nursing. At the

college of nursing there are multiple opportunities for service from service learning classroom

projects to the global outreach programs. Service is key in the definition of nursing because we

take care of and serve patients who are sometimes unable to take care of themselves. We put

their needs ahead of our own

Personal Philosophy

My personal philosophy of nursing includes many different ideals. I try to embody

compassion, proper medical ethics, and advocacy. Ethics is still a piece of my philosophy that

will need continuing lifelong learning throughout my career. I am vigorous in protecting my

patients rights and confidentiality. Ethics is not only about HIPPA compliance; it includes
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recognizing that unique situations can occur because each patient is different. Sometimes

situations can arise where the best interest of the patient is not what the patient or family wants.

In these situations it is our duty to summon an ethics committee to discuss the merits of the

situations and work with the patient and family to come up with a plan of care.

Compassion and advocacy are other aspects of my personal philosophy. I am a strong

believer that compassion will go a long way in forming a bond with our patients. A smile,

holding someone’s hand during bad news, or even just taking an extra minute to listen to what a

patient wants to talk about in my experience makes it easier for my patients to learn to trust me.

Trust is key when building a working nurse-patient relationship. Advocacy is another part of this

philosophy; we are the advocates and the voices for the patient when they have no one to stand

up for them. Advocacy can range from adding another medication to their med list or contacting

home health services for continuation of care after discharge from the hospital.

Nurse-Patient Encounter

Recently, I had a patient that put my current philosophy statement to the test. During my

clinical immersion experience I met a patient and her husband who knew a family member of my

significant other. I knew from the start of the encounter that I cannot come home and exclaim

that I met this client and her husband. I stayed silent and do not discuss my clinical experiences

outside of the hospital or in school except for educational purposes; I maintained confidential

PHI. During the time that the patient was in my care, I maintained a kind and compassionate

attitude; I routinely offered assistance not only to the patient but also to their family (drinks,

pillows, etc.). I answered all their questions even the ones they had about where I was in the

nursing program. I thanked the client and her husband when they wished me luck in the coming
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months. I also relayed and advocated for their requests, such as what pain relief she wanted

during her stay on our floor to the appropriate health care team members.

Values and Beliefs

Values and beliefs can change throughout one’s lifetime based on their experiences. They

can spend their childhood learning one set of beliefs and values and change them once they reach

adulthood and accomplish goals that they had set for themselves. I know that I am a different

person from the time I received my nursing school acceptance to now, only 2 months away from

graduation. I have seen and accomplished so much, that I don’t even recognize myself when I

reflect on who I was as a sophomore. That being said, I don’t think that my personal values and

beliefs have changed too much. They might have grown stronger, and I am more confident in my

convictions but I don’t believe they have changed. I came into nursing school with the belief that

all people are equal and have a right to equal quality of care. I am a firm believer that health and

access to healthcare is a human right and regardless of background, ethnicity, or socioeconomic

status patients deserve the same quality of treatment. These recent years in nursing school and in

the current American climate have definitely educated me on my stance on healthcare access.

I believe that patients have a right to privacy and a right for advocacy. Overall, the nurses

and classmates that I have trained with have been vigilant about not letting the PHI of patients go

outside of the care team, but sometimes I can see medical team members discussing patient

status with an unprofessional tone and it reminds me not to engage in that behavior or bad habits.

I also sometimes see the fatigue that causes medical team members to shortcut or not give their

100% focus to their patients. I know in today’s fast paced and pressured medical field it can be
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difficult to give our patients the individual care that we wish we could give, however it serves as

a reminder to me to give my best to all patients.

Benner’s Theory

Benner’s Theory is based on her book From Novice to Expert: Excellence and Power in

Clinical Nursing Practice in which she describes the 5 stages of development for nurses, ranging

from novice to expert as her book title states. This book also covers the professional practices

and values that are commonly observed in today’s modern nursing. Benner starts her theory with

stage 1: the novice level. Novice is defined as beginners with little to no experience. These are

often students and recently graduated RN who only focus on the hard facts and limits of

physiological state which are context free (Benner, 2001, pg. 21). Benner uses the example of

nurses and students calculating I&O levels; she says that because they haven’t seen these

situations they need to have rules and guides to help them respond effectively (Benner, 2001, pg.

21). Benner next talks about stage 2: the advanced beginner. Benner says that the advanced

beginner is able to “note the recurring meaningful situational components that are termed aspects

of the situation” (Benner, 2001, pg. 22). She uses the example of a new nurse assessing the

learning capabilities of a patient with a new diagnosis. Next in Benner’s theory is stage 3:

Competent. The competent nurse is one that has been employed for a couple of years and he or

she can start to see the long-term goals of their care. They are not as fast or flexible as a higher

level nurse but they can master the lower skills and are able to keep up with the changes in their

patients (Benner, 2001, pg. 27). Stage 4: proficient nurse is the stage were the nurse is able to see

the patient and their situation as a whole and can learn what to expect in the future from said

situation (Benner, 2001, pg. 28). The final stage is stage 5: expert. This nurse is able to rise

above simple skill knowledge and has a firm grasp on the patient’s situation without resorting to
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“wasteful consideration of a large range of unfruitful, alternative diagnoses and solutions”

(Benner, 2001, pg. 32). This stage only comes with years of throughout experience and lifelong

learning.

Skill Acquisition

After reviewing Benner’s Theory, I have come to the conclusion that I am at stage 2: an

Advanced Beginner. According to Benner, advanced beginners have moved beyond just

understanding skills and are starting to understand the bigger picture. These are skills I have been

trying to hone during my immersion experiences. I am by no means competent or proficient yet

as I do not have my license and have not started working. However as senior in nursing school I

am quickly mastering the basics and are starting to look at the bigger picture. Some of this

includes my advocacy skills. I need to start learning to anticipate the needs of my patients and

their families, to be able to convey my assessment to the other members of the healthcare team.

For example, this semester I am on the Labor and Delivery Unit at St. Francis and I encountered

a situation that I feel fits into my current level. My patient was a laboring mom who complained

of shortness of breath when I came in to round on her. I listened to her lungs and quickly

discovered that she had wheezing and rhonchi. I conveyed this to my nurse preceptor and we

called the hospitalist on call and received an order for an albuterol breathing treatment. We then

called the respiratory team, who quickly came in to administer the treatment. I understood that

my patient needs to have a clear and functioning airway in order for her to withstand the labor

process which can include heavy breathing patterns. It was a possibility that her airway could

have gotten worse, therefore restricting oxygen to her and the unborn fetus.
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Action Plan for Moving Forward

So my next plan of action is to advance my nursing skill proficiency. I can do this by

lifelong learning, seeking out new experiences, and following the lead of more competent nurses.

Lifelong learning is a given in the medical field. I can already expect to continue my education

not only in my nursing skills, but in my career; a bachelor’s degree will not be end of the line for

my education. Seeking out new experiences is something I need to incorporate into my nursing

care especially during my first year of employment. If I see a new skill or new illness and disease

process, I can ask my preceptor and fellow nurses about it, and how we would treat it with

nursing care. And last I need to follow the lead of more experienced nurses. This can mean my

nurse manager or preceptor or a nurse role model. Either way, I know that having someone to

look up to can boost my confidence and provide a place for me to ask questions and grow as a

nurse. I know that when I graduate, I will be very new and the only way for me to grow is to seek

out the experiences of other nurses. This will be important for not only me and my patients, but

for the future nurse who will be looking up to me someday. This plan of action starts now and I

will continue to grow and learn and change for as long as my career in nursing lasts.
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References:

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

Upper Saddle River, NJ: Prentice Hall.