¶ … Personal Nursing Philosophy My Nursing Autobiography

I have dreamt of being a nurse all my life. My mother and older cousins tell me stories of how I loved to line up my dolls and animals, place bandages over them to nurse their 'injuries' and stick branches in their armpits to have a feel of their temperature. Well, I believe these stories because to this day, these are the very things that keep my life going; I derive so much satisfaction from just being able to help people when they are in no position to help themselves. I took an elective nursing course in high school, where I was supposed to report at the local facility at least once every week to assist in the administration of basic care to patients. This marked the beginning of my career in nursing, and since then, I have logged almost 15 years of experience in multiple areas of care including a critical care nurse, a medical assistant, a nurse practitioner, a lab technician, and an x-ray technician. I became a board-certified gerontological nurse in 1992, and currently possess two bachelor's degrees (a BSN in Nursing and a BS in Psychology) and a Master of Science (Nursing) degree from the Gerontological Nursing Program of XXX University.

For years, I observed how healthcare professionals overlooked the spirituality of patients and the possible role that it played in their health lives. I felt the need to want to serve my patients better by offering them all-rounded care that tends to their physical as well as spiritual needs. For this reason, I took a second Master's degree program in Pastoral and Spiritual Care in Loyola College, MA. This, coupled with my experience and academic background in nursing, provided a solid foundation for the kind of patient care that I consider holistic and effective. To me, wholeness and healing are matters of the spirit just as they are of the mind and the body, and it is this very mentality that has guided my practice over the years, and that still continues to drive my passion in the everyday running of my own facility, in which I now serve as a full-time gerontologist and manager.

What Nursing Means to Me: My Personal Philosophy

Reed (2012) defines a nursing philosophy as "a statement of foundational and universal assumptions, beliefs, and principles about the nature of knowledge and truth and about the nature of the entities presented in the metaparadigm" (p. 41). My personal nursing philosophy is pegged on the four metaparadigms of the person, the practitioner, health and the environment; and incorporates the concepts of social justice, developmental care, and family-centered care. It is based on my own beliefs, values, reflections, and personal nursing practice, and captures nursing both as an art and as a science, expressing my own personal understanding of what nursing is about and what it ought to entail.

Most nurses structure their theories and personal philosophies in such a way that they pay specific attention to providing quality care to patients so they are able to improve their overall health status. From the experience I have gathered working as a gerontological nurse, I have developed a belief that the best outcome for a patient may not always be an improved health status; at times, a dignified death is the best health outcome that a practitioner can offer their patient. This is the position I take in my nursing philosophy, and for this reason, I base my practice on conveying nursing science with compassion so my patients would have a dignified end-of-life experience that aligns consistently with their patient values and priorities (Volker & Limerick, 2007). The subsequent sections focus on showing how this position shapes my personal practice, how it aligns with theory and nursing concepts and how it shapes my contribution to existing nursing knowledge.

Nursing Metaparadigms

The four nursing metaparadigms -- the patient, the practitioner, health and the environment - are the central concepts of the nursing practice, and the basis for the development of both nursing knowledge and nursing philosophy. The four interrelate and interact with each other and need to be considered concurrently in the development of nursing philosophy (Reed, 2012). The four are also integral to nursing knowledge, which Reed and Lawrence (2008) regard as "useful and significant to nurses and patients in understanding and facilitating human health processes" (p. 432). This explains why the four are a fundamental component of my nursing philosophy and my personal view of nursing.

The Person

The person, in the nursing context, refers to the individual patient for which the nurse is providing care. This...

Understanding a patient's specific needs is the first step towards understanding the patient and offering personalized care. My personal philosophy in reference to the person is focused on offering care to address the unique needs of patients.
For years, I have observed nurses make use of the traditional model of care, where the practitioner focuses only on a specific diagnosis or a limited set of symptoms as reported by the patient. This in my view presents a very shallow approach to the delivery of care -- one that misses the bigger picture by ignoring the fact that a patient has other lived experiences beyond the care setting, and these could also have a hand in their current health condition. My personal philosophy recognizes that individuals are part of the greater society, and this society plays a major role in shaping their health lives and health conditions. For this reason, I commit my practice to providing a holistic approach to care -- one that makes diagnoses on the basis of not only what the patient reveals in the acute care setting, but also their subjective lived experiences within the society.

Health

Simply stated, health refers to a dynamic state between wellness and illness. The state of health or wellness affects the person and their ability to carry out their normal activities. For this reason, the health metaparadigm links closely with that of the person. My personal philosophy covers the optimization of health in terms of not only the individual, but also the population. I am conscious of the fact that an individual's health does not exist per se -- health is determined by a range of social, political, and economic factors in their external environment. My personal philosophy, therefore, connects the individual's health and these societal elements. It looks beyond the health of the individual, and focuses on identifying elements within the society that could be changed to maximize the health standing of the individual and the population. Moreover, it does not limit itself to improving the physical health status only; it also endeavors to nurse the spiritual and psychological health to enable the patient not only regain function and health, but also transition to a dignified death. I find it necessary to try and understand individual patients' perception of health so as to develop care plans that respond to their unique and specific health needs.

The Environment

Individuals are members of the greater society, and their health standing is a function of various elements in their surroundings. The environment metaparadigm places the patient within the context of their external environment rather than as an entity separate from it. The practitioner is supposed to take the effect of the environment into consideration, and not just the symptoms identified by the patient in the acute care setting when developing care plans. As such, the environment metaparadigm interrelates strongly with the person, health, and the practitioner.

In light of the environment metaparadigm, my philosophy places equal emphasis on societal factors that impact the health of individual patients and the population as a whole. I am conscious on taking on a multi-centered approach focused on developing health initiatives for maximizing health outcomes for the whole population as opposed to individuals. My philosophy aims at understanding the geographical location, gender, ethnicity, and socioeconomic status of patients to determine how they influence health outcomes and how they could be changed to improve the health outcomes of the greater population. This broad perspective of health has helped me challenge shallow and short-sighted interventions and be able to think of healthcare from a population perspective, as opposed to blaming patients for poor health.

The Practitioner

My nursing philosophy appreciates the role of the nurse/practitioner in the delivery of care. The nurse has a responsibility to always act in the best interest of the patient and their health. Every interaction between a patient and their practitioner has an impact on their health. My philosophy inclines towards the maintenance of strong therapeutic relationships with my patients. I strive to serve and treat all my patients equally regardless of race, ethnicity, gender, age or culture. My philosophy is focused on the concept of perpetual learning -- improving my range of skills and knowledge about different cultures so as to be able to offer the best quality trans-cultural care to a diverse range of clients. I am conscious about…