Running head: PERSONAL PHILOSOPHY OF NURSING 1

Personal Philosophy of Nursing

L. Blair Holston

Synthesis for Nursing Practice- NUR 4142

March 5th, 2018

Christine Turner, PhD, RN

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Section I

Since childhood, I have always dreamed of working in the medical field. I am becoming

a nurse so that I can provide care and comfort to those that are sick and dying. While doctors aim

to cure disease and illness, a nurse’s role is to care for the patient. I’m not trying to criticize

doctors or accuse them of lacking compassion; I just think that nursing encompasses a bigger

perspective on patient health that seeks answers beyond the cure for disease. Nurses provide

holistic care to their patients alongside hands-on skills and medical treatment. Nursing skills can

be learned, but in order for caring to take place, your heart has to be invested in the work.

Health professionals need to take into account the emotional, spiritual, and environmental

factors happening in a person’s life. Health is a subjective concept that embodies multiple

elements of a person’s life, not just their physical health. As a nurse, it’s my duty to make sure

that all of these elements are taken into consideration when caring for patients. According to

Schiltz, Taylor, & Lewis, “Health is not seen as the absence of disease, but as a process by which

individuals maintain their ability to develop a meaning system that will allow them to function in

the face of changes in themselves and their relationships with their environment” (Schiltz,

Taylor, & Lewis, 1998, p.48). This definition of health has guided me through my final

semesters of nursing school and has helped shape who I am as a nurse.

When a person first becomes sick, it’s hard for them to see the bigger picture of their life.

Their mind becomes cluttered with fear and anxiety and they solely focus on the disease. It’s a

nurse’s job to help this person regain perspective of their life and find meaning alongside

sickness. Health can exist in the presence of illness and disease, so long as there is some level of

control given to the patient. Control can be the remission of a disease or it can be as simple as
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being at a state of emotional acceptance with the disease. Disease doesn’t always have to be the

opposite of health; sometimes disease is just another component of a person’s health.

Nursing is a process of caring that encompasses the mind, body, and spirit of individuals.

Nurses are people who advocate for their patients and keep them from harm's way. A nurse is a

person who is willing to explore the deeper levels of their patient’s life in a non-judgmental, and

compassionate way, so that they can build trusting relationships. It’s a nurse’s job to educate

their patients about their health, and guide them to a healthier lifestyle or a higher sense of self.

Nursing is a practice that must be tweaked to the individual needs of a patient’s cultural,

spiritual, emotional, and physical well-being. Caring will vary from patient to patient, and it’s a

nurse’s duty to be flexible in their delivery of care.

Section II

In my nursing practice, I strive to provide each of my patients with compassionate care. I

think that being kind and positive in front of my patients makes the biggest difference. Even

when a patient is notorious for being mean or annoying, I always try to approach the situation

with a smile and go from there. Some patients will criticize everything you do, no matter how

well you do it; they may even be wrong in their corrections. I used to have very little patience

with these kinds of people. However, since starting nursing school I have come to understand

that this type of behavior is a coping mechanism. It’s still difficult to care for these patients, but

having that insight makes all the difference in my demeanor towards them. A patient’s time in

the hospital is something that they might remember for the rest of their life, and I would hate to

think that someone might carry the memory of a nurse who was rude to them when they were

sick.
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When a patient has been difficult throughout the entire shift, it’s important to remain

unbiased and professional during shift report. Although it may seem necessary to “warn” the

oncoming nurse about a patient’s obnoxious behavior, it’s not fair to them or the patient. Unless

the patient is confused or in danger of harming themselves or others, I try not to relay that

information. Telling the oncoming nurse about how terrible a patient has been will only start

their day on a negative note, and it may cause barriers to care during the shift.

Nursing is a field that requires teamwork among co-workers. This includes fellow nurses,

physicians, turn-team members, social workers, and anyone else who comes into contact with the

patient. It’s crucial to maintain civil relationships with the interdisciplinary team because the

patient’s care depends on it. Even the smallest petty comment can cause barriers and delay care

to the patient. Sometimes disagreements can’t be avoided, but when they do occur, I always try

my best to get over it and move forward.

Section III

My clinical immersion course continually provides me with opportunities to learn and

grow as a nurse. On one of my first days, my preceptor and I were assigned to a patient that

required total care. The patient had suffered from a traumatic brain injury almost ten months

prior, and had been stuck in a comatose-like state ever since. They had a tracheostomy, a feeding

tube, and a massive pressure ulcer on their sacral area.

I was already familiar with this patient from working as a patient care tech on another

unit. This patient was what the staff on other units referred to as a “placement issue”, as they had

been on multiple units throughout their ten month stay. Although not in the patient’s room, the

staff would often imply that they thought the patient’s family was mean and crazy. Some people
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even said that the family was only keeping him alive to reap social security benefits. The family

wouldn’t allow the patient to watch television at any time, and the only form of entertainment

that they allowed was a few gospel CDs. The patient’s family made all decisions regarding care,

and they had chosen not to use anything stronger than Tylenol for pain.

Getting to care for the patient as a nurse gave me deeper insight into the patient’s family

situation. My preceptor is always an amazing example of how to provide unbiased care, and

despite everything on file about this patient’s family, she treated them with kindness and respect

when they came to visit. We made sure to update them about the patient’s care and we spoke to

them with a gentle voice and a smile on our faces. We asked the family member how they were

doing and we provided them with an outlet for their grief and distress. While we were talking, I

could see this earnest look of desperation in the family member’s eyes and it made me so sad.

She was glad that we were checking in with her and she seem relieved that we were treating her

with compassion. I realized that the family had probably gotten a lot of backlash from other staff

members and they could probably sense that the staff was getting fed up with them. It made me

think of how scary it would be to have a family member being cared for by people who are

outwardly annoyed with you. When I saw the family interact with the patient, it was clear that

the patient was happy to see them and there was no indication that the family was trying to take

advantage of the situation. I could see that the family only wanted what they thought was best for

the patient.

This situation really solidified my personal beliefs about how patients and their family

members should be cared for. I think that the other staff members were trying to advocate for the

patient, but it gets difficult when the patient is nonverbal and the family makes decisions that
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differ from you would do. Even when differences arise, it’s really important to maintain a

non-judgmental and understanding demeanor so that trust can remain between you, your patient,

and the patient’s family. I think that a lot of what happened in this situation damaged the

family’s trust in the staff’s ability. It’s a nurse’s job to honor practices and beliefs of the patient,

unless it becomes detrimental to the patient’s health. I think that nurses should be willing to

explore religious beliefs of the patient and their family before branding them as people with

unrealistic expectations. As unrealistic as their expectations may seem, we have to be willing to

hear them out, otherwise we’ll lose the trusting relationship.

Section IV

My values and beliefs as a nurse have changed dramatically since the beginning of

nursing school. I wish I could say that my initial interest in nursing stemmed from a calling to do

good unto others, but my original reason for going to nursing school was so that I could enter a

growing field and have a great career. On the first day of nursing school, one of my instructors

told the class that you can’t be a nurse if you’re only in it for the money. She insisted that you’d

burn out and be unhappy. Since my first semester of clinicals, I believe her words to be true.

Being driven by success is a great place to start, but in order to be a great nurse, you need the

desire to care for others.

I think that some people are naturally gentle and calm, and are born with an ideal nursing

personality. I am not one of those people, as I tend to have a loud and energetic nature. Through

nursing school, I have learned to have a kind and gentle presence around my patients. Although

it’s not my natural state, it’s very sincere. I don’t know how or why, but it has become an easy,

second-nature, for me to be a calm, caring, and gentle person in front of my patients. I feel like
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I’ve completed a transformation through my years in nursing school and I truly value having

those character traits as a nurse. Nursing is a very humbling practice, and although it’s not for

everyone, I believe that it forces individuals to grow and see a stronger side of themselves. My

experiences in nursing school have led me to value compassion, understanding, and

non-judgment in the delivery of holistic care.

Section V

Dr. Patricia Benner developed a theory outlines the process that nurses go through to gain

their nursing knowledge in clinical practice (Benner, 1984). Nursing knowledge begins at the

novice level. The novice nurse can often be demonstrated by any nursing student in their first

year until their second to last semester. These nurses have the ability to perform simple tasks; but

since they have had very little clinical experience, they are unable to take initiative. Novices

understand the basic skills required to monitor patient signs and symptoms, but they don’t have

the experience necessary to recognize trends and patterns. Through experience, novices will gain

the ability to infer what the signs and symptoms mean for the patient.

Experienced beginners are nurses who have had enough experience to be able to draw

their own conclusions about a patient’s current status. These nurses may be in their final

semester of nursing school or a newly graduated nurse starting their first job. These nurses have

the ability to recognize patient changes and interpret trends from the past and present. However,

these nurses don’t have the skill to infer about the future. Experienced beginners still need help

with planning ahead for their next course of action, so they often rely on models or guides for

patient care. Nurses usually become competent after two years of working within the same unit.

Patient care becomes more individualized, as these nurses are able to stray away from care
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models, and perform care in a way that suits the situation. While these nurses aren’t proficient,

they can still plan for multiple goals at one time.

Proficient nurses are able to provide care in a holistic manner, taking each component

into consideration when planning. These nurses are able to plan care on a larger scale and they

have the flexibility to make revisions when need be. Comprehensive understanding guides these

nurses to make better decisions and carry out their tasks with efficiency. Proficient nurses are

able to perform their job with more ease and less stress. When a nurse becomes an expert, they

will no longer need models or guides to plan their care. Expert nurses are able to take immediate

action and they don’t need as much planning ahead of time. The years of experience that expert

nurses have enables them to think intuitively and draw accurate conclusions. Expert nurses have

an in-depth understanding of patient patterns and outcomes, and they can differentiate between

unnecessary and useful information.

Section VI

At this point I would consider myself to be an experienced beginner. Before clinical

immersion, I was very task-oriented and needed someone to direct me. Since starting this

semester, I have learned how to care for multiple patients at one time and how to plan my tasks

in an efficient manner. I can look at patient orders, and prioritize them according to needs. I take

initiative and perform nursing tasks independently. I am able to interpret lab data and compare it

to the patient’s present status. Medication administration has become much easier, and I’m able

to understand why a patient is taking certain medications without having to look it up. I’m not

confident enough to think outside of protocols and guidelines for care, but I know that this will
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come with experience. My goals for patients lie within the short-term, but hopefully within a few

months of being a nurse I will be able to plan ahead for long-term goals.

Section VII

I’ve already started thinking about ways that I can make myself grow as a nurse in the

future. Once school is over, I’ll need to rely on my own plans and guidelines for growth and

success. Early on in nursing school, I accepted the idea that working on a Medical-Surgical unit

would be the best option for me to fine tune my nursing skills, as well as find my niche in

nursing. Although I have some ideas of what I might like to specialize in, I think it’s best to gain

confidence and experience on a floor with a diverse patient population. Medical-Surgical units

force nurses to learn how to prioritize care in a stressful environment. As a new graduate nurse, I

know there are going to be times when I need help from other nurses on the unit. This is why I

also think it’s important to work on a unit with people you enjoy. Nursing is a tough field, and

new nurses need to find a supportive environment that encourages growth. Having a mentor is

another opportunity to learn and grow as nurse.

I have chosen to accept a job on the same unit that I’ve been on for immersion, because it

offers me the opportunity to work on a Medical-Surgical unit with a supportive group of people.

It’s a busy floor with a diverse patient load, so I know that I’ll be learning new things each shift,

and the staff members have been very welcoming and excited for me to learn and grow as a

nurse. I have gained a mentor in my preceptor, as well as the other nurses working on the unit.

Once I gain confidence and experience, I may pick up some night-shifts to challenge myself and

diversify my nursing knowledge.

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In my nursing practice, I’m going to be someone who is people-oriented, rather than

task-oriented. Once I gain confidence at my first job, I want to work in terms of individualized

care rather than a to-do list. I want to be fully present during each patient encounter and I want

my care to be meaningful to the patient. I think that having this mindset will foster deeper

connections with my patients and enable them to be involved in their own care. I believe that

having a people-oriented mindset and the desire to deliver compassionate care, will make me a

great nurse to my patients and allow me to grow in the future.

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Reference

Benner, P. E. (1984). ​From novice to expert: Excellence and power in clinical nursing practice.

Menlo Park, CA: Addison-Wesley Pub. Co., Nursing Division.

Schiltz, M., Taylor, E., & Lewis, N. (1998). Toward a noetic model of medicine. ​IONS Noetic

Sciences Review,​ ​47​, 44-52.