Running head: PERSONAL PHILOSOPHY OF NURSING PRACTICE

Personal Philosophy of Nursing Practice

LaWanda Dunn
Bon Secours Memorial College of Nursing
Synthesis of Nursing Practice
NUR 4142
Mrs. S. Massengill
October 21, 2015

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Personal philosophy of nursing practice

Defining nursing is going to be different for every person. However, I feel that my
personal philosophy in essence defines my nursing practice and allows me to be able to navigate
through the personal and professional on a day to day basis. The personal is being able to be intune with my own personal values and beliefs and how that has the potential to impact care.
However the professional side is being able to check my own beliefs at the door and providing
the best care to the patient. So my definition of nursing is being able to provide holistic and
informative care to the patient while helping them achieve or return to whatever the patient
views as their optimal state of health. My definition falls under the health, caring and nursing
headings of the tenants for Bon Secours Memorial College of Nursing.
One of the tenants under nursing is that nurses provide holistic care to promote wellness,
prevent disease, restore health, and provide comfort (BSMCON Handbook, 2014-2015, p 41). I
feel this relates back to my philosophy and definition of nursing because I feel holistic care is
looking at the whole patient, not just their disease process. You have to understand the patients
situation in combination with their disease process in order to deliver effective care. I also think
that this tenant is not only referring to patient care but also self-care of the nurse. Another tenant
under caring is self-care and self-reverence are requisites to caring for others (BSMCON
Handbook, 2014-2015, p 42). You cant look at a patient holistically if you are not in a state of
wellness. I believe being able to take care of yourself first is a prerequisite to taking care of
others. You cant give what you dont have. You have to be the best version of yourself so that
you can pick up on the subtle nuances that aren't always so obvious in patient care. One of the
health tenants is that human beings are unique and complex, with physical, emotional,
cognitive, sociocultural, and spiritual dimensions (BSMCON Handbook, 2014-2015, p 42).

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Some of the aspects mentioned in that tenant can be a barrier or breakthrough in providing the
best care to your patient. By assessing the patients emotions, spiritualty and doing a cultural
assessment, you can often understand how the non-physical is connected to their physical state.
Personal philosophy reflected in nursing practice
I truly feel that my personal philosophy and definition of nursing is reflected in my
nursing practice on a daily basis. For starters, when I start a shift, I leave whatever issues or
problems I am having at the door. This is part of that self-care piece and being able to give to
others. In addition, when I get hand-off report from another nurse, if they point out a flaw in
the patients behavior or personality I take that with a grain of salt. I dont really give that any
credence due to the fact that I am able to recognize that patients respond to people in different
ways and most of the time (but not always) you get back what you put out there. If you put out
kindness to a grumpy patient eventually you will get a smile or a smirk. Or even if you take the
time to try to get to know them better you will find that their bad attitude or neediness is
actually rooted in something else. In addition, I feel that it is second nature to do a cultural
assessment on the patient to understand where they are coming from. I also make sure that my
patients are informed about their care and answer whatever questions they may have. I actually
love it when patients ask tons of questions. This gives me the opportunity to build a rapport with
that patient and show them that they can trust me because I am aware of the rationale behind my
nursing actions.
Philosophy of nursing applied
During my immersion experience on labor and delivery I received report that this patient
wouldnt make eye contact, stayed on her phone, and was very short when answering questions.
The family dynamic was reported as strange as well, in particular the mother. Even the doctor

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said that they were just not nice. Well as I took over her care and introduced myself, I will
admit I got the very non-conversational patient as described and her mother with this glazed-over
look.
As the shift went on I had time to build rapport with the patient and realize that she didnt
even want her mother there hovering as she had been and she actually preferred her
grandmother. In addition the nicer I was to her, the more she began opening up by not giving one
word answers and actually started engaging with me in conversation. I even got the chance to
coach her through her foley bulb insertion, why it was being put in and comforting her with the
discomfort from it being pulled on every 20-30 minutes. I advocated for her, to her mother, when
pulling on the foley bulb was causing her so much pain. The mother said you have to let her do
it so the baby will come. But I explained to the mother that the baby would come when it was
ready and me not tugging on her foley bulb was not going to change the laboring process
dramatically. Additionally, this was her body and she had the right to refuse anything being done
to it, as long as she understood the possible outcomes of her actions. While this example isnt a
mushy story or example, I think it exemplifies me demonstrating my nursing philosophy in
empowering the patient, looking beyond the physical, and having the chance to build a rapport
with the patient to try to start to figure out what would make her more comfortable.
Changes in values and beliefs
Since writing my philosophy paper in NUR 1100 I was surprised to see that my values
and beliefs had not changed. My thoughts on the terminally ill, self-care, culturally competent
care, and growing in the nursing profession are still the same. I had not read over this paper since
its' submission. Prior to reading it I just knew it was going to sound nave since I had limited

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clinical experiences at the time. Instead, I was shocked at the insight I had and it was a great
reminder as to why I chose nursing as a career in the first place.
Description of Benners Theory
Patricia Benner describes a skill acquisition model that was adapted from Stuart and
Hubert Dreyfus (Benner, 2001). The original Dreyfus model was based on a study using chess
players and airline pilots. Benner however did her own study and applied this model to nursing
to deduce her own findings as to what it meant to be a nurse in one of five levels of skill
development and knowledge proficiency. The five levels in sequential order are novice,
advanced beginner, competent, proficient, and expert. Movement through the spectrum of
acquisition is described as a movement from reliance on abstract principles to the use of past
concrete experience as paradigms (Benner, 2001, p. 13).
The novice stage is one in which nurses or nursing students are beginners and have no
experience. Nurses and nursing student at the novice level rely on rules that have no contextual
meaning in efforts to guide interventions and actions. Benner also notes that there is the
possibility of an expert or higher level nurse regressing back to the novice level if they are
completely unfamiliar with or have not experienced the situation.
Those at the advanced beginner stage are those whose performance is marginally
acceptable (Benner, 2001, p. 22). Advanced beginner nurses and students have some experience
to draw upon. However, when looking at the situation as a whole Benner says that advanced
beginners may look at each piece of the picture or situation as important and can have the
inability to sift out what is the most important. Advanced beginners rely on the rules like a
novice; however, they have more experiences to draw upon. Benner points out that in this stage

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preceptors and mentors are important because they help in developing the skill set of the
advanced beginner and their capabilities to set priorities and identify what is the most important.
The nurse who has been experiencing the same kind of situations for two to three years is
classified as a competent nurse. This type of nurse has the ability to look at the whole situation
and identify what is the most important autonomously. A competent nurse is able to think though
their actions and evaluate how those actions could impact the outcome or goal down the line.
The proficient nurse is one who sees situations as a whole versus individual pieces that
make up a whole. A nurse at this level sees or perceives this whole picture virtually
subconsciously. Benner points out that in contrast to the competent nurse who consciously thinks
through the situation, a proficient nurse already has much more experience to draw upon to know
what to expect in that situation and how to modify accordingly.
The expert level nurse is far removed from relying on rules. A nurse at this level relies on
the tremendous amount of experience as well as their honed sense of intuition with any given
situation. The expert nurse is able to zoom in on the specific problem at hand while immediately
eliminating other less probable solutions based on a wealth of past experiences.
Current stage of skill acquisition and moving to the next level
I think Bon Secours College of Nursing has prepared me enough to where I feel
comfortable saying that I believe I am an advanced beginner in nursing practice. This is because
our curriculum touches on just about every area of nursing, even if it is just for a day. I feel
confident to say that there will be very few situations that I could enter into clinically that would
put me at the novice level with zero experience. In addition, I feel that we focus a lot on
prioritization. While I still have some way to go regarding specific situations, I feel that my

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instructors and preceptors have given me the tools to identify what is the most important in most
situations.
In efforts to move on from the advanced beginner to becoming competent I believe there
are some things that will naturally happen and things that I can do to ensure I become a
competent nurse. One action I can take is to make sure I stay on a particular unit for at least two
years. Through doing this, I can ensure I am building my experiential database to be able to
consciously think through situations. If I were to jump around to different units, I could
potentially be stuck in the novice/advanced beginner stage due to the fact I will always be
entering into a new situation.
Secondly, I believe I can reach the competent level of nursing a bit faster if I were to
continue working on the unit where I currently am having my immersion experience. Through
my many hours spent on this unit, I will already have a knowledge base to build upon and wont
have to overcome some of the administrative procedures related to charting and paperwork on
the patients paper chart because I will know the flow of things. Doing this would enable me to
focus more on my clinical skills.
A third action I could take towards becoming a competent nurse is to identify a mentor
(or mentors). I feel that this would be important no matter what level of skill acquisition you are
trying to attain. I believe it would be beneficial to have a mentor to bounce ideas and thought
processes off of in addition to absorbing their knowledge and skill sets. I also think that it would
be a wise idea to identify more than one mentor since I recognize that everyone brings something
different to the table. The more experienced nurses I draw upon will only enhance my own
growth and development in nursing practice.

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Conclusion
Through taking a look at the bare bones of the profession, I think I have found that at the
core, nursing comes down to having compassion and caring for patients and families when they
are in their most vulnerable moments. I chose nursing as a second career because I realize that I
love helping people and being able to see the fruits of my labor (I know this won't always
happen) in the little moments when I am helping someone take one more step towards becoming
independent in addressing their health needs. If I keep what I believe at the core of my nursing
practice and uphold my philosophy as I care for my patients, I strongly believe everything else
ought to fall into place.

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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.
Bon Secours Memorial College of Nursing. Student Catalog and Handbook 2014 - 2015. (n.d.).
Retrieved September 18, 2015, from http://bsmcon.edu/students/cataloghandbook.