Running Head: MY PHILOSOPHY OF NURSING

My Philosophy of Nursing Mai Nomura Clover Park Technical College RN Program

MY PHILOSOPHY OF NURSING My Philosophy of Nursing Introduction My nursing philosophy is similar to my life philosophy; that everyone is entitled to live a

long, fruitful life with good health, happiness, and fulfillment. By using that as a foundation and utilizing the contributions of theorists Jean Watson and Dorothea Orem I am able to form my nursing philosophy. In this paper I will detail that nursing philosophy as it stands today. Nursing, Health and Illness Defined It is important to first define what nursing, health, and illness is in order to better understand its accepted definitions and how I feel these definitions are meaningful to me. Nursing According to the American Nurses Association (2010), 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 (p. 66). Along with that definition I also closely identify with Jean Watson, whose nursing theory of caring focuses on the importance of the caring relationship and communication in an individuals health (Duncan & DePew, 2011, p. 221). Caring and therapeutic nursing promotes spiritual healing as evidenced by a study by Meleis (Ryan (2005), quoted in Duncan & DePew, 2011, p. 116). Health Health is defined as an experience that is often expressed in terms of wellness and illness and may occur in the presence or absence of disease or injury (American Nurses Association,

MY PHILOSOPHY OF NURSING 2010, p. 65). As I feel that health is a mix of physical, mental, and social well-being with all working towards individual self-actualization, I would also include as a definition of health Abraham Maslows hierarchy of needs; physiologic, safety and security, love and belonging, self-esteem, and self-actualization (Linton, 2007, p. 80). Illness

(Linton, 2007) states that illness is a deviation from a healthy state that may occur acutely or as a series of long-term events (p. 85). I also feel that any internal body condition that interferes with a persons human potential should be considered an illness. External factors play a role as well; Florence Nightingales environmental theory lists concepts that when compromised play an important part in causing illness; cleanliness, diet, light, warmth, noise level, ventilation, and social, mental, and physical environment (Duncan & DePew, 2011, p. 217). Nursing Philosophy Statement My nursing philosophy is based on the concept that health is a mix of physical, mental and social well-being, and in order to treat a patient optimally all areas must be addressed. A nurse plays an integral role in furthering client recovery by addressing his or her physical, mental and social needs. Watsons philosophy of caring supports this by stating; effective caring promotes health and individual or family growth (Current Nursing, 2012), and caring consists of carative factors that result in the satisfaction of certain human needs (Current Nursing, 2012). As a home health and hospice nurse empowerment is another concept that is important to me, Orems nursing theory eliciting their participation in plan of care and return to their highest level of self-care (Duncan & DePew, 2011, p. 221), is one that I practice daily, helping clients as much

MY PHILOSOPHY OF NURSING as I can but trying to not do more than I should, encouraging their self-care. The following concepts are also integral to my nursing philosophy: Advocate An advocate is one who speaks for or acts on behalf of another person (Duncan & DePew, 2011, p. 23). As a nurse I find that when a client places their trust in me they find it easier to relay their concerns and desires. They are also often unable to express themselves to others due to language barriers, fear, or illness. Being an advocate means being there for a patient when they are in need, as part of Watsons importance of the caring relationship and communication in an individuals health (Duncan & DePew, 2011, p. 221). Communicator A communicator uses therapeutic communication to relate information and to explore clients feelings and thoughts (Duncan & DePew, 2011, p. 27). Establishing a relationship is one of my goals when I meet a client, as I feel that once a relationship is made everything else falls into place; trust, open communication, and positive energy. Peplaus theory supports this,

encouraging one to develop therapeutic interpersonal skills in meeting the needs of each client (Duncan & DePew, 2011, p. 222). Counselor A counselor listen(s) to a client and uses therapeutic communication to assist the client in making a choice that determines his health outcome (Duncan & DePew, 2011, p. 24). Being a good listener is a role I do well, and by providing a safe place for them to express themselves I am able to establish a relationship that educates and allows them to evaluate their choices and

MY PHILOSOPHY OF NURSING make a knowledgeable decision in their healthcare. A nurses education and training gives her the skills to assess a clients emotional status, which assists in counseling the client (Duncan & DePew, 2011, p. 24). Collaborator A collaborator interacts with the personnel of several departments to coordinate the clients care (Duncan & DePew, 2011, p. 25). Good communication and working relationships play a large role in fostering efficient care and treatment. Meeting with the client and family

members is another way of collaboration that supports the goal of maximum health (Duncan & DePew, 2011, p. 26). Professional A nurse acts as a professional when they interact with patients, health care team members, and co-workers (Duncan & DePew, 2011, p. 27). Establishing relationships is important but unless I carry myself in a professional manner, with the knowledge, manner and skills that a nurse should have, I will ultimately not be seen as a professional nurse. Another professional trait is accountability which is being responsible for and liable for ones personal actions and for the inaction of oneself and those under supervision (Duncan & DePew, 2011, p. 185). I would also include ethical behavior, utilizing the principles of justice, autonomy, beneficence, nonbeneficence, and veracity (Duncan & DePew, 2011, p. 235). Contrast Philosophy Statement with Nursing Theory Introduction of Nursing Theory

MY PHILOSOPHY OF NURSING A theory is defined as an abstract statement that explains the relationship of concepts (Duncan & DePew, 2011, p. 218). In other words it explains how facts, ideas, principles, or laws (Duncan & DePew, 2011, p. 218) tie in together to define a concept. Nursing theory thus

can be explained as theories that are providing nursing with a framework that will support what we do, how we do it, and when we do it (Duncan & DePew, 2011, p. 218), and supports measures to improve quality care by collecting scientific data (Duncan & DePew, 2011, p. 218). Contrast between my Nursing Philosophy with Nursing Theory. I am influenced by the theories of Jean Watson and Dorothea Orem for their theories of caring and empowerment. When I am with a client we are interact in a synergistic way as human beings with similar hopes, fears, expectations, and ego, and by being empathetic with the client I am better able to provide the care and empowerment that will enable their health and wellbeing. Jean Watson. Jean Watsons theory supports the idea of humanistic and holistic care; focus is on caring, promoting health and preventing illness (Duncan & DePew, 2011, p. 221). Her theory also focuses on the importance of the caring relationship and communication in an individuals health (Duncan & DePew, 2011, p. 221). Dorothea Orem. Orems theory was first published in 1971 as self-care theory (Current Nursing, 2012). Her theory assumes that people are distinct individuals and should be selfreliant and responsible for their own care (Current Nursing, 2012) as much as possible. Nurses assist clients to their highest level of self-care (Duncan & DePew, 2011, p 221) by involving them in their plan of care (Duncan & DePew, 2011, p 221), and providing education so that clients can make a knowledgeable decision regarding their care.

MY PHILOSOPHY OF NURSING Provider of Therapeutic Care

I provide therapeutic client care by establishing a relationship that gains a clients trust by providing safe, competent and therapeutic client centered care and taking the time to listen; enabling the client to be able to share information and thoughts that they would normally be hesitant to share. Therapeutic techniques include; broad open-ended statements or questions, reflection, clarification, silence, reassurance, summarization, and acknowledgement (Duncan & DePew, 2011, p 92). Ethical Responsibility Ethical nursing is based on the following principles; Justice-making sure that clients are treated fairly, Autonomy-that they have the autonomy to make their own decisions, Beneficencepromoting a clients health or wellbeing, Nonbeneficence-not harming a client, and Veracitybeing truthful to the client (Duncan & DePew, 2011, p 235). Being ethical also means demonstrating ethical responsibility in my nursing practice, providing equal and respectful client centered care regardless of diversity. Problem Solving and Critical Thinking, Patient Care, & Professional Role To solve a problem I would; first identify the problem, consider and choose the best solution, implement the chosen solution, and evaluate its effectiveness using ones nursing knowledge, experience and critical thinking skills (Duncan & DePew, 2011, p 125). Critical thinking for a RN in a clinical setting is thinking in a systematic and logical manner with a willingness to be able to consider diverse options utilizing ones nursing knowledge and experience as disciplined, self-directed, critical thinkers (Foundation for critical thinking, 2003). A LPN would usually perform skills based on parameters set by the RN or Health Care Provider,

MY PHILOSOPHY OF NURSING and any deviance would be reported to the RN for follow up. I am learning that the more

knowledge and experience I accumulate the more instinctual and at ease I am in problem solving and critical thinking, which enables me to better provide patient care that optimizes recovery. RN Roles, Competencies, Scopes, & Standards of Practice As I transition from a LPN to a RN I will be doing many of the same skills and assessments, but I will be doing so with more knowledge, critical thinking skills, and nursing judgment (Duncan & DePew, (2011), p33). The National League of Nursing and the Washington State Nursing Commission Scope and Standards of Practice details LPN and RN roles and responsibilities, and while they both have similar roles the responsibilities are different, a LPN will usually perform many of their duties under the direction and guidance of a RN while continuing their career options, while the RN initiates, evaluates, assesses and implements decisions independently, often performing in a managerial role (Duncan & DePew, 2011, p. 70, Washington State Nursing Commission, 2013). Conclusion My goal as a LPN and future RN nurse is to improve the lives of the clients that I encounter utilizing my nursing philosophy, knowledge, and skills to address their physical, mental and social needs. With the current changes in providing health care access to more Americans there will be an increased need for quality nursing and care that optimizes a clients health and wellbeing in a cost effective and efficient manner. If we as nurses are at the forefront of this change as equal partners in improving health care then that portends well for the future of health in this country.

MY PHILOSOPHY OF NURSING

References

American Nurses Association. (2010). Scope and standards of practice - nursing. (2nd ed.). Silver Spring, MD: Nursebooks.org. Current Nursing. (2012, February 04). Dorothea orem's self-care theory. Retrieved from http://currentnursing.com/nursing_theory/self_care_deficit_theory.html Current Nursing. (2012, January 26). Jean watson's philosophy of nursing. Retrieved from http://currentnursing.com/nursing_theory/Watson.html Duncan, G., & DePew, R. (2011). Transitioning from lpn/vn to rn. (2nd ed.). Clifton Park, NY: Delmar Cengage Learning. Foundation for critical thinking. (2003). Critical thinking and nursing. Retrieved from http://www.criticalthinking.org/pages/critical-thinking-and-nursing/834 Linton, A. D. (2007). Introduction to medical-surgical nursing. (4th ed.). St. Louis, Missouri: Saunders Elsevier. Ryan, L. (2005). The journey to integrating watsons caring theory with clinical practice. International Journal of Human Caring , 9(3), 26-30. Washington State Nursing Commission. (2013). Standards of nursing conduct or practice. Retrieved from http://apps.leg.wa.gov/WAC/default.aspx?cite=246-840-700