I am John Horton, Licensed Practical Nurse and soon-to-be Registered Nurse.

I have been

developing my practice and philosophy of nursing for the last seven years. Over this period, my

philosophy has grown and evolved to include greater levels of care and learning. In this paper, I

will describe my personal philosophy of nursing as it is expressed in my practice. In the

beginning of this nursing program, I baked cookies as a metaphor for my philosophy of nursing.

I chose to bake a few different types cookies as it represented one reason I became a nurse; to

bring joy to others. Through this exercise, I was also able to represent other facets of my

personal philosophy of nursing. To represent the importance and necessity of critical thinking, I

ensured that I baked cookies that could be eaten by students who might be vegan or require

gluten-free diets. This also represented my desire to care every one of my patients, no matter

their background or circumstances. This paper will delve into my definition of nursing as it

relates to my knowledge and values. I will provide my definition of what it means to be a nurse

along with my perspective regarding the purpose of the nurse. Finally, I will discuss

assumptions about the relationship between nurses and patients and how those assumptions

evolve into principles. The following section will delve into my personal and original definition

of nursing.

Definition

My definition of nursing has evolved significantly from the time that I first chose nursing as

my future career, to now. I first became interested in nursing following the completion of a

career aptitude test that I took during my senior year of high school. At that time, I would have

defined nursing as a job that is performed by nurses in order to make sure that sick people get

better. That definition is marked by a lack of real knowledge about what nurses do and

accomplish on a regular basis. At completion of my licensed practical nursing program, I would

have defined nursing as the set of actions, communication, and skills that are performed by

nurses throughout their time at work. Following years of experience as a practicing nurse and

the near-completion of my undergraduate education, it has become apparent that my previous

definitions were grievously inadequate. I would define nursing as the act of continuous learning

while caring for others. Nursing is a multi-faceted field that requires the individual to

consciously and selflessly do their best. Nursing is the act of humbling yourself and using all

your knowledge and critical thinking to say and do that which will result in optimum patient

outcomes. As a result, my definition of nursing expresses itself based on the circumstances.

Sometimes, nursing is performing incontinence care. Sometimes, nursing is communicating with

other members of the healthcare team. Other times, nursing is simply asking the patient if there

are any desires that can be met. Nursing is a state of mindfulness that is allows the nurse to

function independently and as a member of the healthcare team.

Purpose

In my opinion, the essential purpose of nursing is to perform the act of healing as prescribed

by physicians who often make decisions based on the observations of those same nurses. It is a

humbling responsibility to receive trust from complete strangers for their loved ones. The

purpose of the nurse is to provide culturally competent care to every patient.

The reason that I am a nurse is because it is my desire that I invest my energy directly into

the wellbeing of others. For as long as I can remember, I have enjoyed making people happy and

putting smiles on their faces. I knew that I could not hold a job where I was stuck in an office

chair performing tasks all day long. Working as a pizza delivery man satisfied a very small part

of my desire to make people happy, but nursing allows me to have a directly positive impact on

the health and wellness of others.

 Assumptions

The relationship between the nurse and the patient must have trust that runs in both directions

in order to succeed to the fullest. The patient must know and believe that the nurse is acting with

their interest in mind. Leininger’s Transcultural Nursing points towards the fact that as health

care is globalizing, nurses will care for more patients with diverse cultural backgrounds (2013).

The nurse has a responsibility to be educated about the cultures of those who might come under

their care, such that a trusting relationship can be established. Even if a nurse is acting out of a

sincere desire to provide competent care, the culturally incompetent nurse may unknowingly

cross boundaries, resulting in distrust. Furthermore, Peplau’s Theory of Interpersonal Relations

states that the nurse meets the patient as a stranger and must build their relationship to the point

of trust (2002).

What do most nurses say about all their friends and family? They say that their friends and

family call them all the time about various health questions. They trust that we will be able to

help them in their time of need. It is the responsibility of the nurse to advocate for their

community. It is important that they remain up to date on legislature that may impact the health

of the community. It is also important for nurses to vote for individuals who will advance health

locally and nationally. Block and Josten presented their Ethical Theory of population focused

nursing. They assert that the nurse has an obligation to the population, that prevention is a

paramount focus, and that care ought to be relationship-based (2006). When nurses have a good

relationship with members of their community, they make the greatest impact.

Regarding the relationship of nurses with other healthcare professionals, I hold that all

healthcare professionals should value each other as members of the same team working towards

the overall goal of patient wellbeing. If any member of the team is not acting with the patient’s
wellbeing in mind, the efforts of every other member of the health care team can be undermined.

Although I could not locate any nursing theories specifically relevant to the relationship between

nurses and other members of the healthcare team, I was able to locate research that supports the

importance of nurse communication with the team. A 2015 study found that the use of bedside

rounds that were structured around inclusion of members of the interdisciplinary healthcare team

contributed to better patient outcomes (Gausvik et al.). The importance of communication

among the team can not be overstated, and all members must value each other’s contribution

equally.

Principles

One of my moral obligations is to do tasks that take only a moment to accomplish but will

convenience another person. Although dietary staff would eventually remove meal trays from

the patients’ rooms, I always removed them if I entered and the patient had completed their meal.

This freed up clutter in the patient’s room, resulting in a safer environment for the nurse and the

patient. Additionally, this allows dietary to return to the kitchen more promptly to serve more

patients. Whenever I noticed that the coffee pots were empty in the patient nourishment areas, I

refilled them so that no one would be delayed if a patient requested coffee.

Another moral obligation of mine is to follow rules and protocol in spit of the actions of those

around me. During wound care, it is inappropriate to clean a wound then apply a dressing with

the same set of gloves. Furthermore, it is inappropriate to dress multiple wounds with the same

set of gloves. I assisted a nurse who was changing dressings on both lower legs of a patient. I

ensured that I changed gloves and performed hand hygiene as many times as were indicated

throughout the procedure, but the nurse failed to change her gloves a single time. This could

have resulted in contamination of non-contaminated area, so I gently suggested that it might be

best to change gloves. The nurse then recognized that she had been acting improperly and

changed gloves when appropriate for the remainder of the dressing changes.

Conclusion

Acting in the role of nurse is an incredibly humbling responsibility that must not be taken

lightly. Nurses must always act selflessly with the patient’s best interest in mind. They must

ensure that they utilize cultural competence to guide care for all patients. I am grateful that my

passions aligned with a career that would be able to provide for my family. An extremely

important aspect of nursing is building patient trust. Along with being advocates for their

community, nurses have a responsibility to value the efforts of other members of the healthcare

team. It is valuable for nurses to go out of their way to accomplish small tasks that will benefit

others. It is also extremely important for nurses to follow established routines and protocols to

maximize patient health. Before I began the nursing program at ODU, my philosophy of nursing

focused primarily on the actions that are undertaken during work as a nurse. My time at this

university has allowed my perspective to grow and evolve into something that will be of greater

benefit. My philosophy of nursing now places a much greater emphasis on learning. When

every scenario is approached as an opportunity to learn, the nurse is opened to experiences that

will increase the quality of their practice. This shift in perspective will aid in pursuing my further

goals. With this newfound focus on learning, I will be better equipped to pursue my end goal of

becoming a geriatric nurse practitioner.

References

Cross, S., Block, D., Josten, L., Reckinger, D., Keller, L. O., Strohschein, S., … Savik, K.
 (2006). Development of the Public Health Nursing Competency Instrument. Public Health

Nursing, 23(2), 108–114. doi: 10.1111/j.1525-1446.2006.230203.x

Lang E. V. (2012). A Better Patient Experience Through Better Communication. Journal of

radiology nursing, 31(4), 114–119. doi:10.1016/j.jradnu.2012.08.001

Leininger, M. M., & Mcfarland, M. R. (2013). Transcultural nursing: concepts, theories,

research, and practice. New York: McGraw-Hill, Medical Pub. Division.

Peplau, H. E. (2002). Interpersonal relations in nursing: a conceptual frame of reference for

psychodynamic nursing. Basingstoke, Hampshire: Palgrave Macmillan.