MY NURSING PHILOSOPHY 1

My Nursing Philosophy

Yi Foster

Bon Secours Memorial College of Nursing

NUR 4140: Synthesis for Nursing Practice

Christine Turner, PHD, RN

October 31, 2020

Honor Code “I pledge…”

MY NURSING PHILOSOPHY 2

Definition of Nursing

Nursing is a profession where there is deep connection and trust built among the patient

and their nurse. Resiliency, Compassion, Integrity, Advocacy, Quality, along with the mindset of

continued learning and growth are parts of nursing. This is the model that helped guide me

throughout nursing school, and especially after I graduate as well. Bon Secours Memorial

College of Nursing (BSMCON) was the school I chosen for my nursing education because their

mission and values. Compassion, Quality and Service are listed under the core values and

learning, and growth are under goal statement of BSMCON.

I had the privilege to have faculty members who exemplify of those BSMCON core

values and have helped facilitate me with my nursing school journey during didactic course and

practicum. One scenario, it was during my sophomore 2 semester, very early on as a nursing

student in practicum. I notice the patient’s I was assigned to was hypokalemia, the level that was

close to critical level. The nurse wanted to me to give to diuretics, however I did not feel

comfortable due to his low of potassium without an order for PO Potassium. I reach out to my

practicum faculty for her expertise and she further supported my decision.

At the beginning of nursing school, I did not understand “why” nursing was referred to as

art and science, but as I reach the end of my nursing school journey, especially as I complete my

practicum hours, I finally understood the reason behind the statement earlier mentioned. Nursing

is art because of active participation with your patient, and skills you accumulate and adapt

through experience. Science because the theory, concepts, process and evidence-practice.
MY NURSING PHILOSOPHY 3

Personal Philosophy

While attending a Sophomore class, I wrote a personal philosophy paper. I remember in

my personal philosophy paper key components of nursing were both compassion and integrity. I

think one of the key elements of being a good nurse is compassion, one must care in order to

provide quality care for others. I took detours prior to nursing, but nursing was always in the

back of my mind, knowing I would one day circle back to my original plan. I chose nursing

because I enjoy helping people and I know I wanted a career path that would provide me with

both purpose and meaning. It’s extremely rewarding and brings me joy when I can help make a

difference in someone’s life. Being a caretaker is a familiar role for me, my mother was

diagnosed with ALS when I was 13 years old. My stepfather and I were the primary caretaker

until we had move her in a nursing home. I remember having to assist her with daily living

activities from age 13 to 16 such as feeding, bathing, toileting etc. it was extremely difficult to go

through. However, having that experience has help me be able to empathize and connect with my

patients and family I provide care for. One of the main reasons I chose nursing as career path is

from my own experience with my mother. During my early practicum of sophomore 2, the

patient I was assign to that day was quiet and compliant with all his care, but as I watch how the

nurses interacted with him throughout the day, they did not introduce themselves or make an

effort to make a connection with him, they treated him like a object and a task. His mood shift

from being cooperative to moody and noncompliant. I am naturally introvert and I not particular

good with comforting words. But I decided to go outside of my comfort zone and be his

companion when he was waiting to get his MRI done. It was awkward at first when I tried to

make a small talk with him, but he could sense I’m not good at it, but could tell I was making an

effort to get to know him. A few words were exchanged between us, I mostly listened as he
MY NURSING PHILOSOPHY 4

shares about his hobbies, family and his fears. That particular scenario stuck with me, because it

taught me the important of always try to make a connection with your patient. Patients not a task

to be checkout off on a list, end of the day, they are people. People who are in a very vulnerable

position and who are putting a lot of trust in me to care of them, to me that’s a huge honor and

it’s my duties to keep them safe.

If one asked me if my philosophy has changed as I am completing the last semester of

nursing school, my answer would be both yes and no. However, over the 3 years having more

clinical experience in practicum and working as care partner in both step-down and critical care,

my nursing philosophy has evolved. I still believe Compassion and Integrity are key

components. Without integrity and honesty how can one build trust. Nursing is about providing

holistic care and in order to do that I must establish a trusting relationship with my patients, their

family and my team. However, being a good nurse, you also need to be strong, tough and have

grit. One must be resilient, who can preserve under difficult circumstances. Nursing is a naturally

stressful professional that will fill with many joyful and heartbreaking moments. It’s imperative

for me to be able to control my mind and body so I can provide quality care for all my patients

under all circumstances.

Values and Beliefs

In Junior year a wise professor who told me that one must know themselves before, they

can take of other. And I whole heartedly agree, in order for me to provide care for other people,

I need to have self-awareness first. I can’t set healthy boundaries with others or practice open

mindedness to create a nonjudgmental and safe environmental for my patient if I don’t know my

own values and beliefs. Beliefs and values set my attitude and shapes me as a person. My

personal experiences in life and my relationship with god has helped shape my beliefs and
MY NURSING PHILOSOPHY 5

values. As I reach the end of nursing school career, I’m happy to say my values have remained

the same and also expanded as I reflect and learn from my previous experiences. It’s very

important to me my character reflects back to my values, and I proud to say my interaction with

my patients and team members shows that I’m resilient, honest, hardworking compassionate and

a valuable team member who strife to continue grow and learn as person and professional

development.

Some of my beliefs for what I thought were required characteristics of a “good” nurse

have changed slightly. Until recently, I always believed if a nurse is “nice” to her patient it must

mean she is compassionate and will have the integrity to do the right thing, even if it’s difficult.

Continuing with that trend, a nurse with many years of experience in my eyes instantly made him

or her a proficient nurse. In my senior practicum, I was put in many uncomfortable situations by

negligence from my preceptor. It was this experience that has made me realize being nice does

not mean a person will care and advocate for their patient. To be proficient at nursing a person

needs more than just years of experience. The person must have a learning attitude and wiliness

to set realistic plans for growth and professional development in order to reach ones true

potential as a holistic healthcare provider.

Nurse-Patient Encounter

I try my best to practice my nursing philosophy as I interact with each patient at the

hospital. During my last semester of immersion, I had to challenge my preceptor over the

multiple unsafe decision she makes for her patient. On my first night of immersion, I had a

patient who was experiencing signs and symptoms of fluid overload after we gave her IV

solution to increase her blood pressure. The patient’s O2 saturation was dropping into mid to low

80’s, tachycardic and her neuro status changed from being calm to agitation and extremely
MY NURSING PHILOSOPHY 6

anxious. She was terrified, verbally complaining she can’t breathe, and was hyperventilating

trying to catch her breath. I immediately address the concern to my preceptor, however she did

nothing, she said she’s not sure what to do, however does not want to call the doctor or rapid

response unless it’s emergency. I stayed with the patient all night to help her stay calm and

encourage her to she slows down her breathing so her oxygen saturation will rise. Since the

incident I have reach out to faculty for assistance, I felt that I need to advocate for the patients

and for myself. I still reflect back to the situation, should I have called the rapid response team

for assistance when there was no support on the unit. That incident taught me to always question

when things doesn’t seem right and to follow my intuition. And just because someone has

experience does not mean they’re competent to their job.

Role as a Changed Agent

During my NUR 4140 practicum class, my peers and I were assigned a Quality

Improvement (QI) project. The group project objective was to allow student to collaborate and

collect data from up to date literature and purpose a solution to a current hospital issue. This

project allows me to apply the nursing process to conduct our research and purpose a solution.

The aim for our group project were to reduce the 30 days heart failure readmission. After

hours of literature research and utilizing cause and root analysis, it helps us come to conclusion

that our proposal needs to be improving discharge education. Quality education is the key to help

to a patient understand their condition, self-care and disease management so they can maintain

an optimal health. Mrs. Miller my practicum faculty was extremely helpful and seek out

opportunity for us to have zoom meeting to with Cardiovascular Nurse Partitioner from St. Mary,

which further support our hypothesis.

MY NURSING PHILOSOPHY 7

Technology is everywhere now a days; majority of cellphones have access to both the

internet as well as endless apps. For our proposal we wanted to do something that’s different and

that’s cost effective. After more research, my group decided to propose utilizing technology for

effective discharge. It would be multimedia learning application that will allow the patient and

family members to learn in their own pace which promote patient independence. The application

will be in 5th grade literacy which would reduce difficulty of the material. The nurses will still be

responsible for role of discharging teaching and will provide support for the patient by using

teaching back method and provide further clarifications. This research project gave me the

opportunity to think outside of the box and allow my group and I to put together that’s creative

and long-term cost effectiveness using technology to further enhance retention of patient self-

management.

Benner’s Theory and Skill Acquisition Stage

In Dr. Benner’s book From Novice to Expert: Excellence and Power in Clinical

Nursing Practice, she introduces The Dreyfus Model of Skill Acquisition and how it applies to

nursing. The Dreyfus Model of Skill Acquisition demonstrate how learners obtain skills though

formal instruction and clinical practicing and how develop and growth occur into different levels

of proficiency in nursing. The model consists of total of 5 levels of proficiency: novice, advance

beginner, competent, proficient, expert. A novice nurse at level 1, they are beginners and have

no clinical experience of the situation where they expect to perform. They use knowledge and

nursing theories they learned from didactic to help them make clinical judgment. A novice relies

heavily on their preceptor or mentor for guidance in clinical practice and are inflexible and

ridged, must have rules given to follow. (Brenner, 2001). At level two are advance beginner

which begins to gain clinical experience and begins to understand their environment and notice
MY NURSING PHILOSOPHY 8

reoccurring patterns from past clinical scenarios. However, advance beginner will need support

in clinical setting such as setting priorities, and it’s difficult for them to perform tasks and

concentrate on applying the rules they have learned (Brenner, 2001). The next level above

advance beginner is competent. A competent nurse is someone who has clinical experience two

to three years, who can perform efficiently, prioritize and knows which actions to take based on

prior experiences. Proficiency is the 4th level, in this level the nurse views the situation as a

whole, or the bigger picture and can set long-term goals (Brenner, 2001). The last level of the

Dreyfus Model of Skill Acquisition is Expert. “The expert performer no longer relies on analytic

principle (rule, guideline, maxim) to connect her or his understanding of the situation to an

appropriate action” (Brenner, 2001). When I apply Brenner’s theory with my life, I think with

my practicum experience I have had from school and working as a care partner. I would consider

myself as advance beginner but only in a step-down unit. But as I start my new role as ICU

nurse, I still consider myself as novice.

Action Plan for Moving Forward

I will be starting my career as a new graduate critical care nurse February 21’ after taking

my NCLEX. Continued growth and learning are components I both value and are passion about

maintaining growth and professional improvement. I’m aware there will be a huge learning gap

going from student to my starting position as an Intensive care unit (ICU) nurse. Even though I

felt that in the end of my practicum experience I considered myself an advance beginner in the

step-down unit, I will be essentially starting over as a novice within my new ICU setting. The

strategies I have taken to help me transition to a new nurse, I have reach out to my manager and

nurse clinician and ask for permission to requested for my preceptors that I would like to work

with, who are exceptional role model, with great leadership and proficient in providing quality
MY NURSING PHILOSOPHY 9

care for their patients. I will be utilizing all the resources that are provided and intelligent staff I

will be working with to gain knowledge and not to be afraid to ask questions. The hospital I will

be working at also offers mentorship programs for nurses, which I plan on joining after I finish

the new graduate nurse residency. In my last semester of nursing school, I have joined American

Association of Critical Nurses (AACN) and the Greater Richmond Area Chapter of AACN

which both I will utilize to help me with my professional development and meet other nurses

who share similar passions as I do.

One thing I learn in nursing school is the importance of self-care and resiliency. I’m a big

believer of in order to provide care for others, first I need to take care of myself. I know I excel

with a structured environment; I will be creating a routine exercise plan that is manageable and

realistic to my new work schedule. Sleep deprivation was one of the biggest struggles I had

during nursing school and it rapidly deteriorated my mental health. To prevent that from

occurring when I start my nurse residency program, I plan to create a sleep schedule that I can

strictly follow, which will be an enormous help as I transition between night and day shifts. I

also think it’s important for me twice a month make a whole day for myself and do something

that brings me joy such as plan for a day hike or an overnight camping trip to get away from the

city and be surround by peace and joy of the mother nature.

MY NURSING PHILOSOPHY 10

Reference

Benner, P. (2001). From novice to expert: excellence and power in clinical nursing practice.

New Jersey: Prentice Hall.