RUNNING HEAD: PHILOSOPHY OF NURSING PAPER

Philosophy of Nursing Paper

Christine Turner, Ph.D., RN

Synthesis for Nursing Practice NUR 4142

October 17th, 2018

“I Pledge” Lillian Facka

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Define Nursing

Nursing is a career that assesses and evaluates human beings as a whole. When I first

started nursing school, I developed a vague idea that a career in nursing is based upon the desire

to serve. Now after several semesters, I believe this medical profession facilitates healing

processes that include the mind, body, and spirit with the essential goal of increasing quality of

life. Nurses must cultivate some level of understanding regarding how a patient feels about their

present illness. We do this by using caring interactions that foster a trusting relationship with the

patient. Development of this relationship may include successful management of a patient’s pain,

creating a dialogue surrounding the patient’s spiritual beliefs, or simply sitting at the bedside

providing a quiet, comforting presence. Bon Secours Memorial College of Nursing instilled their

principles of compassion, quality, and service within my nursing practice.

Throughout my academic career at BSMCON, I have encountered patients who lacked

self-love, negatively impacting their health outcomes. This deficit often manifests in the patient’s

communication, impairing their desire to ask for help. I am able to recognize this and anticipate

the need for what I often refer to as an extra set of hands. A patient’s disposition is not something

I judge; I use it as motivation to practice and maintain compassionate care. In this pursuit of

compassion, my educational background continues to encourage the highest standard for delivery

of care. Bon Secours ensures that the compassionate care practiced by the medical staff is

nothing short of excellent.

Quality is a multitude of components: time management acts as the foundational element

for this principle. Personally speaking, my clinical practicum is an environment where the art of

multitasking is quickly learned and constantly refined. It is up to myself, as a health care

provider, to recognize my own limitations. During my clinical experiences, there have been more
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times than not that I have suffered the consequences of not managing my time wisely. On a

specific shift, I chose to give a bath and also administer medications to several patients. What I

quickly learned was a bath can take more time than expected. Perhaps it was the desire to prove

myself; the unyielding, selfish need to show that I could handle multiple tasks at once despite

still identifying as a student or novice. This stubborn behavior created multiple oversights:

elevated blood pressure due to delayed medication administration, an infiltrated IV from lack of

assessment, and undocumented meal intake. These mishaps could have been avoided simply by

utilizing my resources. Asking a patient care technician to give a patient a bath gives me ample

time to assess vital signs then deliver the appropriate medication. I could check an IV, preventing

infiltration and maintaining patency of the line. Delegating care appropriately is an element of

the nursing practice I am still working on, but I use with confidence now versus not at all.

Practicing my nursing skills on several units granted me the opportunity to witness

effective and ineffective service delivery. Poor communication, ranging from delivery, tone, and

timing, is the culprit. I have made it my mission to be a team member that encourages the group

with words of affirmation. Several instances where classmates came to me low in confidence, I

encouraged them to see their growth throughout their academic journey, to focus on how far they

have come in this process. Whenever I am in doubt about a piece of information I have received

from a team member, I politely clarify, making sure to maintain respect for them as well as

myself.

Reflection on Philosophy

Brene Brown is a mentor to me for providing care to my patients. She frequently

discusses human connectedness in her teachings; that all humans are connected based on the

desire to be free from suffering (2017). Her wisdom fully encompasses why I am able to
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maintain my sensitive heart during a twelve-hour shift. In order to provide nursing care

consisting of compassion, quality, and service, I have to feel connected to my patients. My care

begins and ends with both of us on the same level; meaning we are both human and have the

desire to be free from suffering. Patients in the hospital are not strangers to me; they are my

grandmother, my brother, my neighbor, my teacher. The connections I build are forged upon my

desire to free them from suffering. I want to understand their experiences, I want to celebrate

their goals, I want them to know I am on their side.

Brown discusses that an important element of this process is also believing in science and

the power of mystery, an awareness of the lived experiences of yourself and/or others (2017).

My relationship with my philosophy is just that, an awareness of my lived experiences that

enable me to provide empathetic, quality care to my patients. Nursing empowers me to live a

wholehearted life; though I have encountered and endured my own pain, I use those events to

encourage love and understanding in my practice.

Example of Nurse-Patient Encounter

Wednesday morning, I walked onto the labor and delivery unit with my teacher and

classmates. I was last on the list to watch a vaginal birth; I was comfortable with where I fell on

the list given that I was incredibly anxious. This morning brought my opportunity to fruition.

Nervous and slightly light-headed, I walked into my patient’s room with the oncoming nurse to

receive report. The mother was experiencing her first childbirth. She and her husband intended

on following their birth plan: delayed cord clamping, delayed erythromycin, delayed bath. She

had been in labor for eighteen hours, after refusing Pitocin the doctor recommended. I later

learned that the husband’s previous wife used Pitocin in her birthing experience; the drug did not

produce desired results and she was taken back to the operating room for a cesarean section. He
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was under the impression that Pitocin leads to cesarean sections and preferred his wife to not

accept the contraction inducing medication.

The labor process was nothing short of intense. Keeping the goal of a natural birth in

mind, we practiced breathing exercises and changed positions frequently to alleviate pain. Once

the contractions became frequent and her pain was not alleviated by alternative pain relieving

techniques, we paged the doctor. The patient’s cervix was dilated and she was ready to push. I

stood to the side, watching the patient’s husband hold her leg; I could see after a few pushes, he

needed relief. I tagged in, holding the patient’s leg for the duration of her labor. I felt honored to

witness one of the greatest gifts life has to offer. Once I saw the baby’s head, I smiled and

cheered the patient on; “I can see her head!” as if I had witnessed a touchdown.

Then plans changed. As quickly as my smile materialized into a full grin, it faded. The

baby’s umbilical cord was wrapped around its neck twice. The doctor untangled the cord and

placed the baby on her mother’s chest. Small, quiet, and blue all over, the doctor made the vital

decision to cut the baby’s umbilical cord and page the Neonatal Intensive Care Unit. She was

whisked away to the warmer with intubation equipment next to the nurse performing chest

compressions.

I was not mad. The parents had the right to develop a birth plan and refuse the Pitocin.

They had no way of knowing about the cord, they had no way of knowing the full duration of

labor and the toll it would take on their daughter. In this situation, it was not justice that needed

to be served, but grace. I stood there alone with the patient holding her leg as tears streamed

down our faces. This was not her fault, this was no one’s fault. I reassured her that the baby was

in the best care possible and they are both in a safe place.
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Thankfully, the baby was breathing on her own in NICU shortly after she was transferred

to their care. I peeked into the patient’s room to check on her; she was surrounded by family,

glowing with smile on her face. After our experience we shared, I knew in my heart I had to

thank her for allowing me to be a part of her daughter’s birthday.

Values and Beliefs

Entering nursing school, I envisioned myself as a selfless nurse that would work tirelessly

to foster trusting, nurturing relationships with my patients. However, in order to deliver excellent

care, I must also care for myself. I quickly learned that I must provide self-care that is

compassionate, of high quality, and service to myself. As my clinicals began, I developed an

understanding that in order to advocate for patients, I must advocate for myself. This included

recognizing when my body was sick, asking for help when I felt undereducated, and in turn, this

would increase the quality of my care to myself and my patients.

Describe Benner’s Theory

Dr. Patricia Benner’s theory, From Novice to Expert, captures a wide spectrum of nursing

education as well as leadership. The first stage, entitled “Novice”, is defined by the first year of

nursing school. This novice nurse is in their first year of clinical experience. A novice nurse’s

defining characteristic is the minimal ability to anticipate patient outcomes. While they are

learning the tools to do so, making the link is still a progress.

Stage two is the advanced beginner. After acquiring clinical experience in the hospital

and passing the NCLEX to obtain a license, this title best suits a new graduate nurse. This nurse

is able to anticipate patient needs and outcomes based on the clinical experience they possess.
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A competent nurse is a caregiver that executes advanced planning and utilizes

organizational skills. In addition to this skill set, this nurse maintains the ability to recognize

patterns and the general nature of a clinical situation.

Proficiency is achieved when the nurse perceives situations as wholes rather than aspects.

A proficient nurse is the fourth stage of Dr. Benner’s theory. This nurse expresses ease in the

decision-making process and best learns by examining case studies.

Lastly, Dr. Benner’s final element to her theory is an expert nurse. This nurse no longer

relies on guidelines. Rather, they trust their intuition based on the clinical experience they have

acquired over time.

Describe Skill Acquisition Stage

Referencing Patricia Benner’s theory, I struggle with how to define myself. One reason

being I am still a student writing this paper. However, while I am not advanced, I have

undoubtedly surpassed the confidence I possessed in my first year of clinical. Benner describes a

beginner as someone with no clinical experience. Differing from a beginner, an advanced

beginner develops the ability to recognize vital details of recurrent situations and how to respond

to those patterns. Immersion is building a strong foundation for my anticipation of patient needs.

One of the many beauties of clinical immersion, no situation has been like the other. While

patient diversity may be inhibiting the climb to an advanced beginner due to lack of patterns, this

clinical experience has exposed me to situations I had previously heard about in lecture.

Managing a patient in diabetic ketoacidosis, facilitating peritoneal dialysis to a patient in end-

stage renal failure, and performing a sepsis workup on a patient with abnormal vital signs

resulting in a high MEWS score: these are a few examples of situations that put me past the

beginner stage. Accumulating this vital, clinical time with my preceptor on medical telemetry
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refined my assessment skills, established a strong link between critical thinking and disease

processes, as well as an appreciation for teamwork amongst the interprofessional teams within

the hospital. These facets of immersion will help me transition into my new graduate nursing

career, where I will begin my path to an advanced beginner. All things considered, despite

having accepted a job, I would not title myself as an advanced beginner just yet; if there was an

intermediate beginner, I would choose that.

State Three Things

I view my nursing career is a ladder, based on a strong foundation of care, quality, and

service. To begin my growth to an advanced beginner, I will begin my new job at Virginia

Commonwealth University on the Bone Marrow Transplant Unit. Here, I will acquire extensive

clinical experience and knowledge surrounding blood cancers and the healing processes for

pediatric and adult cancer patients. Lastly, I would advance my education. Eventually, I would

like to pursue a masters or doctorate degree; at the moment I am unsure of what field I would

want to explore. Accepting a job, gaining more clinical experience, and pursuing further

education are how I would move from a novice to advanced beginner and hopefully proficient.
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Works Cited

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

Upper Saddle River, NJ: Prentice Hall.

Brown, B. (2017). Rising Strong How the Ability to Reset Transforms the Way We Live, Love,

Parent, and Lead. Random House.