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RUNNING HEAD: PHILOSOPHY OF NURSING PAPER

Personal Philosophy of Nursing Paper


Sophie D. Guillot
Nur 4142 Synthesis of Nursing Practice
October 19, 2016
Dr. Turner
I Pledge

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Introduction

To define nursing or describe my nursing philosophy, at first seemed like an impossible


task. How can I possibly put the profession of nursing and my philosophy towards it in mere
words? Well, I started by looking at the Merriam-Webster (2016) definition for nursing which is
the job of taking care of people who are sick, injured, or old. At first this definition seemed
like a gross understatement, but it truthfully was not a bad place to begin.
Nursing Definition and Philosophy
My personal beliefs regarding nursing highly align with the values of Bon Secours and
the tenets of the Bon Secours Memorial College of Nursing (2016). I believe that nursing is the
art of giving high quality, compassionate care to all patients. To do this I believe nurses must
commit to being lifelong learners and teachers to provide quality, evidence based care. I believe
that nurses must treat all patients with respect and equality regardless of personal bias and in
such must be aware of ones own values and biases. I also believe that nurses should strive to
provide our patients with holistic care to not only include caring for the physical body but the
mental and spiritual aspects as well (Bon Secours Memorial College of Nursing 2016). Finally, I
believe that we must advocate for our patients to ensure they are receiving appropriate medical
care, that they are well informed, and that their wishes are being honored.
Philosophy Reflected in Nursing Practice
As a nursing student, a patient care technician, and a soon to be new graduate nurse, I
strive to fulfill my own philosophy every time I am caring for patients. Throughout my education
and working in an Emergency Department, I have learned many invaluable skills and tools, and
continue to learn ways to improve my practice every day. I start by always treating my patients

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with respect and compassion including simple tasks such as introducing myself, explaining what
I am doing, and asking about their needs. I continue my patient interactions by being thorough
and practicing safe, evidence based care. For example, I utilize strict sterile technique when
inserting a urinary catheter, have another person present to ensure I did not break sterile
technique, only insert a catheter under a doctors order or protocol when deemed necessary, and
ask every patient if they are allergic to iodine or shellfish before applying the iodine skin
cleanser. I also practice moral courage when I feel that something more needs to be done or done
differently for a patient, whether that is approaching the patients nurse or the physician in
regards to a concern I have. Not all skills or knowledge that I draw upon comes from nursing
school or my clinical experience, some of my communication skills with patients comes from a
background of working various customer service jobs; my always checking for an iodine allergy
comes from having a grandmother with a severe shellfish and iodine allergy; and, my ability to
stand up for my patients and what I believe is right comes from my parent instilling that strength
in me since I was very young.
Nurse-Patient Encounter
All throughout nursing school, I have had many valuable interactions and learning
opportunities; however, I have also gained much of my experience through working as a patient
care tech in the Emergency Department. Even in my role as a patient care tech which has a
different scope of practice from a nurse, my mind still thinks like a nurse. My most meaningful
experience with a patient was from a patient I felt I could do nothing to help. I went into a room
with a nurse to help her receive an elderly male patient brought in by ambulance. We quickly
changed him out of his regular clothes, and into a hospital gown and we immediately noticed
wounds almost covering the mans entire body. They were open and resembled pressure ulcers,

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but there was not a single part of his body that did not have one of these wounds on it. These
sores were not just the typical places you saw pressure ulcers, including on his chest . The nurse
instantly asked him were all of his wounds had come from and he did not have an answer for
them except that he had recently fallen in the garage and his son had to drag him back into the
house. Judging by the appearance of the wounds and shear number of them I knew this could not
be the whole story and by sharing a glance with the nurse and listening to her follow up
questions I knew she was thinking the same. I continued to proceed with his work up and starting
an IV while she attempted to document all of his wounds when one of his sons came into the
room. I instantly felt a wave of judgement and sadness overcome me and I fought to push those
feelings to the back of my mind.
I spoke with the nurse in private after we had gotten the patient settled in and learned that
she was contacting Adult Protective Services and that the patient was going to be admitted to the
hospital for treatment. A few hours later, I was able to take the patient and his son upstairs to his
new room and talk with them for a short while. The son informed me that his dad lived with his
brother, but his brother still worked full time and he felt that his brother did not have the time or
resources to properly care for his father. He expressed an interest in talking with case
management to learn about other options.
On my way home that night I could not get this patient off my mind, he was the sweetest,
most thankful person I had ever seen come through my work. My heart broke thinking about all
those wounds and how I felt that I was not able to do anything to help him. I started to question if
I wanted to be an ER nurse with the limited patient care we provide by stabilizing and sending
out and not knowing what would happen with him, and then I started to question if becoming a
nurse at allwas even the right decision for me. I finally said to myself: I have to be stronger than

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that, I will continue to see things in practice that make me sad and that will make me feel my
hands are tied, and I have to find acceptance in what I am able to do to help people.
I felt that because I could not medicate him, I could not make his pain away, I could not
protect him, and that I could not see his care through that I was not able to help him. However,
that thinking was not entirely right, I reflected back on how happy that man was, how thankful
he was for every little thing I did for him, including putting in his IV, and even just talking with
him. I reminded myself that Adult Protective Services and been contacted, that he would be safe
in the hospital, and that we have a great case management team that would do their best to see he
received the long term care that he needed. I was reminded that sometimes your simple
interaction with a patient can make a difference for your patient, and that you have to accept
when you have done everything you can do and know when something is no longer in your
hands. I learned that treating all of your patients with respect and compassion is the foundation
for being a good nurse and goes a long way for our patients. I also learned that sometimes you do
make judgements, and you cannot let those affect the way you treat others, that you do not know
what another person is going through, but you have to feel comfortable asking those questions
and without passing judgement.
Changes in Philosophy of Nursing
When I first wrote my philosophy of nursing paper in Nur 1101, I had very limited
experience with nursing and patient care and I expected that my philosophy would be
distinctively different by the time I finished school. While I would not say that my values and
beliefs have completely changed, I would say that now I am able to expand on those thoughts,
and I have experience with them. I talked about caring for patients holistically, but I had just a

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basic understanding of what that meant. Now, I have worked with people who not only have
health issues but social, mental, and spiritual problems as well, and I know how to approach
those topics and feel comfortable talking to my patients about them.
I wrote about bias in my mind thinking about other people, and thinking to myself I
have no bias; I think all people should be treated equally. However, I have learned through my
practice that there are certain situations that affect you differently. It is hard to push back your
judgement when a three year old comes in with a spiral leg fracture, or an elderly man comes in
covered in open sores. Ive learned that having patients close to my age critically ill or dying
because of alcohol abuse affects me differently from other patients due to experiencing
alcoholism within my own family. These biases or feelings are not necessarily something you
know that you have until you are faced with them in your practice and you are forced to confront
them. Throughout this experience the core of my nursing philosophy has stayed true for me to
treat patients with respect, compassion, and possessing a desire to help.
Patricia Benners Theory
In the book From Novice to Expert: Excellence and in Power Clinical Nursing Practice,
Patricia Benner (2001) uses the Dreyfus Model to describe stages of nursing skills. The first
stage is novice, in which the nurse has never seen or experienced the clinical situation before and
must completely rely on rules or preceptor guidance to direct tasks and care (Benner, 2001). The
novice has textbook knowledge but may not know the implications or contextual meanings
(Benner, 2001). The advanced beginner is similar to the novice in that he/she must follow rules
to direct tasks (Benner, 2001). The advanced beginner is different from the novice in that he/she
has seen the situation and is able to cope and perform, but may struggle with prioritizing outside

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of the set rules (Benner, 2001). The competent nurse has a few years of experience, is working
independently and able to think of long term goals (Benner, 2001). The competent nurse is trying
to master organizing and prioritizing care for multiple patients (Benner, 2001). The proficient
nurse is able to see the whole patient and all of the pieces of puzzle. The proficient nurse is able
to utilize clinical judgement based on past experiences to direct care (Benner, 2001). The final
level of expert is able to work on intuition and disregard futile data or other possible diagnoses
(Benner, 2001).
My Skill level
After reflecting on my education and clinical experience, I would rate myself as an advanced
beginner using Benners descriptions of novice, advanced beginner, competent, proficient, and
expert. My experience of working in the hospital and completing hundreds of clinical hours for
school has afforded me many opportunities to see various patient scenarios. While I know there
is a great deal left for me to see, I feel confident with many situations and the rules/algorithms
associated with what to do. Because I have seen people come into the ER with typical or atypical
symptoms of stroke, myocardial infarction, sepsis, or unresponsive I feel confident that I will be
able to perform in these and other circumstances.
Advancing Skill Level
While I believe the biggest factor in moving from an advanced beginner to a competent nurse is
experience, there are other things I can do to help aid that transition. I will work closely with my
preceptor as we create guidelines based on aspects and attributes of patient situations and
evidence based practice, which I will follow as I am learning (Benner, 2001). I will work on
identifying patient acuity and prioritizing and organizing my tasks based on my patients (Benner,

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2001). Lastly I will actively seek out learning opportunities, while in the clinical setting my
preceptor may not have the time to explain every aspect of the assessment, diagnosis, and
treatment or answer every question I have, so I will have to take additional time to research
topics that I need further clarification in.
Conclusion
After reflecting on how my nursing philosophy has changed and deciding where I feel
that I fit on Benners stages of skill acquisition I am able to see just how much I have grown in a
few short years. The combination of clinical experiences as a student and working as a patient
care technician have taught me so much more about being a nurse that I never knew when I first
started nursing school. I have learned how hard it can be to fulfill your own philosophy when
caring for patients, sometimes you get sad, sometimes you get angry, but at the end of the day
you gain so much joy and pride in the care youre able to provide and the difference you are able
to make in your patients lives.

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References

Benner, P. (2001). From novice to expert: Excellence and power in clinical nursing
practice (commemorative ed.). Upper Saddle River, NJ: Prentice-Hall
Bon Secours Memorial College of Nursing (2016). BSMCON Faculty Handbook. (39).
Merriam-Webster, Incorporated. (2015). Nursing. Retrieved from: http://www.merriamwebster.com/dictionary/nursing