1

Philosophy of Nursing Paper

Caroline Stewart

Synthesis for Nursing – NUR 4142

October 17, 2018

Christine Turner, PhD, RN

I pledge.
 2

Definition of Nursing

To many people, nursing is a job. It is a career choice that one decides on and follows to

the end goal of becoming a nurse and getting their dream job. To others, nursing is a calling. I

have heard many people throughout my time in healthcare say that they just felt called to

nursing, it just felt right, and they could never imagine doing anything else because they were

meant to be a nurse. When I think about what nursing means to me, some of this comes to mind,

but the thought that is brought directly to the forefront for me is that nursing is an action.

Nursing is not just a career or a calling for me. Nursing is something that you do. It is something

that you have to choose day in and day out to act on in order for it to be truly meaningful and

fulfilling. I have known individuals who went into nursing because they could get their degree at

the local community college in two years and make a decent salary starting out. Not to say that

nursing school is easy by any stretch of the imagination, but they chose this field because it was

a short, simple, path to a stable career. I have always said that if you are going into the nursing

profession solely for the money, you are doing it for all the wrong reasons. In my opinion,

nursing requires to utmost degree of compassion and dedication to yourself as well as others.

That is something that you just cannot be taught in nursing school. Compassion and dedication

are traits that some individuals just naturally possess and they are the basis of good nursing care.

When I say that nursing is an action that you must choose daily, I mean that you cannot just

decide to go to school and be a nurse and stop your actions there. The real action of nursing

comes after graduation and long after you have begun patient care. One must choose ever day

when walking into the hospital to be the best nurse they can be and to provide the most

compassionate and selfless care possible to their patients. Nursing is not a career in which you

can bring baggage from home to work with you and still be able to perform well. Your mind
 3

must be completely focused on your patients and their best interest should be of utmost

importance, certainly above your own. To me, nursing also means committing to lifelong

learning. Healthcare is always evolving and changing and we, as nurses, are at the forefront of

these changes and how they will be implemented. This means we must be able to expand our

knowledge and learn and grow with healthcare in order to continue providing the best care

possible for our patients.

Personal Philosophy

The fact that I view nursing as an action and a commitment rather than just another

profession encourages me daily to recommit to the compassion and drive that I put behind my

own nursing practice. Having a personal philosophy of nursing is an even greater driving factor

that pushes me to continue being the best nurse I can be every day. My personal philosophy of

nursing stems from my core values of compassion, integrity, kindness, and selflessness. I believe

that every patient deserves to be treated with respect and kindness and when they are sick and in

need of my care, I believe that their needs should take priority over my own. To me, integrity is

what you do when no one is watching. It is an extension of honesty. Being honest means to do

the right thing or tell the truth to someone else, but integrity is continuing to do the right thing

and be truthful even when no one is watching. Integrity is vital in nursing because, as nurses, we

often work alone with our patients and there could be circumstances where a nurse is to provide

a certain standard of care for his or her patient and no one is there to see if they really do or not.

That nurse may have every opportunity to avoid doing whatever the task is but still document

completing it, but having integrity would mean that the nurse would do what was right even

behind that closed door where no one else may ever know otherwise simply because it is right.

My personal philosophy has shaped my nursing career so far by continuously reminding me of

 4

the nurse I aspire to be. My philosophy is like the ultimate goal of how I want to practice

nursing. I want to be the most compassionate, kind, and selfless nurse that I possibly can be. So,

having a personal philosophy that stems from those values helps to keep me in line with the way

I aspire to provide care. With every patient that I care for, I strive for these things and even when

I am placed in a difficult situation with a patient who may be combative or rude, I try my best to

put myself in their shoes for a moment. Are they scared? Are they unsure or upset about

something? I really try to evaluate what they are going through and attend to whatever fear or

issue they are facing in a kind compassionate manner instead of just taking them at face value

and writing it off as blatant disrespect because most often, it is much more than that. My

personal philosophy can be applied to interprofessional relationships also. I have been in

situations where a nurse was doing something that was not professional and their patient’s care

was suffering for it. I had to reflect on my philosophy of nursing and pull from the value of

integrity to discuss with the nurse what I felt was not right about the situation. Having those

beliefs and values helps me to make ethical decisions regarding patient care.

Nurse Patient Encounter

I recently had an encounter with a patient in the emergency department in which I work

where the patient came to us for heart palpitations. He stated that it felt like his heart was beating

irregularly and also mentioned a history of atrial fibrillation. Once on the cardiac monitor and

after obtaining an EKG, the physician determined that he was indeed in atrial fibrillation. The

physician suggested that he be admitted to the hospital for further care. The patient agreed and

the admission process began. A few minutes later, the patient called out asking for a cup of

coffee which the physician did not want him to have because the caffeine would cause a further

increase in his heart rate that was already around 120 beats per minute. The patient was
 5

extremely frustrated to learn that he could not have coffee at that time and began to mumble

under his breath about how he thought the physician was crazy and not a good doctor as well as

how the nurses were horrible for not bringing him coffee anyway. I could tell that the patient was

getting increasingly agitated as he continued talking aloud about the situation in the room alone,

so I entered the room and apologized for not being able to bring him coffee at the time and asked

if there was anything else I could get for him to make him more comfortable. He very angrily

declined, stating that we were not taking care of him and he wanted to leave. I explained further

the reasoning for him not being able to have coffee hoping that he would understand, but that

was not the end result. He remained angry despite our efforts to get him something else to drink

that was caffeine free and explain our reasoning and he continued to ask to leave the hospital. He

began to try to get out of the bed and pull out his IV. So, we went through the process of having

him sign out against medical advice. He was on his way out the door when he began to feel weak

and dizzy as if he might fall. I saw him grab onto the railing on the wall and hunch forward so I

ran to bring a wheelchair behind him. He sat down and asked me if I thought he should stay. I

told him that the physician recommended that he stay and I agreed that it was the best idea with

his heart rhythm being irregular. He decided to check back in to the ER and proceed to be

admitted.

This situation was extremely difficult for all of us in the department as the patient had

said some things to each of us that were quite disrespectful and hard to hear. We all knew that we

were just trying to look out for his best interest by not giving him coffee, but he was not content

with that. I used my personal philosophy of nursing in this situation by trying to put myself in his

shoes. He was obviously scared and the one thing that he wanted, he could not have at the

moment so he took that fear and turned it into frustration and anger towards all of us. I could see
 6

that he was frightened and frustrated, so that is why I entered the room the first time to try and

address the problem and reconcile it with him. Later in the circumstance, when he was about to

fall, I used my nursing philosophy again to provide compassionate care to him and make sure he

was safe and helping him to get back to his room to be admitted for further care despite the

hurtful things that I had heard from him earlier.

Values and Beliefs

My values and beliefs have evolved so much since beginning nursing school. In my first

philosophy of nursing paper I stated that my values were kindness, honesty, patience, and

compassion. While most of these are the same as what I identified as my values in this paper, the

reasoning behind them has changed greatly. In my first paper, I related the importance of

kindness to maintaining a patient’s dignity since they are in a very vulnerable place when we are

caring for them. Now, I believe that maintaining dignity is a value all of its own. Kindness, to

me, is simply interacting with someone in a polite, friendly manner and taking the time to do

things for them that are not expected of you just out of the goodness of your heart. The value of

compassion has gained so much more meaning to me over these last three years. I have had the

opportunity to care for patients and their families who are going through some of the most trying

times in their lives and I couldn’t even begin to fathom the amount of compassion and service

that they deserve in those situations. As a growing nurse, I believe that I have improved on

providing intentional compassionate care to others. I feel as though there is no way that I could

ever do justice to the amount of caring and compassion that these patients deserve, but by having

this value as a part of my philosophy, I am constantly reminded to do everything in my power

and go above and beyond to reach that level. The value of honestly that I wrote about in my first

paper was just that; honesty. Now, as I discussed earlier, that value of honesty has evolved into
 7

integrity. After caring for more patients in so many different settings, just being honest isn’t

enough for me anymore. I feel the need to identify with a much deeper value, and integrity is one

that identifies me as a person. Anyone can be mindlessly honest as we are taught from a young

age not to lie and to do what is right. But growing in that value leads to having integrity and not

only telling the truth and doing what is right when you know someone is watching or judging

your actions, but also when you are alone and the only one you are accountable to is yourself.

Benner’s Theory

Patricia Benner’s theory, From Novice to Expert, is a clearly laid out model of how a

nurse progresses through their career from being a student to being a seasoned nurse with years

of experience. In the book, Benner walks through each stage, giving a brief explanation behind

what the stage is, where in the career of nursing one would likely be when they are at this stage,

and an example of how someone is each stage might present in different situations. Benner’s

theory spans novice, advanced beginner, competent, proficient, and expert.

Skill Acquisition

I believe that at this point in my nursing career, I am at the advanced beginner stage. In

this stage, an individual has been in enough clinical situations to know what aspects to pay close

attention to, what aspects are important, and what can wait until later should something more

important come up. Advanced beginners can begin to reason through situations and the causes

behind them. They should be able to complete tasks assigned to them, but may not yet be able to

differentiate between what is most vital and least vital. If they are focusing on one task, they do

just that, focus on that one task. And if something else happens that need their attention they may

have difficulty breaking away from the first task to tend to the new one because they are often

unsure of priority. I feel that I fit into this stage of skill acquisition because I am fully capable of
 8

completing tasks of patient care, but at times I have difficulty deciding what to do first and what

should take priority.

Action Plan for Moving Forward

In order to move to the next stage of skill acquisition, I will first begin working as a nurse

and gain experience in the clinical setting. After all, that is the best way to learn. I will be in a

nurse residency program that will help me to adapt to nursing independently, as well as continue

education with periodic lectures and assignments throughout the program. Next, I will gain

certifications such as ACLS and PALS to continue my education and gain new nursing skills that

will help me to advance my critical thinking ability. Finally, I will ask questions and be engaged

when on orientation, and long after. The only way to improve knowledge and skill is to ask and

learn. I find it extremely helpful to jump into situations that I am unsure of some aspects and ask

a more experienced nurse what is causing things to happen, what is connected, what

interventions are necessary and what the expected complications and outcomes are. Learning on

the spot where I have a live situation playing out in front of me to learn from is most helpful for

me. I am able to see everything that is happening, have hands on experience and learning

opportunities, and actually connect the dots and critically think about what is going on. These

three things are what I plan to do to move to the next stage of skill acquisition.