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Running head: REFLECTIONS

Reflections of Nursing Practice

Danielle Bular
Ferris State University


One of the many aspects of nursing that is encouraged is reflection. This paper is a
reflection of the current nursing practice, skills, attitudes, and outlining knowledge. Secondly,
this paper is an introduction to the authors experiences, attitudes, and personal philosophy of
nursing. Lastly this reflection hopes to shed light on nursing and all its different aspects.

Reflection of Nursing Practice
I am writing this paper about my practice in medical oncology nursing. I have never
taken the time to take an outside look at what I have accomplished being a nurse. I look forward
to analyzing my everyday routines and training. In this paper, I hope to have some self-
discovery. This paper has given me a chance to look at the extensive knowledge, skills, and
attitude that are needed in everyday practice. I will talk about the definition of philosophy and
my understanding of how it affects my career every day. I will discuss my personal understand
of the three nursing concepts. I will explain what I believe effects a person, environment and
health. The last section in a short synopsis of the standards of nurse practice and how they effect
my role as an oncology nurse.
Current Practice
The authors current area of practice is in general medical/oncology. I have been a nurse
for six months and have loved every second it. In day-to-day interaction there is a variety of
different patient with illnesses on the floor ranging from cellulitis to hospice. On the floor,
emotions can run high at times, but one must remember that it is all part of this wonderful career
we all have chosen. The next sections will talk about the knowledge, skills, and attitude that are
needed to be successful on a medical oncology floor.
The knowledge needed to be successful on my current floor is extensive. Black (2011)
outlines that having a basic unique knowledge, though an educational program is one
characteristic of a profession (Black 2011, p. 52). As a new graduate, and generalist, I have the
basic knowledge needed to care for patients, however, the nurses in this specialty are certified in
chemotherapy, reading cardiac telemetry strips, and in hospice care. According to White and
OSullivan (2012), education is an important standard for professional nursing and my
knowledge of respiratory acidosis, oncology crisis, and amputations is essential to perform safe
care. The care that we provide on my floor varies greatly from patient to patient. Some of the
required knowledge is of peripherally inserted central catheter (PICC or PIC line), Port
access, and jejunostomy tubes. This is a wonderful floor for a nurse to start out on because of all
the knowledge that one acquires while working there. The next section will discuss the different
skills a nurse would acquire while working on a medical/oncology floor.
I have many skills that I acquired in nursing school that I use every day. Some of those
skills are basic care for a patient; such as someone whom needs a bed bath and/or bed change. I
hang blood and blood products on a daily basis, because I deal with a lot of sickle cell patients. I
access power ports, peripherally inserted central catheter lines, and perform blood draws each
morning. I do wound care on amputations, surgical incisions, and chronic wounds. I deal with
patient controlled analgesics pumps and patients with chronic pain everyday. Almost all of my
patients are on cardiac telemetry monitoring which means that I must read and analyzing the
strips. Some of my ongoing learning is how to do comfort care, hospice and post mortem care.
According to Black (2011) nursing technologic development include genetic, biomedical,
information and knowledge (p. 45).
I love my job and I love the patients I work with on a daily basis. I enjoy learning new
skills and becoming certified in new areas. Some days it is hard to separate myself from my
patients. What I find hard is taking care of a patient from when they first get diagnosed with
cancer, then when they are on hospice care, and then pass away. I try to leave it at work, but
sometimes I am lacking in will power. I have patients who want to stuff their faces with food
while saying that their pain is at a 24 and get mad when you do not bring them their needed pain
meds on time, while the patients family in the next room over is weeping because their dad is 50
years old and dying of brain cancer. Sometimes I need to take a breath between rooms. Overall
I try to have a great attitude about work. Black (2011) explains that there are five stages of
grieving denial, anger, attempting to gain control, depression and acceptance (p.197). When I
work with a cancer patient, I find myself going through the stages of grief for the patient. When I
started work I thought that I would be immune to getting attached to my patients, I know now
that is the farthest concept from the truth.
In this paragraph I will outline the nursing concept of philosophy. According to Merriam-
Webster (2013) philosophy is an analysis of the grounds of and concepts expressing
fundamental beliefs(p.1). Personally I believe that philosophy is your views and beliefs of care
and understanding of the patient and their needs. These views can change everyday depending on
what situation a person is in. Each person has to have a understanding of what their belief system
consist of including their morals and ethical standing. Some nurses never have their beliefs/ of
views challenged, however I work with patients that challenge what I believe everyday. After
being a nurse for seven months on the medical oncology floor, the authors philosophy of people,
health and environment have become stronger. Every nurse has a different philosophy of what
nursing is, many nurses believe the American Nursing Association (ANA) definition of nursing,
which is close to the authors personal one belief as well. Nursing is 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(ANA, 2013, p.1).
I will outline the nursing concept of person. A person is a unique, adaptable being who
seeks homeostasis. They are motivated by their hierarchy of needs and influenced by genetics
and their environment(Black, 2011, p. 240). A human is a complicated being, their environment
changes rapidly and frequently. Some people thrive in a stressful health crisis and others give up
the fight. I believe how successful a person is in life depends on support systems, personality and
In this paragraph I will outline the nursing concept of health. Health is a dynamic,
continuum, holistic ever changing beliefs and behaviors that affect a person(Black.2011, p.
240). Personally I define health as a blending of mental and physical health. To be mentally well,
I believe there need to be a support system in place whatever "support system" means to an
individual including but not limited to proper coping techniques, people they can rely on in times
of need and a sense of self confidence in their everyday life. To be physically healthy can range
from a women doing yoga everyday to a man running a marathon. People need to start believing
that their bodies are beautiful works of art, but just like a priceless piece of art if it not cared for
or preserved in the right fashion it will slowly fade away. I believe that physical health is just as
important as mental health.
In this paragraph I will outline the nursing concept of environment. Environment can
affect a person both physically and mentally(Black, 2011, p. 240). A persons environment can
change on a daily basis. I see this everyday with oncology patients. I have had patient who come
is that ten days ago they were up walking around and independent and now they have been
diagnosed with stage four lung cancer. This person environment has changed very dramatically
since ten days before. I believe we need to be flexible with what the day brings us. We must
learn how to adapt and change or we will cease to exist.
Nursing Theory
Black (2011) discuses how the foundation of nursing are like bones of a human skeleton
that work together to hold all the pieces of the body together. There are three essential factors
that affect a human being they are person, health and their environment. Each of these factors has
sub concepts that help forum the ever-changing philosophy of professional nursing. Each part
of a system is a necessary or integral component required to make a complete, meaningful while.
These parts are input, throughput, output, evaluation and feedback. (Von Bertalanffy, 1968)
When I completed my associates in nursing at Southwestern Michigan College, I did not
have a clear picture of what nursing meant to me. I was so busy working on just passing nursing
school to think about how the standards of nursing practice affected me. During my first
semester at Ferris State University I have learned many aspects of where I stand morally and
ethically. I now have a better understanding of nurse practice and how is affects my practice as
an oncology nurse.
The professional standards that have stood out to me this semester are ethics and
education. Ethics are a subject most people do not want to discuss, but I have found that it is
essential to know where you stand morally to be able to give your patients the best care. During
this semester I have been forced to think about where I stand on moral issues. I have found this
experience to be challenging and enlightening.
Education is a very important aspect of professional nurse practice (ANA, 2013, p.1). We
must take continuing educational credits during the year to keep our license active. Each state
has different requirements for what the continuing education will be every two years. Evidence
based practice and research is another aspect of the education nurses must keep current with to
be able to give their patients best care and outcome (ANA, 2013, p.1). Most companies
encourage their nurses to go back to school to receive a higher level of education. I know
personally going back to school for my bachelors in one of the best decisions I have made in the
last year.
During my transition into my bachelors, I have learned the importance of quality of care I
give to me patients daily (ANA, 2013, p.1). Some nurses I work with lack in giving their patients
quality care. When I speak with the patient during my assessment, they start to talk about the
care they received during the day and how they felt like a burden to the staff. I hope if I am ever
complacent with my nursing care that someone pulls me aside and speaks to me about it.
Communication is vital for great patient care (ANA, 2013, p.1). At my work, nurses do
bedside repost. It has greatly improved the communication between the team and patient. When
giving bedside report I always ask the patient if I missed anything or they would like to add
anything. Collaboration is working together as a team (ANA, 2013, p.1). This can include the
family, doctor, nurse and other multi-disciplinary teams. I find that I must be a leader when
asking the patients about their care and concerns at the bedside. I want to be a leader in giving
the best possible care to my patients. There are many aspects of bedside report that I find to show
our dedication to the standards of nurse practice.
As a professional nurse, I must be able to have my practice evaluated by other
professionals and be willing to change if necessary. When working in a team setting, we must
keep each other accountable to the professional standards (ANA, 2013, p.1). If a nurse is unable
to preform the best care for the patient, they must be able to trust another nurse or team member
can step in and help with the problem. This is part of using your resources. I enjoy working in a
hospital because I have a multi-disciplinary team surrounding me if I need them. As nurses we
must provide the best possible care for our patients. We must make curtain that we provide a safe
and healthy environment (ANA, 2013, p.1).
This paper has made me discover my personal definitions of a few nursing concepts. I
have learned some key feelings I have about the care of my patients. After writing this paper, I
will continue to have a personal understanding of how I believe these nursing concepts shape my
current practice.

American Nurses Association [ANA]. (2013). Professional Standards. American Nursing
Association. Retrieved November 29,2013, From
American Nurses Association [ANA]. (2013). What is Nursing. American Nursing Association.
Retrieved October 7, 2013, from
Black, B. (2011). Professional Nursing Concepts and Challenges (7 ed.). St. Louis: Pearson.
Webster. (2013). Philosophy. Merriam-Webster. Retrieved November 10, 2013, from