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Nursing Philosophy
Aida D. Zuniga
I pledge
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Nursing Defined
Over the course of my nursing education at Bon Secours Memorial College of Nursing, I
have come to understand that there is much more to nursing than just following doctors orders
or taking care of sick people. Nursing is practically an art form, and like any art form, it is
developed and crafted over time. With that being said, as a student nurse approaching graduation,
holistic care that aims to leave the patient in a better state (physically, mentally, and/or
The three tenets of Bon Secours nursing philosophy statement I feel align best with my
definition/philosophy of nursing are to 1.) Practice loving kindness, 2.) Promote and accept
the expression of negative and positive emotions, and 3.) Create a healing environment for the
physical and spiritual self, which respects human dignity, ("Nursing", 2017). Practicing loving
kindness coincides with my definition of nursing because treating patients with kindness builds
trust. As trust is established, the patient is more likely to share his or her needs with the nurse,
which in turn allows the nurse to advocate on the behalf of the patient. Advocating for patients
will then hopefully result in a positive outcome. Much like the practice of loving kindness, the
acceptance of self-expression also fosters trust because the patient does not fear judgment.
Moreover, it enables the patient to be honest with the nurse, which allows the nurse to better
holistically assess the patients needs. Finally, creation of a healing environment that respects
human dignity allows the patient to feel they are in a safe place, where they do not need to fear
judgment, exploitation, or ridicule. The patient will understand that their opinions matter, and
that their wishes will be honored. As such, the patient can relax (at least as much as someone can
Although I am still very new to the world of nursing, I do try to incorporate my personal
philosophy (as stated above) into my nursing practice. I will admit that I am not always
successful, but I make every effort to leave my patients in a better state than that in which I find
them. During my time as a nursing student, I have encountered patients from all walks of life,
some of which are very different from my own. I have cared for patients who practice different
religions, who come from different parts of the world, and who were raised with different
moral/ethical beliefs than the ones I grew up with. I can honestly say that I tried to treat them all
with the same kindness, respect, and compassion regardless of their religion, race, age, gender, or
ethnicity.
As a student nurse, the interventions that I can implement (without the supervision of a
registered nurse) are somewhat limited. However, during clinicals, I always make a point to do at
least one thing on my own whether it is the use of therapeutic touch/listening or simply fetching
a cup of ice water that brings some measure of comfort to my patient and/or their family. I
would like to believe that these interventions, along with those I implement with the help of the
RN, leave my patients in a better state of health (mentally or physically) than they were in before
Nurse-Patient Encounter
During the second semester of my junior year of nursing school, I came across a patient
on the neuroscience telemetry unit whose plight resonated with me. This particular patient had
been on the unit for three days. Because of the patients condition, she was unable to shower
independently, and had been receiving bed baths, which did not allow the patient to wash her
hair. This patient was near hysterics because no one could figure out a way for her to wash her
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hair without using the shower. She repeatedly told the nursing staff that washing her hair was a
part of her daily routine, and she felt dirty and gross having gone for three days without
washing her hair. With a little patience, a large number of towels, a plastic cup, and two clean
washbasins, I was able to shampoo and condition the patients hair while she sat in a chair. It
took a while and made a bit of a mess (which I cleaned up, of course), but the sense of peace it
brought the patient made it well worth the effort. She said she, felt human again. Obviously,
washing a patients hair is not a life saving, revolutionary intervention, but it was something I
was able to do for this patient that made her happy. It brought her comfort, and left her in a better
mental and emotional state of mind. With that being said, I believe that this story is a good
without changing in some way. Prior to entering nursing school, I placed a higher value on
recognition. I thought that being recognized for my work meant that I was doing a good job. As I
entered clinicals, I soon learned that nursing is often thankless work. I learned that the real
thanks comes from seeing your patients recover, and from seeing them go home in better health
and in better spirits. Not being recognized and praised does not mean that Im not doing a good
job; it just means that my sense of validation is not a priority. The priority as a nurse is to
provide high quality, evidence based care for those who are in need of it.
Overall, my beliefs and values have generally stayed the same, apart from what I have
already mentioned about my former need for recognition. I still believe that healthcare is a basic
human right that should not be denied based on someones ability to pay for it. I still value hard
work, as I believe it is the only way to achieve my goals. Above all else though, the thing I value
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most is love. It is the love of my family and friends that has brought me to where I am today, and
it is my love for helping others that allows me to practice the sacred profession of nursing.
Benners Theory
According to Benners From Novice to Expert (2001), there are two types of knowledge:
knowing how and knowing that (p. 2). The first of these refers to practical knowledge
(the acquired ability to perform a skill), while the latter refers to theoretical knowledge (Benner,
2001, p. 2). Per Benner, as a nurse gains experience, he or she transitions from a state of heavily
relying on practical knowledge to a state of relying on his or her theoretical knowledge. As this
transition takes places (over the course of many years), the nurse passes through the following
At the novice stage, the nurse demonstrated less flexibility, and strictly follows the rules,
as he or she has little real-world experience to work off of. Once the nurse reaches the advanced
beginner stage, the nurse beings to recognize aspects, or the immeasurable, non-objective
pieces of data that can only be detected once some level of experience has been gained (Benner,
2001, p.22). The competent stage is reached at approximately the two to three year mark. At this
point, the nurse gains the ability to prioritize and organize his or her tasks. This goal-setting
ability enables the nurse to better manage the unpredictability of nursing (Benner, 2001, p.25-
27). At the proficient stage, the nurse is able to use their experience to view situations as wholes
rather than in terms of aspects, (Benner, 2001, p. 27). This enables the nurse to predict (to some
extent) what will happen in certain cases. Finally, at the expert stage, the nurse no longer needs
to depend on hospital policies and procedures, as he or she now has the experience and intuition
As a part of her theory, Benner (2001) has also identified seven domains of nursing
practice, each with their own set of competencies (p.46). The Helping Role domain simply
speaks to the fact that as one of the worlds most trusted professions, patients will seek help in
many forms from nurses (Benner, 2001, p. 47). The Teaching-Coaching Function domain refers
to the nurses role as an educator. Proper teaching and patient education can have a big effect on
patient outcomes (Benner, 2001, p. 77). Next is the Diagnostic and Monitoring Function domain.
This domain describes the importance of a nurses ability to understand diagnostic results and
interpret what they meaning for the patient (Benner, 2001, p. 95). The Effective Management of
Rapidly Changing Situations domain makes reference to the reality that nurses are often the ones
to pick up the signs that a patients condition is declining. As such, it often falls to the nurse to
handle the situation until the physician becomes available and can take over (Benner, 2001, p.
109). The Administering and Monitoring Therapeutic Interventions and Regimens domain
describes the additional skills a nurse must master beyond simply knowing how to
successfully implement the interventions required for their patients (Benner, 2001, p. 121).
Monitoring and Ensuring the Quality of Health Care Practices is the domain that addresses the
nurses ability to catch mistakes (hopefully) before they negatively impact the patient (Benner,
2001, p. 135). Finally, the Organizational and Work-Role Competencies domain speaks to the
organizational skills a nurse must learn while actually on the job to successfully perform all her
As a nursing student albeit a nursing student who will be graduating in the very near
future I consider myself to be at the novice stage of skill acquisition. The experience I have is
limited to what I have seen and done during my lab simulations and clinicals. Similarly, my skill
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set is limited to what I have learned from my textbooks and what I have practiced in lab (and on
a few occasion, in the hospital setting). If I were to start working tomorrow, I would have to
make my decisions according to what I have been taught in class, existing hospital policies and
orientation training, as I have no real-world experience to guide me. Next semester, I will have
my Immersion experience, which I am hoping will at the very least bring me to the cusp of the
thinking skills, and gain some pseudo-real-world experience. Having said that, Immersion is first
on my list of things I will do to help me progress through the novice stage toward the advanced
beginner stage. Next, I will continue use my textbook, Winninghams Critical Thinking Cases in
Nursing, to practice case studies, as I have found them to be a great way to bring together all the
content I have been taught thus far. Case studies force me to think critically, which is why I
prefer them to practice questions (although practice questions can certainly be helpful, too).
Lastly, I plan to use every opportunity I have to seek advice from more experienced nurses to
learn skills that cannot be learned from a book (time management, organizational skills,
instructors have been during my time in nursing school, and I am positive that my future
preceptors will prove to be just as invaluable. I understand that many different factors combined
with hours of hard work and dedication go into reaching the expert level of nursing skill
acquisition, but I hope that these three steps will jumpstart my progress towards becoming an
expert nurse.
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References
Benner, P. (2001). From novice to expert: Excellence and power in clinical nursing practice
https://bonsecours.com/richmond/jobs-and-education/nursing