Abagail Boinest

Personal Philosophy Paper

NUR 4142

October 17th, 2018

Dr. Christine Turner

“I pledge.”
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Definition of Nursing

Nursing is the ongoing process of learning, caring, teaching and empowering. Nursing

requires a desire to learn how to be the best help and improving upon oneself to best serve

others. By improving upon oneself, continuing education and sharing knowledge and ideas with

others, nurses have a large impact on the healthcare system and experience of patients. Serving

others and being a teacher takes practice and skills that can only be learned through experience

and determination making nursing a fluid concept without an ending. Nursing inspires

innovation and through a culture of caring and an ever changing society, nursing is pushed to

evolve and grow into a holistic and an encompassing profession that will forever be an important

part of the healthcare system and world.

Personal Philosophy

My personal philosophy revolves around compassion, integrity and empathy, which I

demonstrate through all my contact with others; with my patients and their families, with my

fellow students, or with other employees and faculty. I strive to provide a caring and

compassionate environment for all patients by maintaining a non-judgmental approach to all care

and contact, by showing empathy and seeing patients as people first and not as their diagnosis or

disease. Integrity has always been an important value in my life and I strive to maintain a high

level of integrity in my personal and professional life. I maintain this level of integrity by telling

the truth and being accountable for my actions and documentation. I enjoy getting to know my

patients so that I can relate to them on a personal level and show empathy, I do this by always

taking time to ask what they prefer to be called, if there is anything I can bring them or anyway I

can make them more comfortable.

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Nurse Patient Encounter

As previously stated, I strive to bring compassion, integrity and empathy to all my patient

encounters, as I did with one of my most recent patient encounters involving a postpartum

patient that was having an unpleasant post-operative experience. I was performing a

reassessment on the patient and she made a comment during the fundal check that while the

assessment was painful I didn’t “push nearly as hard as the previous nurse”. This statement made

me uncomfortable as I had felt confident in my findings but after hearing that others had to press

harder to get the same result I wasn’t feeling as confident with my assessment of the fundal

location. I voiced my concerns to my preceptor and she agreed that she would assess my patient

with me to confirm my findings. I was embarrassed to have to ask my preceptor to assist me in

an assessment after having been on the unit for two months, but I wasn’t comfortable

documenting my findings with the gnawing feeling that I wasn’t confident in my findings. It was

awkward to explain to the patient why my preceptor and I would be doing another fundal check,

thankfully the patient was very understanding and actually thanked us for double checking as she

was feeling nervous because she was having a different experience post operatively compared to

her first cesarean section. By reassuring the patient and comforting her and then reassessing, I

felt confident in my assessment findings and documenting my findings. I embodied my nursing

philosophy during this patient interaction in that I created a caring environment by reassuring the

patient and maintained my integrity by being honest and performing a reassessment when I felt

doubtful.

Values and Beliefs

Since writing my first philosophy of nursing paper I would like to think that my

philosophy has stayed the same while being reinforced by clinical experiences and the passage of
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time. I still believe that compassion and quality are important values that influence all aspects of

one’s life. I still agree with my belief that you must love what you do and not just work for a

paycheck. I have seen and even experienced times in the clinical setting where I felt negatively

about what I was doing but by reflecting on the experience I am able to see the positive side of

the situation and learn from all situations in the clinical setting. I can say that I still want to be a

good nurse to my patients but also maintain a positive work environment with my coworker at all

levels. In my previous philosophy paper, I wrote about how important being a patient advocacy

is for a nurse and I can say with full confidence that I put my patients first and try to be as

accommodating as I can while maintaining a competent level of care and professionalism. I also

have learned that accountability and integrity are vital values in nursing practice not just as

personal values. Having integrity and being accountable for my nursing practice has at times

made me uncomfortable when I have to explain the reason something was late or when my

assessments are questioned by my preceptor or faculty. But by having strong personal values I

have been able to always tell the truth and accept accountability for all my actions in my nursing

practice which is something that I take pride in.

Benner’s Theory

Patricia Benner’s theory describes the progression of the nurse from a novice to expert

with focus on skill acquisition and perceptual awareness. Described in this theory, are five stages

of proficiency starting with novice, advanced beginner, competent, proficient and expert. The

novice is equated to a nursing student or a nurse entering a clinical situation that they are not

familiar with or have limited experience with that patient population or patient care. (Benner,

2001) To progress to the next stage of advanced beginner, the nurse will have experienced and
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then recognize the important components in situations. The nurse or student begins to form a

perceptual awareness in this stage, but they still have to consciously try and remember rules and

concepts they have been taught for clinical situations. Stage three in the model is competent, a

nurse who has had many experiences in similar situations for two or three years as Benner (2001)

states, the nurse begins to think in terms of planning and puts the situation into perspective based

off of previous experiences. The competent nurse adheres to their plan which is formed from

conscious and analytic thought and is not flexible like the next stage, proficient. The proficient

nurse perceives situations and interprets and responds to the situation as a whole as opposed to

the lower stages when situations were addressed in terms of aspects of importance. The fifth

stage is expert where the nurse does not have to rely on analyzing and applying to situations in

an order but rather an “intuitive” knowledge that comes from an expansive background that

encompasses all situations, allowing the nurse to focus on the problem without miscellaneous

detours and diagnoses.

Skill Acquisition

In my opinion I am an advanced beginner as I still have to consciously remember aspects

from my course work and apply them when new situations arise. I don’t have the repetitive

experience in all of the nursing fields to for me to consider myself to be in the competent stage. I

believe that I am just on the cusp of advanced beginner as I progress to the completion of my

nursing degree. I am able to apply some concepts and begin to prioritize aspects of situations

when they arise but not without conscious thought. I have learned to plan and look forward to the

long-term plan, but I still struggle with being able to respond without relying on rules and

concepts for many situations.

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Action Plan for Moving Forward

To bridge the gap into the competence stage I will need three components: time,

repetition but also diverse experiences. I need time to gain experience and finish my degree but

also to study and pass my NCLEX as without the time to study I would not get licensed. In my

last year of nursing school my clinical experiences have been specialty oriented and my

immersion experience is on the same unit as one of the specialties from the previous semester.

The repetition of patient population and problem has improved some areas of my nursing skills

but also negatively affected other areas. While my last semester of clinical experience has been

very similar to the previous semester, allowing me to begin to develop a perspective and plan for

long-term, not just the 4 hours between my first assessment and reassessment but to the next day

and even discharge for the patient. This ability to begin developing a perspective occurs when

repetition is present and critical thought processes become second nature along with

prioritization. I need to experience diverse situations and populations so that I will maintain

knowledge and skills learned in previous semesters but now with the incorporation of long-term

goals and perspective in the effort to transition to the competent stage.

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Reference List

Benner, P. E. (2001). From novice to expert: Excellence and power in clinical nursing
practice(Commemorative ed.). Upper Saddle River, NJ, NJ: Prentice Hall.