Running Head: PHILOSOPHY OF NURSING

Amanda Wise
Philosophy of Nursing
NUR 4142 Synthesis for Nursing Practice
October 14, 2016
Dr. Turner
I Pledge Amanda Wise

Section 1

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I define nursing as caring for the sick, injured, and dying; but more than that I define
nursing as protecting the patient, promoting health, preventing illness, and being accountable for
providing optimal care; this includes families of patients combined. Nurses must maintain a safe
environment for all by performing as a competent professional committed to lifelong learning.
Collaboration and communication are essential to providing quality care; this encompasses the
patient, the patients family, and each healthcare member involved in care (physician, nurse,
social work, BSMART ect.). Consistent care for all patients is essential to providing respect,
compassion, and dignity to all patients. At Bon Secours we are taught to bring compassion to
health care as part of the healing ministry of Jesus Crist (Bon Secours Mission). As part of the
values of Bon Secours, innovation is necessary for the continuation of being good help.
Innovation is developing new ways of practicing by using technology or another means; not just
continuing to do something just because we have always performed in a certain way. As nurses,
we strive to be better not just in how we care for patients but also in providing a safe
environment and not putting our patients in harms way. For example, when we do research to
find causes for infections or when we try new codes to better expedite care. Innovation is a
crucial part of any nursing philosophy because as we change and the health care system changes
we become more knowledgeable and experienced and therefore our philosophies change. This
change is innovation and crates better care for all.
Section 2
The above philosophy of nursing is reflected in my nursing practice. When I have a
patient who is young and has attempted suicide or a patient with dementia who cannot
communicate or perform activities of daily living; each patient is always treated with the utmost
respect, compassion, and dignity. Collaboration may involve different specialties such as

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BSMART and hospice; professionalism is maintained and quality of care remains consistent.
With the use of different specialties, collaboration is essential in providing quality care for the
patient and increasing the chance of success and health for the patient in the future.
Nursing ethics are an integral part of providing quality care to each patient. Ethics in the
medical field include; beneficence, non-maleficence, justice, and autonomy (Bon Secours
Mission). Autonomy is very important because as a nurse I promise to provide quality care and
to treat each patient with dignity but ultimately it is up to the patient to make informed decisions
about their health and how they receive care. This comes in many forms such as; a DNR or a
living will. Each patient has the right to refuse a Tylenol just as much as they have the right to
refuse intubation. As a nurse I must respect this decision and make sure that the patient has all of
the information needed to make these types of healthcare decisions because ultimately the
decision is theirs to make. Ethics is about morality and each person differs in what they think is
moral. At Bon Secours we take a Christian outlook on morality and this guides not only how we
treat each other but how we treat our patients and their families.
My personal nursing philosophy reflects Bon Secours philosophy statement, mission,
vision, and values. Each patient is to be treated with compassion, respect, justice, and integrity.
At Bon Secours we also value quality, stewardship, innovation, and growth as a way to provide
care to patients. (Bon Secours Mission) I use this in my practice in every situation I encounter.
Each patient deserves quality care and treatment.
Section 3
To give an example, I was caring for a patient in the Emergency Department at Richmond
Community Hospital; the patient was brought in by Emergency Medical Services (EMS). The

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report provided to me was that the patient was found in an ally drunk and he had urinated on
himself. Other nurses on the unit said he was a frequent flyer and is always coming into the
emergency department drunk and having hurt himself. I did listen to this information, but I did
not let it change how I would care for my patient. I entered the room with a full heart and an
open mind, just as I do with each patient I care for. In the Emergency Department we ask many
screening questions, as well as a full assessment. As part of my nursing philosophy I am
dedicated to providing consistent quality care that embodies respect, compassion, and dignity.
With this in mind, I went through each question slowly and clearly so the patient could
understand and follow along. By taking the time the patient deserved, I learned that he was
depressed, with suicidal ideation and no support system. At this point I initiated a safe
environment, and provided one-to-one care, with checks every 15 minutes. I made the provider
aware and we collaborated with BSMART to consult. As the nurse I am accountable for this
patients care and had I not treated this patient with the respect and dignity he deserved he may
never have received the care and treatment he needed.
Section 4
Reading back the philosophy of nursing paper I had written three years ago brought a
smile to my face. While the philosophy is vague because of my lack of knowledge, the heart was
still there; as it always should be. I spoke of caring for the whole patient, mind, body, and spirit;
teaching the patient and allowing them to use that information to better their future. I said that
beliefs are based on experiences, which I had forgotten. I am glad to have been reminded. I also
said that all of my efforts must go to my patients care and wellness, that communication is key
and I will constantly be learning from everyone around me. I hold these beliefs and values still
today and find them to be of utmost importance. I have learned so much about how important

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communication is to the patient. As the nurse we know the process when we test blood or order
a type of scan, we know how the tests are performed and we know how long to expect to wait,
(and we can call if we want to know when results will come); but patients do not have this
information and are not as familiar and comfortable with the hospital system like we are.
Keeping the patient updated goes a long way. Even if we just pop our heads in the room to say,
what we are waiting on and when to expect to hear more information or provide the patient in the
beginning with a timeline of events. I have seen this in action many times; conflict and upset
patients can be avoided by simply communicating with them. Looking back, I thought I would
laugh at what I wrote, but instead I was proud of what I wrote because even then I knew what
being a nurse was truly about at its core; even though I did not know how to be a nurse. Reading
my philosophy paper back again inspired me to bring back how I felt about patients in the
beginning of nursing school.
Section 5
Patricia Benners Theory: From Novice to Expert sheds light on to the levels of
proficiency for nurses. As the need for experienced nurses has increased, so has the need for a
tool to describe levels of knowledge and skill (Benner, 127). The Dreyfus Model of Skill
Question was originally developed by a mathematician and a philosopher (Benner, 127). The
Dreyfus model breaks down proficiency into five levels: novice, advanced beginner, competent,
proficient, and expert (Benner, 127). It was Benner who developed this model to measure
performance and education in clinical nursing. A novice nurse is described more as a CNA,
where the nurse has no experience in situations and is only able to measure parameters such as:
weight, intake and output, blood pressure, heart rate, temperature, and respiratory rate. The
advanced beginner is minimally able to perform as a nurse; this individual has participated in

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situations to expand their knowledge but the nurse still has to expend excessive amounts of
energy and time thinking about what they are supposed to be doing and why. Therefore the
advanced beginner needs extensive mentoring with priority setting, finding patterns, and judging
how important a finding may be. A competent nurse has had 2-3 years experience honing these
skills and can now plan extended care but still does not have speed and flexibility (Benner,130).
A proficient nurse can see a patient situation as a whole and can expect outcomes and respond
accordingly. An expert level nurse is more complicated to explain. Patricia Benner herself has
difficulty explaining the extent of the knowledge of an expert nurse (how an expert nurse knows
what they know) because their instincts are now so tuned in that the nurse has a deep
comprehension of each patient situation and can care for the patient holistically and not as a
guideline to follow. This level requires multiple years of experience to attain. (Benner, 132).
Section 6
After reading the article by Benner I learned that I am more of an advanced beginner than
a novice. We use the word novice so much that I enjoy seeing the word advanced, because of
this I expected that I would consider myself a novice before reading the article by Benner. I see
myself as an advanced beginner because I have more experiences to offer than simply the ability
to obtain vital signs. I have been in many clinical situations throughout nursing school, work,
and immersion. However, I still have to think very hard during these times and need excessive
training and precepting because, while the information is in my head, I still have to struggle to
make sense of the information and require an unquantifiable number of situations to become
competent.
Section 7

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To move to the competent level of nursing, I will continue my education once I graduate.
With classes offered to new nurses to help us remember and apply many topics we learned in
nursing school but forgot, as well as new information to build on the knowledge I have already
attained. I will not be afraid to ask questions during the 16-18 weeks of initial orientation to my
first job. During this time I will have a preceptor to guide me and begin to build my situational
skills. After this time, I will not be afraid to go to another nurse for help or simply ask a question
if I do not know the answer because this is how I will learn, grow, and gain experience to
advance to a competent level of nursing. Learning opportunities are not limited to personal
patient experiences. I plan to reflect on my experiences daily or weekly. I will look back at my
actions during specific situations and determine what I did and what I could have done
differently. This will help guide me to become a competent nurse.
I have learned so much from when I wrote my first philosophy of nursing paper until
now. I still believe in caring for the patient holistically and providing consistent and quality care.
I understand that I still have so far to go and so much to learn. I am excited at that prospect. I
want to come back to this paper in three more years to reflect on my growth and come up with
ways I can move to the proficient level of nursing.

References

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Benner, P. (2001). From novice to expert: Excellence and power in clinical nursing
practice (commemorative ed.). Upper Saddle River, NJ: Prentice-Hall.
Bon Secours Health Care. (n.d.). http://www.bshsi.org/about-us-our-mission-our-values.html