Running head: NURSING PHILOSOPHY 1

Nursing Philosophy

Aida D. Zuniga

Bon Secours Memorial College of Nursing

NUR 4142: Synthesis for Nursing Practice

March 21, 2017

I pledge
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Nursing Defined

Over the course of my nursing education at Bon Secours Memorial College of Nursing, I

have come to understand that there is much more to nursing than just following doctors orders

or taking care of sick people. Nursing is practically an art form, and like any art form, it is

developed and crafted over time. With that being said, as a student nurse approaching graduation,

I personally define nursing as the following: An unbiased, unprejudiced method of providing

holistic care that aims to leave the patient in a better state (physically, mentally, and/or

spiritually) than that in which he or she was found.

The three tenets of Bon Secours nursing philosophy statement I feel align best with my

definition/philosophy of nursing are to 1.) Practice loving kindness, 2.) Promote and accept

the expression of negative and positive emotions, and 3.) Create a healing environment for the

physical and spiritual self, which respects human dignity, ("Nursing", 2017). Practicing loving

kindness coincides with my definition of nursing because treating patients with kindness builds

trust. As trust is established, the patient is more likely to share his or her needs with the nurse,

which in turn allows the nurse to advocate on the behalf of the patient. Advocating for patients

will then hopefully result in a positive outcome. Much like the practice of loving kindness, the

acceptance of self-expression also fosters trust because the patient does not fear judgment.

Moreover, it enables the patient to be honest with the nurse, which allows the nurse to better

holistically assess the patients needs. Finally, creation of a healing environment that respects

human dignity allows the patient to feel they are in a safe place, where they do not need to fear

judgment, exploitation, or ridicule. The patient will understand that their opinions matter, and

that their wishes will be honored. As such, the patient can relax (at least as much as someone can

relax in a hospital setting) and focus their energy on recovery.

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Reflection on Philosophy in Practice

Although I am still very new to the world of nursing, I do try to incorporate my personal

philosophy (as stated above) into my nursing practice. I will admit that I am not always

successful, but I make every effort to leave my patients in a better state than that in which I find

them. During my time as a nursing student, I have encountered patients from all walks of life,

some of which are very different from my own. I have cared for patients who practice different

religions, who come from different parts of the world, and who were raised with different

moral/ethical beliefs than the ones I grew up with. I can honestly say that I tried to treat them all

with the same kindness, respect, and compassion regardless of their religion, race, age, gender, or

ethnicity.

As a student nurse, the interventions that I can implement (without the supervision of a

registered nurse) are somewhat limited. However, during clinicals, I always make a point to do at

least one thing on my own whether it is the use of therapeutic touch/listening or simply fetching

a cup of ice water that brings some measure of comfort to my patient and/or their family. I

would like to believe that these interventions, along with those I implement with the help of the

RN, leave my patients in a better state of health (mentally or physically) than they were in before

being placed in my care.

Nurse-Patient Encounter

During the second semester of my junior year of nursing school, I came across a patient

on the neuroscience telemetry unit whose plight resonated with me. This particular patient had

been on the unit for three days. Because of the patients condition, she was unable to shower

independently, and had been receiving bed baths, which did not allow the patient to wash her

hair. This patient was near hysterics because no one could figure out a way for her to wash her
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hair without using the shower. She repeatedly told the nursing staff that washing her hair was a

part of her daily routine, and she felt dirty and gross having gone for three days without

washing her hair. With a little patience, a large number of towels, a plastic cup, and two clean

washbasins, I was able to shampoo and condition the patients hair while she sat in a chair. It

took a while and made a bit of a mess (which I cleaned up, of course), but the sense of peace it

brought the patient made it well worth the effort. She said she, felt human again. Obviously,

washing a patients hair is not a life saving, revolutionary intervention, but it was something I

was able to do for this patient that made her happy. It brought her comfort, and left her in a better

mental and emotional state of mind. With that being said, I believe that this story is a good

demonstration of my personal philosophy of nursing.

Values and Beliefs

Nursing school is a life-changing experience, and I doubt anyone can go through it

without changing in some way. Prior to entering nursing school, I placed a higher value on

recognition. I thought that being recognized for my work meant that I was doing a good job. As I

entered clinicals, I soon learned that nursing is often thankless work. I learned that the real

thanks comes from seeing your patients recover, and from seeing them go home in better health

and in better spirits. Not being recognized and praised does not mean that Im not doing a good

job; it just means that my sense of validation is not a priority. The priority as a nurse is to

provide high quality, evidence based care for those who are in need of it.

Overall, my beliefs and values have generally stayed the same, apart from what I have

already mentioned about my former need for recognition. I still believe that healthcare is a basic

human right that should not be denied based on someones ability to pay for it. I still value hard

work, as I believe it is the only way to achieve my goals. Above all else though, the thing I value
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most is love. It is the love of my family and friends that has brought me to where I am today, and

it is my love for helping others that allows me to practice the sacred profession of nursing.

Benners Theory

According to Benners From Novice to Expert (2001), there are two types of knowledge:

knowing how and knowing that (p. 2). The first of these refers to practical knowledge

(the acquired ability to perform a skill), while the latter refers to theoretical knowledge (Benner,

2001, p. 2). Per Benner, as a nurse gains experience, he or she transitions from a state of heavily

relying on practical knowledge to a state of relying on his or her theoretical knowledge. As this

transition takes places (over the course of many years), the nurse passes through the following

five stages: novice, advanced beginner, competent, proficient, and expert.

At the novice stage, the nurse demonstrated less flexibility, and strictly follows the rules,

as he or she has little real-world experience to work off of. Once the nurse reaches the advanced

beginner stage, the nurse beings to recognize aspects, or the immeasurable, non-objective

pieces of data that can only be detected once some level of experience has been gained (Benner,

2001, p.22). The competent stage is reached at approximately the two to three year mark. At this

point, the nurse gains the ability to prioritize and organize his or her tasks. This goal-setting

ability enables the nurse to better manage the unpredictability of nursing (Benner, 2001, p.25-

27). At the proficient stage, the nurse is able to use their experience to view situations as wholes

rather than in terms of aspects, (Benner, 2001, p. 27). This enables the nurse to predict (to some

extent) what will happen in certain cases. Finally, at the expert stage, the nurse no longer needs

to depend on hospital policies and procedures, as he or she now has the experience and intuition

to think independently and proceed accordingly (Benner, 2001, p. 31-33).

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As a part of her theory, Benner (2001) has also identified seven domains of nursing

practice, each with their own set of competencies (p.46). The Helping Role domain simply

speaks to the fact that as one of the worlds most trusted professions, patients will seek help in

many forms from nurses (Benner, 2001, p. 47). The Teaching-Coaching Function domain refers

to the nurses role as an educator. Proper teaching and patient education can have a big effect on

patient outcomes (Benner, 2001, p. 77). Next is the Diagnostic and Monitoring Function domain.

This domain describes the importance of a nurses ability to understand diagnostic results and

interpret what they meaning for the patient (Benner, 2001, p. 95). The Effective Management of

Rapidly Changing Situations domain makes reference to the reality that nurses are often the ones

to pick up the signs that a patients condition is declining. As such, it often falls to the nurse to

handle the situation until the physician becomes available and can take over (Benner, 2001, p.

109). The Administering and Monitoring Therapeutic Interventions and Regimens domain

describes the additional skills a nurse must master beyond simply knowing how to

successfully implement the interventions required for their patients (Benner, 2001, p. 121).

Monitoring and Ensuring the Quality of Health Care Practices is the domain that addresses the

nurses ability to catch mistakes (hopefully) before they negatively impact the patient (Benner,

2001, p. 135). Finally, the Organizational and Work-Role Competencies domain speaks to the

organizational skills a nurse must learn while actually on the job to successfully perform all her

assigned tasks (Benner, 2001, p. 145).

Skill Acquisition Stage

As a nursing student albeit a nursing student who will be graduating in the very near

future I consider myself to be at the novice stage of skill acquisition. The experience I have is

limited to what I have seen and done during my lab simulations and clinicals. Similarly, my skill
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set is limited to what I have learned from my textbooks and what I have practiced in lab (and on

a few occasion, in the hospital setting). If I were to start working tomorrow, I would have to

make my decisions according to what I have been taught in class, existing hospital policies and

orientation training, as I have no real-world experience to guide me. Next semester, I will have

my Immersion experience, which I am hoping will at the very least bring me to the cusp of the

advanced beginner stage.

Three Things to Move Forward

As I mentioned above, I will finally have my immersion experience next semester.

Immersion will be my first experience having some independence to exercise my critical

thinking skills, and gain some pseudo-real-world experience. Having said that, Immersion is first

on my list of things I will do to help me progress through the novice stage toward the advanced

beginner stage. Next, I will continue use my textbook, Winninghams Critical Thinking Cases in

Nursing, to practice case studies, as I have found them to be a great way to bring together all the

content I have been taught thus far. Case studies force me to think critically, which is why I

prefer them to practice questions (although practice questions can certainly be helpful, too).

Lastly, I plan to use every opportunity I have to seek advice from more experienced nurses to

learn skills that cannot be learned from a book (time management, organizational skills,

communication/collaboration skills, etc.). I realize just how invaluable of a resource my

instructors have been during my time in nursing school, and I am positive that my future

preceptors will prove to be just as invaluable. I understand that many different factors combined

with hours of hard work and dedication go into reaching the expert level of nursing skill

acquisition, but I hope that these three steps will jumpstart my progress towards becoming an

expert nurse.
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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.

Nursing. (2017). Bon Secours. Retrieved 18 February 2017, from

https://bonsecours.com/richmond/jobs-and-education/nursing