Running head: PHILOSPHY OF NURSING CARE AND PRACTICE 1

Philosophy of Nursing Care and Practice

Danielle Beard

Old Dominion University

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Philosophy of Nursing Care and Practice

As my undergraduate nursing education begins to come to a close, it is essential that I

reflect back on my nursing philosophy and how it has evolved since the beginning of my junior

year at Old Dominion University. At the beginning of my nursing education, I based my

philosophy of nursing off of Jean Watson’s Theory of Human Caring, which incorporates the

basic need for an individual to be understood, cared for, and respected, especially when in a

vulnerable place such as when one is in the hospital (Watson, 2010). I emphasized that nursing

care should be holistic and unbiased in which the nurse should give each patient individualized

care that meets their unique needs. Although the basic principles of my personal nursing

philosophy have remained the same throughout my baccalaureate education, they have evolved

and matured as my nursing practice has over the last few years. In this paper, I will be

discussing how my nursing philosophy has changed and ways that it has stayed the same. I will

define what nursing means to me, what purpose I believe nursing serves in society, and other

guiding principles to my nursing practice.

Definition of Nursing

Throughout my time in nursing school, by understanding and belief about what nursing is

has changed greatly. I believe that nursing is a profession that requires a compassionate and

empathetic human being who can care for someone experiencing their worst moment. Although

nursing often consists of tasks such as medication administration, hanging IV fluids, changing

linens, taking patients to the bathroom, charting, and others, nursing is so much more than that.

It’s comforting someone who just lost a loved one, celebrating with a family who just welcomed

a new baby into the world, grieving with a mother who just lost their child, and supporting the

patient that is fighting cancer again for the third time. As a nurse, I am privileged to be a part of
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each of these unique and beautiful moments and am able to have an intimate knowledge of my

patient’s fears, concerns, apprehension, excitement, and all emotions in between. Nursing is a

field that requires a passion and drive to be there for someone else even when it is difficult or

seems impossible.

The American Nurses Association (ANA) (2012) outlines a nurse’s responsibility as

using “their judgment to integrate objective data with subjective experience of a patient’s

biological, physical and behavioral needs […, ensuring] that every patient, from city hospital to

community health center; state prison to summer camp, receives the best possible care regardless

of who they are, or where they may be” (para. 4). This idea that all patients, regardless of their

background, should receive proper care is the basis of my definition of nursing as well as my

nursing philosophy. In addition, provision one and two of the nursing Code of Ethics are central

to my beliefs regarding nursing practice. Provision one states that “the nurse practices with

compassion and respect for … every person” and provision two discusses how the nurse’s

commitment should be to the patient only, whether it be one individual or a whole community

(ANA, 2015, p. 5). This ideal matches perfectly with what I believe nursing is.

Purpose of Nursing

As stated earlier in this paper, nursing goes far beyond the simple tasks of handing out

medications and the various responsibilities nurses have throughout their shift. Nursing should

be holistic in nature and address every aspect of a patient’s needs, such as their emotional and

spiritual well-being, not just their physical self. We are to meet a patient where they are in their

journey through life and care for them in that moment, without hesitation or judgement.

My journey to pursue a career in nursing was a very simple one. I have always enjoyed

learning about medicine, the human body, and how body systems interact to function as a whole.
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When I was in high school, I was in a medical and health specialties program which allowed me

to learn about the vast number of career paths available in medicine. Nursing had caught my

attention because of the very hands on interaction that they have with patients. I have always

been inclined, even as a child, to help anyone out that needed it, which is the essence of nursing.

I also grew up in a Christian household where serving others was emphasized and was the central

idea behind my faith.

Thinking back on when I originally decided to go into nursing school, I actually had a

very inaccurate representation of what nurses actually did, however, after starting school, I

discovered that although nursing was very different than what I pictured, it was still the perfect

career for me. Pediatric nursing had always been an interest of mine, and as I got further into the

program, I found that I loved critical care and its aspects, thus sprouted my desire to work in the

PICU.

Assumptions

The Nurse and the Culturally Diverse Client

Each patient that the nurse interacts with is unique: they have their own culture,

preferences, and opinions about healthcare. In order to provide appropriate and individualized

care, a nurse must take this diversity into account when catering to patient needs. One theory

that supports this idea is Madeleine Leininger’s Transcultural Theory of Nursing, which

emphasizes the idea that the “values and beliefs passed down from generation to generation can

have as much of an effect on a patient’s health and reaction to treatment as the patient’s

environment and social life” (Nursing Theory, 2016, para. 3). Many people think of culture as

something as surface level as someone’s skin color or ethnicity, but as a nurse, we must

acknowledge that it goes much deeper than that and includes things such as food choices,
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relationships, health practices and customs, and many others. When I provide care to my future

patients, I must be sure to not only look at their physical attributes, but also the social and

cultural dimensions of their health as well.

The Nurse and the Community

Baccalaureate prepared nurses have a unique education provided to us that incorporates

teaching regarding community needs. As a nurse it is essential that you participate and engage

with the community around you, especially with vulnerable populations who would benefit from

a nurse’s involvement in their activities. This also relates back to nurses in the culturally diverse

setting: in order to effectively care for patients with diverse backgrounds, the nurse should first

have an understanding of the community that is around them so that they understand where their

patient is coming from and what their individual struggles might consists of. The nursing theory

that I found matched this requirement was Florence Nightingale’s Environmental Theory.

Although her theory focuses largely upon the patient’s physical environment in the hospital

setting, such as the temperature and cleanliness of their hospital room, the last principle states

that nurses should “consider not only the individual patient but the context of where he or she

lives,” indicating that the patient’s environmental conditions outside of the hospital influence

their health just as much as any other medication or intervention (Union Media, n.d., para. 11).

The Nurse and Other Healthcare Professionals

Throughout their practice, all nurses interact with some sort of other healthcare

professional, whether it be a doctor, fellow nurse, physical therapist, radiologist, pharmacists,

and a wide variety of others. In order to foster the best care for patients and their families, we as

nurses must remain professional and respectful to all peers. We should strive for teamwork,

effective communication, and work to involve the patient as much as possible. The more we
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communicate, the better off our patients are according to Imogene King’s Theory of Goal

Attainment.

Principles

Ethical principles such as autonomy, benevolence, confidentiality, and informed consent

are all basic rights that all patients should be provided with. Nurses should go above and beyond

expectations to ensure that all individuals are afforded these basic rights. The first ethical

principle that has guided my nursing practice so far is patient confidentiality in which all patients

is “personal and fundamental” (American Academy of Family Physicians, 2018, para. 6).

Although the idea of confidentiality seems like a simple act to follow, it can often be very

difficult to maintain. I personally experienced these difficulties over the summer of 2018 during

my pediatric clinical rotation. While I was on the oncology unit at a local children’s hospital, I

was informed about a teenage patient who had recently been unexpectedly diagnosed with a very

severe type of cancer and had only a few months to live. I was saddened to learn about her

diagnosis and hear about her struggles coping with her diagnosis while at clinical. About a week

later, a friend of mine was talking about how one of her very close friends had been diagnosed

with cancer and was in the hospital on hospice care. I found out that her friend was in fact the

patient I had cared for not even a week prior. This was a struggle for me as I wanted to comfort

my friend, but also had to maintain the confidentiality of my patient as well. This experience,

although very sad, allowed me to grow as a nurse and provided a very powerful lesson regarding

the invaluable concept of patient confidentiality.

The second ethical principle that I have utilized consistently throughout my nursing

practice is autonomy, which is defined as the “right to make decisions regarding care, even when

their decisions contradict their clinicians’ recommendations” (Sedig, 2016, para. 5). Autonomy
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is vital to making the patient feel as though they have control over their situation and gives them

full right to choose what is done in regards to their care. While in clinical, I often saw older

patients who were incapacitated and could no longer make decisions for themselves, such as

those with severe dementia. Although these patients have very little understanding of the

environment that they are in, they still have the feeling of losing control. Because of this, I

would always try and incorporate small tasks that they could have autonomy over, such as what

time they had a bath, what they want to eat for their meals, and other simple decisions. This

made them feel independent and I often found that it improved their moods throughout the day.

Conclusion

Since the beginning of my nursing education, I believed that nursing was a holistic

practice that should involve all aspects of a patient’s life. However, now that I am finishing up

my senior year in school and am revisiting my original nursing philosophy, I can see how my

views and opinions about what nursing is has expanded and matured from what it was two years

ago. I am excited to go into my first job as a practicing nurse with this expanded nursing

philosophy and look forward to seeing how it continues to evolve over the many years to come.
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References

American Academy of Family Physicians. (2018, January 04). Confidentiality, Patient/Physician.

Retrieved from https://www.aafp.org/about/policies/all/patient-confidentiality.html

American Nurses Association. (2012). What is nursing & what do nurses do? Retrieved from

https://www.nursingworld.org/practice-policy/workforce/what-is-nursing/

American Nurses Association. (2015). Code of ethics for nurses with interpretive statements.

Retrieved from http://nursingworld.org/

Nursing Theory. (2016). Madeleine Leininger - Nursing theorist. Retrieved from

http://www.nursing-theory.org/nursing-theorists/Madeline-Leininger.php

Sedig, L. (2016, January 01). What's the role of autonomy in patient- and family-centered

care when patients and family members don't agree? Retrieved from

https://journalofethics.ama-assn.org/article/whats-role-autonomy-patient-and-family-

centered-care-when-patients-and-family-members-don't

Union Media LLC. (n.d.). Florence Nightingale's Environmental Theory. Retrieved from

https://uniontestprep.com/hesi-exam/blog/florence-nightingale-s-environmental-theory

Watson, J. (2010). Caring Science Theory. Retrieved from

https://www.watsoncaringscience.org/jean-bio/caring-science-theory/
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Philosophy of Nursing

NURS 314- Foundational Concepts

NURS 481- Role Transition

Purpose of the Assignment: The purpose of this assignment is to enable the student to

rediscover his or her personal philosophy of nursing as it exists upon the completion of the

baccalaureate nursing program.

Student Approach to Assignment: My personal philosophy of nursing is what will guide my

nursing practice throughout years to come. I was able to analyze my beliefs about what nursing

is, its purpose, and clarify what values I felt were most important to my practice. Including an

assignment that incorporated my nursing theory from the beginning of the nursing program till

graduation allowed to me to see how my views about nursing had evolved, expanded, and

matured over the years. It also made me more aware of how my professional behavior can

influence my patients and makes me want to strive to be the best nurse I can be at all times.

Reason for Inclusion of this Assignment in the Portfolio: This assignment allowed me to

showcase my development over the years in the program and share some of my experiences

throughout. It displays what I believe nursing is and truly should be. The end-of-program

objectives that are identified are as follows:

 Critical Thinking
o Uses nursing and other appropriate theories and models to guide professional

practice
 Example: I discussed how the nurse should interact with three entities: the

culturally diverse client, the community, and other healthcare

professionals. I used three theorists to support my claims. See paragraphs

6-8 on pages 4-6.

 Leadership
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o Articulates the values of the profession and the role of the nurse as a member of

the interdisciplinary healthcare team

 Example: I incorporated Watson’s Theory of Human Caring to support my

definition of nursing and nursing practice. See paragraphs 1 and 2 on

pages 2-3.
 Professionalism
o Applies an ethical decision-making framework and legal guidelines to clinical

situations that incorporate moral concepts, professional ethics and advocacy for

patient well-being and preferences

 Example: I applied the ethical concepts of patient confidentiality and

autonomy to real-world scenarios that required professionalism and

adherence to a higher standard. See paragraphs 9 and 10 on pages 6-7.

 Culture
o Integrates knowledge of cultural diversity in performing nursing interventions
 Example: I emphasized that nursing is not just the care of the physical

symptoms presented on a client, but it is in fact holistic and should

incorporate all aspects of a patient’s well-being, including thei cultural and

social background. See paragraph 2 and 3 on pages 2-3.