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Personal Philosophy of Nursing

Jennifer Pierce

Bon Secours Memorial College of Nursing

NUR 4142: Synthesis of Nursing Practice

Christine Turner, PhD

September 25, 2018

On my honor, I have neither given nor received aid on this assignment, and I pledge that I am in

compliance with the BSMCON Honor System.


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As I am about to graduate from nursing school and enter professional practice, it has been

beneficial to reflect on the questions put forth to our class. What do we value? What do we

believe? What has changed since we first entered nursing school? Going through the process of

writing this paper has increased my self-awareness and helped me to answer these questions in a

meaningful way.

Definition of Nursing

In my first semester of nursing school in NUR 1100, I defined nursing as “an art that

involves transforming science and technology into a meaningful and positive experience for the

patient” (Pierce, 2016, p. 6). However, at its core, as I have learned over the past three years,

nursing is about caring. It is not about “taking care of” patients but rather “caring about patients”

with genuine concern. This care is expressed through kindness, presence, and most importantly,

addressing a patient’s needs.

The tenets of the Bon Secours College of Nursing program philosophy statement

(BSMCON, 2016) that resonate most with my own values and beliefs are caring, health and

service. For example:

Caring

As noted above, I believe caring about patients is at the heart of nursing. As one of the

College’s tenets articulates so well, nurses “facilitate healing across the lifespan by extending a

caring human presence” (BSMCON, 2016, p.39). Self-care is another of the College’s tenets

that I have come to embrace. I did not identify self-care as a driving value in my original

philosophy paper. However, I have learned in what some might term the hard way, the

importance of self-care when enduring the hours, the emotional and mental stresses, and the

physical demands of nursing.


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Health

I continue to believe that “health is a dynamic state of optimal well-being that is

influenced by physical, emotional and spiritual factors” (Pierce, 2016, p. 6). I wholeheartedly

agree with the College’s tenet that health cannot be achieved without equitable access to health

care (BSMCON, 2016). Through my immersion experience in the emergency department, I have

seen firsthand how lack of access, most notably due to lack of insurance, has negatively

impacted people and consequently leads them to utilize the ED for primary health care needs.

During my time in nursing school I also have witnessed on many occasions how environments

can be healing or detrimental for health.

Service

I believe service is how we care for our community and address the needs of our most

vulnerable neighbors. In my mind, service and nursing are inherently linked. Although nursing

is indeed a profession, there is a reason why we say we are called to serve. Nursing is about

serving others and caring for others regardless of circumstance. To be a good nurse you must

value human dignity and justice, fairness and equality for all people. Healthcare is a social

justice issue and health disparities are just as detrimental to society as economic or racial

disparities. Therefore, I am glad that Bon Secours includes the tenets of service in its philosophy

statement (BSMCON, 2016).

Personal Philosophy

The values and beliefs that inform my personal philosophy are reflected in my nursing

practice every day. For example, my commitment to caring is reflected in my demonstration of

presence. I practice presence with all of my patients and I always take the time to spend extra

moments with patients who may be scared, sad, or lonely. Oftentimes when I am with patients I
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am not providing medical care per se, but simply listening and demonstrating my interest in them

as unique individuals.

My beliefs about health and human dignity intersect on a regular basis this semester when

I am in clinical. My immersion is at the Emergency Department at Richmond Community

Hospital. It would be easy to assume that some of the patients seen there are making bad

choices, not taking care of their health, abusing drugs and are the “dregs of society.” However,

when looking through the lens of my personal philosophy, I see that many of our patients are

living in detrimental environments, with few economic or educational opportunities. I see the

interconnectedness between the patient and his environment. I see that, regardless of how the

patient presents or acts and regardless of why the patient is in the emergency department, the

patient is a human being that should be treated with kindness.

Nurse Patient Encounter

My philosophy of nursing was demonstrated in a nurse-patient encounter that I had

during one of my rotations on a med-surg unit. The patient was an elderly woman who appeared

non-communicative and was assumed to be a non-English speaker because of her physical traits

(she appeared to be of Asian descent). The nurses on the unit also assumed the patient had some

mild dementia because she was acting confused. The primary nurse came in and out of the room

to perform his nursing duties, but he did not engage in any conversation with the patient.

One of the ways I apply my philosophy of nursing is by always talking to my patients.

Regardless of whether a patient is unconscious, suffering from dementia, or a non-English

speaker, I always talk to my patient as if he/she is alert and oriented. I say hello, I explain what

I’m doing, etc. As I was caring for this particular patient, and talking to her, I noticed that she

appeared to be comprehending what I was saying. As I took the time to sit with her, talk and
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assess the situation, I realized that she was hard of hearing. Her apparent confusion and

uncommunicativeness were not due to dementia or not speaking English but those were the

assumptions that were made because no one took the time to be present and truly care for the

patient. She did have some deficits with her speech but after a while, with me carefully listening

and focusing on her, the patient vocalized a few words that I understood.

Values and Beliefs

In writing this paper I have had the opportunity to reflect on the values and beliefs I

articulated in my first semester of nursing school in NUR 1100 (Pierce, 2016). At that time, I

identified the following values as playing an important role in my nursing practice: human

dignity, integrity, autonomy, justice, caring, education, creativity, accountability, health and

wellness, stewardship, courage, and perseverance. These values continue to provide the

foundation for my beliefs about nursing.

Similarly, my beliefs and the convictions that I hold to be true have remained steady

since I wrote my original personal philosophy of nursing paper. One of the beliefs I articulated

in that paper was the belief that all people deserve to be treated with respect and loving kindness.

I also stated that “each patient is a unique person with different physical, emotional and spiritual

needs. Each person brings their own history, family and culture into the patient-nurse

relationship” (Pierce, 2016, p.6). Additionally, I stated that I believe people need to take

responsibility for their own health and well-being but that some people can be vulnerable or

unable to take responsibility for their health and that they need caring support. These beliefs, of

all the beliefs I discussed in my original philosophy of nursing paper, are the beliefs that have

been reaffirmed over and over through my nursing program.


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Benner’s Theory

Patricia Benner (2001) is a renowned nursing theorist who developed a model for how nurses

learn and build clinical competence. At the crux of the theory is the notion that nurses learn

through experience and that nurses must apply their classroom and textbook learning to real-life

clinical situations. The model includes five stages that nurses move through as they develop

competence.

• Stage 1 novice, includes nursing students with no clinical experience and/or clinicians

entering new clinical areas.

• Stage 2 advanced beginner, includes new graduate nurses. Benner notes that advance

beginners need support in the clinical setting, which is seen in practice through the use of

nurse preceptorships.

• Stage 3 competent, includes nurses with two to three years of experience. Competent

nurses are able to deliver quality care but are still developing their speed and

prioritization skills.

• Stage 4 proficient, includes nurses who have three to five years of experience in a

specific clinical setting or with a similar patient population. Benner notes that proficient

nurses are able to see the big picture and apply the knowledge gained from past

experiences to present situations.

• Stage 5 expert, includes nurses who have “an intuitive grasp of each situation” (Benner,

2001, p.32). Expert nurses can hone in on a problem and take quick action because they

have experience with similar patients and situations.


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Stage of Skill Acquisition

After reviewing Benner’s five stages and reflecting upon my experience to date, I believe

I am in the Novice stage of skill acquisition. Although a second semester senior nursing student,

most of my clinical experiences have been short and/or had limited opportunities for skill

acquisition. Additionally, each new semester I enter a new clinical area, which aligns with

Benner’s description of a Novice. Most notably, Benner states that nursing students “have little

understanding of the contextual meaning of the recently learned textbook themes” (Benner,

2001, p.21). For example, my clinical immersion is in the Emergency Department. Prior to my

first day of immersion, I have only spent a few hours in the Emergency Department and most of

my time was spent shadowing/observing a Registered Nurse. Therefore, I not only feel but also

act like a novice as I have entered this new clinical area. As I write this paper it is still early in

the semester and I recognize that I will be building my skills and confidence with every hour

spent in immersion. If I were writing this paper at the end of the semester I might possibly feel

like an advanced beginner.

Action Plan for Moving Forward

In order to move to the next stage of skill acquisition, I have identified the following

three action items. First, I will pursue job opportunities with hospitals that offer new graduate

nurse residency programs. Residency programs are typically one-year programs that offer

transitional support to new nurses, including in-depth orientations, continued classroom/skills

training, and peer networking. Second, I will seek out a preceptor who embraces the role of

teacher and mentor. Also, I will strive to have a preceptor who is a Stage 4 Proficient nurse. If

my learning needs are not being met by my assigned preceptor, I will speak up and request that

changes be made to my preceptorship. Third, for my first job, I will identify an area of practice
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that interests me at a facility where I can see myself staying for a minimum of two to three years.

As Benner notes, it is only through practice in the same or very similar clinical areas that a nurse

can become competent. Moving around too much between specialties keeps you at an advanced

beginner stage. Therefore, I will approach my job search with a long-term vision of how I want

my career to progress. I recognize that my interests may change or unexpected opportunities

may arise, but when I pursue and accept a job, I want to at least feel right now that it is the first

step on my path from novice to expert.


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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). Academic Year 2016-17 BSMCON Faculty

Handbook. Retrieved from https://bsmcon.blackboard.com/bbcswebdav/pid-230127-dt-

content-rid-2817039_1/courses/201819FALL-NUR4142-

GAGB/Fall%202018/Assignments%20and%20Rubrics/CON%20Philosophy%20Stateme

nt.pdf

Pierce, J. (2016). Personal philosophy of nursing. Unpublished manuscript, Bon Secours

Memorial College of Nursing.