Running head: NURSING PHILOSOPHY 1

Nursing Philosophy

NUR 300 2W1

Katelyn Tilghman, RN

February 18, 2019

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Nursing Philosophy: Week 6

Nurses are medically trained professionals who are dedicated to teaching and providing
quality care to patients. Nurses have an immense amount of responsibility. The main roles of
the nurse can be summarized by the nursing process we are taught in nursing school. The
nursing process: Assessment of the patient, analyzing assessment data to form a diagnosis,
identifying expected outcomes, collaborating with other healthcare professionals to develop a
plan of care for the patient, preforming identified interventions, and teaching while
evaluating outcomes. Nurses are ranked first as the most ethical profession. Nurses are the
heart of healthcare, practicing in a wide range of environments. The most important
characteristics of a good nurse are empathy, compassion and integrity. A few others that
come to mind are strong communication skills, interpersonal skills, and excellent time
management. When I graduated from Chesapeake College’s nursing program in May of
2016, I was excited about all of the opportunities that would come my way as a brand new
nurse. I had an idea of the field of nursing I would like to pursue, and I have always had big
dreams. Today I can say I am a completely different person than the girl that walked across
the stage on graduation day. Being a nurse has changed my life in many ways. We had a
powerful speaker at our graduation talk about how being a nurse would become a way of life,
and it certainly has become my life. As I reflect on the last three years, I am in awe. I have
been blessed to work not only in critical care, but also in mental health in that time. My
current role is working in adolescent mental health, where I see children and families at their
absolute worst. I take care of the children and their families, working closely with the
treatment team to make a plan not only for optimal physical health but their mental health. I
have never felt more fulfilled, because this allows me to take care of the “whole” patient and
carry out a more holistic care plan. Although my field of nursing has changed in three years,
my philosophy has not. I am devoted to my personal and professional growth. I will provide
holistic, patient-centered care. I will always remember how I felt as a new nurse, and will
lead and guide new nurses on a path to excellence. I will exceed the standard of care,
collaborating with the team of professionals working with me to care for my patient. Finally,
I will advocate for my patients. I will do everything I can to practice with beneficence,
preserving their dignity.
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Being a good nurse means to keep the patient and their family at the center of care
provided. We need to never forget the reason we decided to become a nurse in the first place.
I am a strong believer in holistic nursing. This involves looking at all aspects of the patient,
identifying treatment goals, and including the patient as an active member of the healthcare
team to achieve optimal care results. A great nurse takes time to explain treatment, educating
the patient and their family while maintaining the patients dignity. It can be easy to fall into a
task oriented practice when there are many responsibilities and deadlines. We are often times
seeing patients when they are ill and vulnerable, and it is often the nurse that makes or breaks
their treatment experience. We have a responsibility to our patients to show up as the best
version of ourselves, and provide the quality care we were taught to provide. We must
remember that anything we can do, can be done by another nurse. The nurse that takes the
time to make their patient feel more human by listening to their concerns and going the extra
mile, will be the one they remember the most. The main thing I want to see when I look back
on my career as a nurse is that I helped as many people as I could, and I was able to be a
mentor to new nurses coming into the profession. I have a responsibility to keep myself well,
so I can present my best self to my patients and uphold the reputation of nursing being the
most ethical career. If all goes as planned, I will graduate in the winter of 2020 with my
BSN. I then plan to apply to Walden University to their BSN-MSN program, where I will
study to become a psychiatric-mental health nurse practitioner specializing with the
adolescent population. I at that time will have a good amount of experience working with the
adolescent population, and with the education I will have, I will be able to successfully
accomplish my professional goals and dreams.
When I reflect on my personal values, I identify them as integrity, authenticity, and
personal growth. Professionally, I would identify them as teamwork, excellence, and
beneficence. My current job aligns with my personal and professional values, which helps
me to feel more satisfied with my work than I have in past positions. I now am a highly
valued employee at SUN Delaware because I am known to do the right thing, advocate for
best care practices, and will be the first to volunteer to help where help is needed. To satisfy
my value of personal growth, I have a plan for my future which includes furthering my
education. Furthering my education will not only help to open new doors for me
professionally, it will help me gain valuable knowledge I will be able to integrate into my
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daily practice. Nurses are constantly learning new things whether it be through a new drug
being released, a training seminar, a new policy, a patient experience, etc. There are many
benefits to lifelong learning, but I think the most significant is how it helps us to keep our
minds open and find our niche in the professional world. Nurses are required to take a broad
range of courses to prepare us for nursing programs. I value knowledge in all subjects, and
truly believe the general education courses I have taken and will take in the future have made
me a more well-rounded individual as well as a better nurse. There have been many studies
to support that BSN-higher prepared nurses provide safer nursing care, and well as overall
promoting better health outcomes for their patients. I have been working a lot as a charge
nurse, but I would like to eventually move into a supervisor position while furthering my
education. The opportunities we have as nurses are endless, and it is up to us to do the work
to achieve our full potential.
I feel I can relate to Imogene King’s goal attainment theory the most in my practice as a
psychiatric nurse. Imogene King defined nursing as “a process of human interactions
between nurse and client whereby each perceives the other and the situation; and through
communication, they set goals, explore means, and agree on means to achieve goals”
(Petiprin, 2016). King’s goal attainment theory is rather dynamic, but is very realistic in the
psychiatric world as it looks at the importance of therapeutic relationships in relation to
treatment goal achievement. I think now more than ever, I can relate to the holistic approach
Imogene King had as I am working with the adolescent population. I work closely with
parents, and see the many different factors influencing my patient’s current state. It is my job
to work with the healthcare team to assess, identify problems, develop goals/identify desired
outcomes, and assist the patient and family by providing resources to achieve the identified
goals. Imogene King’s goal attainment theory “has three interacting systems: personal,
interpersonal, and social. Each of these systems has its own set of concepts. The concepts for
the personal system are perception, self, growth and development, body image, space, and
time. The concepts for the interpersonal system are interaction, communication, transaction,
role, and stress. The concepts for the social system are organization, authority, power, status,
and decision-making” (Petiprin, 2016). I really like how King breaks down her theory,
because it again shows how complex nursing is while reminding us how dynamic our patient
is that sits before us. They are more than a diagnosis or a room number. The children, and
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their families, are in crisis at the time they are brought to me to get help. I chose King’s
theory based on her emphasis on the importance of a therapeutic interpersonal relationship
with patients and their families. I feel we all have something we can learn from every patient,
and if we treat them as such, most of the time it will be a better interaction. King’s theory
aligns with my personal and professional values by considering the importance of the nurse-
patient relationship. By keeping care patient centered and collaborating with the treatment
team, there will be increased satisfaction and improved patient outcomes.
I reflect on my own wellness goals identified when I remember Imogene King’s goal
attainment theory. As a nurse and a mother, I spend a majority of my time caring for others. It is
important to remember our own wellness is a priority. In my practice I strive for excellence, and
by doing this I can at times put my own personal needs on the backburner. Working in mental
health can be physically and emotionally draining. Prior to my current job, I was working in
intensive care, where I saw far more tragedies than happy endings. I have witnessed horrific
things. It is important as nurses we take the time we need to process the things we see, and do
what we need to do to nurture our own mental health. We are also complex beings, needing a
balance between our many responsibilities. I owe it to my patients to come to work as the best
version of myself, so I am able to provide the best care to them. I was able to identify areas of
strengths and weaknesses I have in my own wellness, and I have been working to improve
myself daily. I am very fortunate to have a strong support system to help me do this.

After taking the conflict management style assessment, I scored “collaborating” as my

most used conflict resolution style. I think the “collaborating” style fits my personality type,
because I am all about teamwork, considering the needs and opinions of everyone involved while
still solving the issue. Working in mental health, collaborating is the preferred conflict resolution
style since there are so many care providers for one child. To achieve the best result for the
patient and their family, we often come together in meetings with the patient’s family and all
providers to discuss options before we implement a care plan. This also fits well with Imogene
King’s goal attainment theory I identified as most closely relating to how I practice nursing. By
including the patient and their family in the plan of care, the providers are able to identify goals
that are achievable with the patient to promote treatment compliance and improve patient
outcomes.
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In mental health as in other healthcare facilities, safety is the top priority when providing
care. The Quality and Safety Education for Nurses (QSEN) identifies safety competencies to
remember when providing patient care. Those are: Patient-centered care, teamwork and
collaboration, evidence-based practice, quality improvement, and safety and informatics. Patient-
centered care is the idea that the patient needs to be well informed and actively involved in their
treatment plan. Not everything in healthcare will be black and white. Teamwork and
collaboration refers to the interactions between all members of the healthcare team when it
comes to patient care decisions. Collaborating with all levels of the healthcare team is essential
in promoting the best care. Evidence-based practice refers to the utilization of research and
supporting evidence in healthcare to promote the safest and highest quality care. Quality
improvement refers to data collection and evaluation for improved patient outcomes. Safety and
informatics focuses on preventing harm and utilization of resources to promote safety and quality
care. The most important qualities of a health care provider is the ability to be a team player and
keep care patient centered, which are strong values of mine as a nurse. You will have to learn to
work with many different personalities and various members of each specific patients healthcare
team. Nurses are known as the heart of healthcare for a reason. We are usually the last line of
defense, so at times, we can get more backlash from leadership when we express a concern
initially. As a new nurse this can be intimidating. We go to work to do what we love and to
advocate for our patients. The best way to handle a conflict is to follow the chain of command,
starting with addressing the problem to the appropriate person and providing safe, quality
nursing care to your patients while working towards a plan or solution. Having “huddles” with
all the staff involved in that patients care is essential to express any concerns, to highlight
anything of urgency, and work collaboratively on finding a solution to provide the best care. We
are human and do not always do everything perfect, no matter how much experience or
knowledge we believe we have. We will always see things to challenge us and help up grow as
providers. Everything should be taken as a learning experience.

Now that I have been a nurse for about three years, I am more confident and starting to
take the lead much more than I would have as a brand new nurse. Good leaders have excellent
communication skills, they are passionate, fix problems collaboratively, are supportive but
driven, and are confident but humble. A few other examples of successful leadership in nursing
is remembering how you felt at the beginning of your career, and remembering your core values.
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There is a quote I was told in my nurse residency by a nurse that has been practicing over thirty
years by Patch Adams, stating “You treat a disease: You win, you lose. You treat a person, I
guarantee you win- no matter what the outcome”. I think this quote changed the way I took on
every patient assignment. When I am charge nurse now I always remember that quote. I strive to
inspire new nurses to get excited about their jobs, and really show up for work by giving your
patients the best version of you. If you do not feel that much passion about your position, you
should consider switching fields.

Working in mental health in leadership, I am fortunate to be able to implement my

personal and professional values and use what I have learned over the years to help others. I will
always practice with integrity, keeping my care patient centered. I will always collaborate care
decisions with the healthcare team to get the best possible plan in place for my patient. I will
always practice mindfully with beneficence. I will continue to learn new things daily, because I
will never know all there is to know. I will not give up on my dreams to further my degree. Most
importantly, I will find a healthy balance between my work life and home life, so I will be able
to be the best version of myself not only for my family but for my patients and their families. I
am so thankful to be a part of the nursing profession, and I am excited to see what the future has
in store for me.
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References

King, I. (2001). Imogene King: theory of goal attainment. Nursing theories and nursing practice,

275-286.

Petiprin, A. (2016). Imogene King-Nursing Theorist. Retrieved from: http://www.nursing-

theory.org/nursing-theorists/Imogene-King.php

Sherwood, G., & Zomorodi, M. (2014). A new mindset for quality and safety: The QSEN
competencies redefine nurses’ roles in practice. Nephrology Nursing Journal, 41(1), 15-
22, 72. Retrieved from http://www.prolibraries.com/anna/?select=session&
sessionID=2965