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Personal Philosophy of NursingShal M. BiacsiOld Dominion UniversityAbstractThere exist many definitions of nursing. In 2003, the American Nurses Association (ANA), defined nursing as “the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations” CITATION Ame152 \l 1033 (American Nurses Association, 2015). Although this definition encompasses much more than their previous definition, in 1980 the ANA defined nursing as “the diagnosis and treatment of human responses to actual or potential health problems” CITATION Ber111 \p 7 \l 1033 (Berman, Snyder, & McKinney, 2011, p. 7). This is where I struggled.I lived most of my life under the fallacy that nurses merely implemented doctor’s orders. As I proceed through my journey in nursing school, I am reevaluating my own understanding of what nursing is. One aspect of that reevaluation is to understand how my personal values and beliefs will apply to my new profession as a registered nurse: my philosophy of nursing. Ethical standards, the patient as a unique individual with respect for their own beliefs, the patient’s environment, application of evidence-based practices, holism, and education (for the patient and the nurse) are all critical elements in the duties of nurses. *Terminology usage: throughout this paper, the use of the term patient, individual, or individual patient all refer to a collective portrayal of the person or persons to whom the nurse is providing care. They may be an individual person, that person’s family, or the community as a whole.A mother of six children was asked if she truly loved all of her children equally. She surprisingly answered, “No”.This was followed by an obvious follow-up question, “Well, then which one do you love the most?”The mother replied, “Whoever needs my love the most at that moment.”Nurses are constantly making the same decision as this mother: who needs me the most right now? In order for the experienced nurse to be able to make the best decisions as to which patient needs what and when, the nurse must be able to draw upon information learned and evaluated. As a nursing student, I am still forming the roots of knowledge, wisdom, values, and gut intuition that will feed these same decisions as I begin to practice as a Registered Nurse. These roots are what make up a philosophy of nursing. According to Cambridge Dictionaries, philosophy is simply “the beliefs you have about how you should behave in particular situations in life” CITATION Cam15 \l 1033 (Cambridge Academic Content Dictionary, 2015). So, before I enter into the field of nursing and begin caring for patients, I must have a good understanding of my own values and knowledge that will guide my professional decisions.My philosophy of nursing incorporates various basic core values. I believe it is critical to treat the patient as a unique and complex individual with respect for their personal beliefs, and utilize the patient’s own environment to facilitate healing, promote health, and provide comfort in dying. No nurse is a solo act, but rather a member of a dynamic team. Nursing should be an evidence-based practice, relying not only on scientific research but also clinically-proven beneficial treatments. I believe every act of nursing should be performed with honesty, dignity (for the patient and the profession of nursing), and integrity. In everything (every action, every word spoken, every assessment and diagnosis) there are opportunities for teaching, and holistic teaching is what sets nursing apart from other healthcare professionals. Helen Erickson’s Modeling and Role Modeling Theory provides much of the groundwork of my philosophy of nursing. Erickson’s theory revolves around the concept of the patient as a unique individual and respect for their beliefs and environment. The uniqueness of a patient is not limited to their cultural or racial identity, but also to their individual past experiences, level of knowledge, and their basic perception (real or perceived) of their environment. Growth-promotion and growth-impeding affect a patient’s ability to cope. The ability to cope affects a patient’s response to stressors. The way an individual responds to stressors can impact a person’s overall health and well-being, both psychological and physiological. Ultimately if a person perceives [emphasis added] his or her environment as growth-impeding, it can negatively impact a person’s overall health and well-being. So, if a nurse can recognize the items (people, objects, values, fears) in a person’s environment that are important to that person, then care can be focused with those items in mind and the patient will perceive a better situation. A nurse needs to focus on more than the illness, and instead focus on the person as a whole, to enhance the individual’s experience of care.Another aspect of utilizing a person’s environment to promote healing is based on Florence Nightingale’s Environmental Theory. Nightingale includes in her definition of nursing that nursing should “utilize[e] the environment of the patient to assist him in his recovery” CITATION Bla11 \p 100 \l 1033 (Blais & Hayes, 2011, p. 100). I believe that a patient’s environment should not hinder his recovery. It is the nurse’s responsibility to utilize a combination of medical knowledge and creative thinking to come up with goals and education for each individual patient, regardless of their station or socioeconomic status in life that will not place extra burden upon the patient, yet will work to assist the patient in achieving a status of health by accessing the tools that are available to that patient. If the patient does not have access to prescribed equipment or medications, and the nurse is not able to find resources for the patient to access these items, it is the nurse’s responsibility as advocate for the patient to work with the physician or other team members to make every attempt to find alternative solutions. Another aspect of utilizing the environment of the patient is the idea that a patient can best heal when exposure to foreign flora is limited. While cleanliness is essential, the introduction of someone else’s flora often results in infections in the clinical setting. Every effort should be made to prevent cross-contamination between patients and cross-contamination of the individual’s own regional flora. As a nurse, the focus should also be on getting the patient returned to a state of self-care so they may be discharged quickly and returned home where the exposure to others’ flora is greatly reduced. I believe the nurse is not a solo act. The nurse is a team member of collaborative efforts with other healthcare professionals. The nurse is not the doctor’s handmaiden, but has skills and knowledge specific to nursing that meet the needs of the individual patient in a way no other healthcare provider can offer. However, the nurse usually comes into contact with the patient a great deal more than the other team members, and it is the nurse’s responsibility to work with them in relaying changes in patient status, advocating for the patient’s personal beliefs and desires, and coming up with solutions to best fit the individual patient.Unlike many healthcare professions, the nurse does not rely primarily on symptoms and lab values when treating a patient, but also on the patient as an individual person. An abnormal symptom for one person may be normal for another person. In nursing, we may encourage the use of contemporary and alternative medicine (CAM), but we do so within a scope of evidence-based knowledge. We are not using guess-work, fads, or what-grandma-always-did; unless of course that guess-work, fad, or what-grandma-always-did turns out to have been proven, through research and successful practice in the clinical environment, to be beneficial for the patient. Evidence-based practice (EBP) is not the same as research. Research uses “a systematic investigation focused on creating new knowledge that can be generalized to a target population” CITATION Hai15 \p 12 \l 1033 (Hain & Kear, 2015, p. 12). EBP focuses on what is needed to make an informed clinical decision. EBP allows for application of the patient’s personal desires, the nurse’s expertise, as well as proven research. In order for a nurse to have an effective and productive relationship with the patient, trust must first exist. Trust is built upon ethical standards such as honesty, accountability, and integrity. If the nurse does not portray these qualities in his or her actions, a trusting relationship will not develop. Without trust, healing will be slower as stressors will be introduced from the strained relationship. Additional stressors may damage any future relationship with other nurses the patient may encounter. Building a trusting relationship with patients will also provide dignity to the work of the nurse. The nurse should always act in a manner that upholds dignity for the profession of nursing, and respect the dignity of the individual patient (and the patient’s family). Human dignity is the inherent worth of the individual, and the right to self-determination. Provision 1 of the Code of Ethics for Nurses describes self-determination as “the moral and legal right to determine what will be done with and to their own person, to be given accurate, complete, and understandable information in a manner that facilitates an informed decision” CITATION Ame151 \l 1033 (American Nurses Association, 2015). The last part of this statement encompasses everything: the right to be given information [emphasis added]. Every aspect of the nurse’s job involves teaching. As soon as the nurse begins the assessment, as soon as the nurse states the first diagnosis and sets the first goal, there exist teaching opportunities. Nursing as a whole encompasses assisting patients to a state of improved health or peaceful death. Assistance comes in the form of teaching. Isabel Hampton Robb stated of the nurse: “She is also essentially an instructor; part of her duties have to do with the prevention of disease and sickness” CITATION Zer14 \p 192 \l 1033 (Zerwekh & Zerwekh-Garneau, 2014, p. 192). A patient may come to us with an illness, but we are entrusted with providing that patient knowledge and education on ways to prevent the illness from advance, healthy coping with the illness, and healthy choices and lifestyle changes to prevent secondary illnesses from occurring. Our job as educators is to help our patients utilize the resources at hand to enhance both psychological and physiological wellness. Nursing is a wide and varied application of knowledge, values, respect, and ethics. Having a clearer understanding of my own beliefs and values, level of knowledge, and understanding of my fellow man will allow me to apply these concepts more effectively to the practice of nursing, and in turn provide more consistent, compassionate, and thorough care for my patients. My personal philosophy of nursing will be always changing as I grow in my education, my experiences, and my career. As I have journeyed through this exploration of my own values, I have learned that my actions, in general, have supported my declared values. I have been able to look back at what I have valued in previous times and how they have changed, not only with time (and age), but also with my education. Nursing school has been critical in transforming my maturity and depth of my values.Honor Code:I pledge to support the Honor System of Old Dominion University. I will refrain from any form of academic dishonesty or deception, such as cheating or plagiarism. I am aware that as a member of the academic community it is my responsibility to turn in all suspected violations of the Honor Code. I will report to a hearing if summonedSignature _______Shal M. Biacsi 03/28/2015__________Works Cited BIBLIOGRAPHY American Nurses Association. (2015). Code of Ethics for Nurses with Interpretive Statements. USA: .American Nurses Association. (2015). What is Nursing. Retrieved from American Nurses Association: , A., Snyder, S. J., & McKinney, D. S. (2011). Nursing Basics for Clinical Practice. Upper Saddle River, NJ: Pearson.Blais, K. K., & Hayes, J. S. (2011). Professional Nursing Practice: Concepts and Perspectives (6 ed.). Upper Saddle River, NJ: Pearson.Cambridge Academic Content Dictionary. (2015). English definition of "philosophy". Retrieved from Cambridge Dictionaries Online: , D. J., & Kear, T. M. (2015, January 1). Using Evidence-Based Practice to Move Beyond Doing Things the Way We Have Always Done Them. Nephrology Nursing Journal, 42(1), 11-20.Zerwekh, J., & Zerwekh-Garneau, A. (2014). Nursing Today: Transition and Trends (8 ed.). Elsevier: Health Sciences Division. ................
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