Running head: PERSONAL PHILOSOPHY

Personal Philosophy of Nursing

NUR 4142: Synthesis for Nursing Practice

Kelsey Singh

October 16, 2018

“I have neither given nor received aid, other than acknowledged, on this assignment or test, nor
have I seen anyone else do so.”
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The purpose of this paper is to capture my personal philosophy of nursing based on my

thoughts, reflections, values and beliefs. As I will discuss below, my current philosophy of

nursing has more nuance than my initial philosophy when I began this BSN at Bon Secours. My

philosophical evolution has been a fascinating journey shaped by education, practical experience,

and individual maturity. The narrative below traces this journey.

Definition of Nursing

I define nursing as the professional involvement in the healthcare industry that bridges

the gap between the patient, the doctors, team caregivers, diagnosis and care, and between

community education and civic involvement. Nursing provides personal, hands on care and

education at the patient level that includes the actual patient and the surrounding support

community. As both an art and a science, nursing collaborates with other health care

professions to adapt evidence-based practices to individualized care plans. Nursing requires

continuing education because treatment modalities are constantly evolving and so is the nurse.

Thus, nurse education will enhance personal and professional growth, and allow the nurse to

fully participate in healthcare outcomes. In addition, nursing is a service profession. A nurse’s

impactful treatment of a patient’s physical health must include acknowledgement of the role

mental health, family, and community play in a patient’s illness and healing. A nurse’s service

must engage with the patient’s total community to define the patient’s health care imperatives

that shape the patient’s health care needs. Ultimately, a nurse’s service should extend beyond

individual patient care to embrace civic engagement opportunities in the healthcare industry and

the legislature. A good nurse will provide informed patient care; a great nurse will engage with

the patient, the patient’s community, and the community at large to provide maximized

healthcare outcomes.
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Personal Philosophy

My personal philosophy of nursing is based on shared values with society and my

personal experiences. When it comes to nursing, I share many values with society, especially the

following three principles. We are all accountable. We should treat others with compassion. We

should conduct ourselves professionally. My personal beliefs are based on these broad principles.

I believe accountability requires me to be a life-long diligent student of nursing best practices, to

incorporate best practices in my nursing, and to engage with the community to educate and

advocate based on those best practices. Accountability also requires me to bring my “A-game”

to work daily because anything less is unfair to my patients and my colleagues. I believe

compassion must direct my interaction with my patients and their families, and with my

colleagues. On a daily basis, compassion forces me to employ the “golden rule” to guide my

treatment of others. I believe professionalism requires me to be accountable and compassionate

even when no one else is looking.

The values and beliefs formed because of my faith, my life experiences and my education

to date have blended into my personal philosophy of nursing. I believe that nursing offers an

ever-evolving career path that presents opportunities to assist patients and their communities

through the illness process. In addition to being accountable, compassionate, and professional, I

must also be ethical. This requires active dialogue with the patient, the patient’s community, and

the team of healthcare providers serving the patient. Ethics require me to listen responsively to

patients and their community’s concerns, and to accurately report those concerns to members of

the caregiving team. With the caregiving team, a nurse must evaluate what is appropriate

information to share with the patient and community, and when to share it; regardless of those
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parameters, an ethical nurse will always share information honestly, even if the honest answer is,

“I will let the doctor know you want to discuss this matter.”

During nursing school, I have been honored to work at a state teaching hospital as a care

partner in the surgical trauma unit and the cardiac surgical ICU. I am now also working as a

coronary care nurse in my clinical immersion. In all these roles, I bring my A-game everyday to

be the best possible member in my role on the interprofessional team. I work hard, volunteer for

responsibilities that will share a burden or teach me a new skill, observe experienced nurses

intensely, and engage in authentic team dialogue about care of patients and their communities.

In real life settings, I now have the opportunity to test my theoretical philosophy of nursing in

very difficult situations. Although accountability, compassion, professionalism and ethics are

still the foundations of my personal philosophy, I realize now that these principles can be

difficult to define in clinical settings because daily there are different patient and community

needs, and team imperatives. Nevertheless, whether the task is seemingly minor or life-defining,

I must apply my philosophical principals to each decision and action I take.

Nurse Patient Encounter

As a nursing care partner and a clinical immersion nurse, my most impactful contacts in

each role are with patients and their communities. In each position, I have been a part of a Code

Blue team. The first experience, as a care partner, was sobering. I was part of the CPR team that

worked accountably, compassionately, professionally, and ethically. No matter—that patient

died. I was forced to face my feelings about life and death, and about my role, however human,

in it. As I said, these reflections were sobering. The second experience during my clinical

immersion was equally sobering. Again, I was part of the CPR team; this time, after similarly

accountable, compassionate, professional, and ethical efforts, the patient lived. When I had an
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opportunity for solitary reflection, I was sobered by the realization that my informed actions are

essential, but not predictive of the health outcome. If my team and I do not do our jobs, the

outcome is almost certain. If we do our jobs, the patient health outcome has several predictors

beyond our control—patient health, patient will, and Divine Will. These patient encounters have

confirmed for me the vital yet limited role of the nurse.

Values and Beliefs

Since I wrote my original Personal Philosophy of Nursing paper two years ago, I have

come to understand two things. First, accountability, compassion, professionalism, and ethics

are absolute principles that must be applied situationally, depending on the patient, the

community, the healthcare team, and spiritual intercession. Two years ago, I believed the

defined principles would present the answers to appropriate healthcare. Now I realize that nurses

and other healthcare professionals struggle daily to define their roles in terms of their personal

philosophies of nursing as they relate to specific decisions regarding patient care, whether

routine (like giving medications or taking vitals) or life and death (like Code Blue responses or

reporting to doctors and giving medications). Now I know that nursing is an informed profession

that makes lightening decisions based on evidence-based practices grounded on many

imperatives, from an immediate patient medical need to broader community necessities.

Benner’s Theory

In her book, The Dreyfus Model Applied to Nursing, Patricia Benner defines the

evolutionary stages a nurse undergoes in the professional journey from Novice to Expert

(Benner, 2001). Benner describes the characteristics of each stage of a nurse’s development

from Novice to Advanced Beginner to Competent to Proficient to Expert. According to Benner,

the Novice nurse is one whose only tools are governed by learned rules to be applied in defined
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situations; their nurses are usually in their clinical immersion experience. The rules are

necessary to the nurse’s care because the nurse does not yet have situational experience. Novices

are at the clinical rotation stage, where each rotation offers opportunities for new nursing

experiences, but because of the lack of context, the Novice’s response is rule-governed and

inflexible. Benner clarifies that the limitations at this level are based on the nurse’s experience

in a given situation, not on the nurse’s talent (Benner, 2001).

Benner’s stage 2 nurse is the Advanced Beginner. This nurse has been exposed to

minimal situational aspects that are learned only from specific experience. The Advanced

Beginner has some experience in the global characteristics of a situation, so that the nurse, still

with a mentor, can define guidelines that include both context-free rules, or attributes, and

aspects of global characteristics. According to Benner, the Advanced Beginner cannot yet

differentiate between a rule and a guideline, so that each is given equal importance during

decision-making. The Advanced Beginner is the nurse in a clinical immersion setting. At this

level, the nurse still needs preceptor guidance in setting priorities and flushing out guidelines, to

protect the patient and the new nurse (Benner, 2001).

Benner’s stage 3 nurse is Competent. The Competent nurse has worked in the same area

for two to three years and has awareness of and understands her role in the patient’s long-term

goals. The Competent nurse achieves efficiency and organization in the limited practice area

because the nurse has developed a mastery of clinical nursing contingencies. Despite her

mastery, the competent nurse is not as quick or as flexible as the next level nurse (Benner, 2001).

When a nurse achieves stage 4, she is proficient and able to perceive a patient’s status,

subject to long-term goals rather than rules or guidelines for specific tasks. The proficient nurse

has sufficient experience to develop a perspective on what to typically expect and how to modify
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a response to the atypical, as an almost unconscious calculation of required actions. The

Proficient nurse has a holistic prospective that allows her to quickly determine the most

important presenting aspects of a patient’s health and to rely on maxims as guidance for

appropriate action (Benner, 2001).

At Stage 5, a nurse is an expert. The Expert nurse does not rely on guidelines or maxims

to determine the course of her healthcare. Instead, the expert relies on her informed instincts to

guide her responses to patient care. In unfamiliar situations, however, the Expert nurse still

relies on analytic tools to solve a care problem (Benner, 2001).

Skill Acquisition

Currently, I am at the Advanced Beginner stage of development as a nurse. On my shifts,

I am given supervised responsibility to make decisions. I go through my checklists, both mental

and written, to ensure that I am considering all the necessary aspects of a patient’s care. I am

becoming more comfortable in making decisions on how to prioritize my caregiving, based on

broader guidelines. My preceptor has been a great help in my development, because he gives me

guidelines then stands back to let me incorporate them into my checklist of aspects requiring

care. My preceptor’s confidence in my assessments have given me the confidence to formulate a

decision and state it rather than suggesting a decision with a question mark behind it. My

experience as a care partner in trauma surgical and cardiac surgical units has also helped me to

gain confidence in my ability to be an effective healthcare partner, but I still need supervised

experience to enhance my effectiveness.

Action Plan for Moving Forward

As I begin my nursing career, I plan to take several actions to advance my career. First, I

will gain on the job experience. The Competent nurse has two to three years of experience in a
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specific practice area. After graduation and passage of the NCLEX, I plan to work in the dream

job that I have been offered in the Cardiac Surgical ICU for at least three years, to hone my skills

and my professional instincts, so I can move to the level of a Proficient nurse. As a part of that

experience, I intend to observe all that I can see and ask every question that comes to mind,

especially to the most seasoned nurses. I will embrace every care responsibility that is presented,

even though I will need assistance and guidance to provide optimal patient care. In addition, I

plan to take advantage of continuing education opportunities, both in-house and academic. I will

be at a teaching hospital with a nursing school and a medical school, and unlimited research

studies. If opportunities present, I will benefit myself of these learning experiences. Finally, I

will subscribe to nursing journals to expose myself to the most recent learning trends and

community imperatives. I want to become an informed advocate for the profession of nursing.
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References

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

(commemorative ed.). Upper Saddle River, NJ: Prentice-Hall.