PERSONAL PHILOSPHY 1

Personal Philosophy and Reflection Paper

Angela Jackson

Bon Secours Memorial College of Nursing

Christine Turner, PhD, RN, Professor

NUR 4140 – Synthesis for Nursing Practice

April 2, 2022

“I pledge”
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Definition of Nursing

Nursing can be defined in one word (to me) servitude. When we pursue a career, we

should consider the necessary steps to succeed in that profession. The most significant step in

that pursuit is to understand the purpose of that role. For nursing, it is servitude. The drive of

service as a nurse should start with service to patients, their families, communities, and the care

team, which is why nursing is such a unique calling. The act of service requires selfless acts,

compassion, kindness, and respect for everyone you encounter. Servitude in nursing helps you

connect with your patient personally to meet and address their needs to achieve the best health

outcome with their treatment. As nurses, our compassion and service are gifts that help us see a

need in others and respond with care. Nursing also means treating each patient with dignity. We

use our skills, evidence-based practice, clinical knowledge, and sometimes our intuition to

provide personalized care and comfort for our patients. Nurses are also called on to help maintain

health outcomes on a community level. We do this through appropriate health education,

offering preventive health measures, and promoting wellness to reduce preventive chronic

diseases.

Personal Philosophy

As a nurse, I want to provide care to each patient I encounter based on respect and

personalized care. My goal as a nurse is not just to treat a patient’s medical condition or illness

but also connect with them to address things that are not always visible, such as socioeconomic

determinants, lack of health care resources, or deficient knowledge. I want to be a strong patient

advocate for my patients. To do this, I will utilize the skills I have obtained through my nursing

education and the experience I will gain as a nurse. I will be attentive to detail and provide the
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best care I can with a non-judgmental attitude to ensure I connect with my patients to help them

achieve optimal health outcomes.

Values and Beliefs

For me, values are standards that never change. They guide our behaviors in any

circumstance of life. The core values of nursing are human dignity, integrity, autonomy,

altruism, and social justice. (Fahrenwald et al., 2005) I learned about the core values of nursing

during my first semester of nursing school. I can still remember the feeling of excitement as I

read the values and the class discussion regarding the core values of nursing. As I listened and

discussed among my classmates, I was full of anticipation and excitement to propel forward in

nursing. As these values are significant in nursing and healthcare, they made me feel like this is

what healthcare is.

I have a Bachelor of Science in Healthcare Management and worked in administration

before finally deciding to pursue my dream of becoming a nurse. While I enjoyed working in

healthcare administration, I was not fulfilled. I also did not think that our values were

demonstrated in our interaction with patients or as a team. I wanted to improve health outcomes

based on the core values I discovered in nursing. These values have driven my beliefs thus far as

a nursing student, and I am sure I will hold the same standard of beliefs as a nurse. My belief in

servitude is how I have practiced some of the core values of nursing by showing human dignity,

integrity, and social justice. The core values have also helped me reflect on caring behaviors that

I practice when I encounter a patient and their loved ones. For example, I use a caring touch,

listen attentively, and I am non-judging. I also respect a patient’s personal beliefs and even their

culture. Focusing on the nursing core values and my personal belief in servitude has also helped

guide my intuition when interacting with patients. It has been that small voice (I call it the voice
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of the Holy Spirit); that helps me make respectful decisions and treat patients/people with love

and kindness even in difficult situations.

Nurse Patient Encounter

During my junior two semester, one of the patients assigned to me during a practicum

shift had a fall resulting in a deep head laceration. The patient also was confused and disoriented

and had been placed in restraints the morning of my practicum. After I completed my assessment

and administered his morning meds with my instructor, I asked the patient if he would like to get

cleaned up; he had on a bloody tee shirt. He said yes. A PCT on the unit came in to assist me

since the patient was confused. As I started his hygiene assistance, the patient made a racial

statement to me. I ignored him at first, then he continued. Finally, the tech spoke up and asked

him not to be disrespectful. However, he continued, and the tech left the room and returned

shortly with the manager. The manager also asked the patient to stop being rude. Shortly after,

my instructor walked into the room. The manager and I gave her a quick update, and my

instructor reassigned me to another patient.

The following week, I was assigned two new patients. After completing their morning

care, the patients wanted to rest. I charted and started answering call bells. One call bell

happened to be due to a patient’s bed alarm. When I walked into the patient’s room, it was the

gentlemen from the prior week. I could tell he needed hygiene assistance. I reintroduced myself

to him and asked if I could assist him? He nodded, yes. When I walked over to his bedside, I saw

that he was soiled and needed to be changed. I let him know that I needed to gather supplies and

I would be back.

As I was caring for the patient, his nurse walked in and thanked me and said she would

assist me. We completed his care. She recognized me and had heard about the incident the week
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prior. She told me that she commended me for my act of kindness. And that not many people

would have done what I did; they probably would have ignored the patient or asked someone

else to handle his care. I smiled and thanked her. I thought to myself that service requires us to

operate in forgiveness continuously. As nurses, we should not tolerate any forms of disrespect or

abuse. However, we must remain professional at all times and act in dignity. The lesson I learned

from this patient experience is beneficence. As a nurse, I want to practice each ethical principle

and take them seriously. “Jean Watson’s philosophy of a “human-to-human” relationship allows

nurses to use human caring to connect to patients. Her philosophy of Caritas motivates me to

want to show and give care to others by seeing beyond the person to see their need and

connecting to them through human kindness.” (Jackson, 2019).

Change Agent

As I was working on obtaining my Bachelor in Healthcare Management, we often

discussed how the healthcare industry continually evolves. “With these changes, the one

structure that remains constant with evolution in healthcare is the need for service. Every

healthcare professional must be willing to serve in their profession. As a nurse, servitude can

come in showing empathy and compassion or other caring behaviors.” (Jackson, 2019) The

ability to serve will continue to be my focus during my nursing career. I also have learned that

healthcare is built not solely on theories or practices but on resiliency. The past three years have

proven that to be true. The resiliency we witnessed in healthcare during the pandemic solidifies

that service is a strong foundation in nursing. The brave nurses that showed up to fight this

unforeseen enemy sustained us through the pandemic. However, we have also seen the additional

mental stresses and burnout that nurses are experiencing due to their continued service to

healthcare. Turnover rates in nursing also continue to increase. Based on my group EBP/QI
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project, we (I) want to encourage nurses to continue their service to healthcare. However, we

also want to encourage nurses to take time to care for their mental health by practicing self-care.

Nurses play vital roles in healthcare. Unfortunately, nurses are not encouraged to practice

self-care. As a change agent, I want to encourage myself and other nurses to take time for self-

care. As nurse, we should demonstrate the same grace that we willingly give others to ourselves.

This may seem like a small action for change, but it has a tremendous impact on how well we

would function as nurses and lead to a more significant benefit for nursing and healthcare. Our

EBP/QI project research points out that healthcare organizational support for the mental health of

nurses is essential. Healthcare organizations can help by offering peer and social support systems

and psychological and mental health support services that help to reduce stress among nurses.

Making this small change can help improve work satisfaction for nurses, enhance employee

health, reduce psychological distress and decrease turnover among nurses. (Labrague and de los

Santos, 2021)

Benner’s Theory

Dr. Patricia Benner utilized the Dreyfus Model of skill acquisition to examine the and

development of skills and knowledge a new student nurse develops during their career as a nurse.

There are five stages in development.

• Stage 1: Novice – during this stage, a new nurse is considered a beginner with no

experience in the tasks they are to perform. Based on Dr. Benner’s book, this would be

like the ability of the nurse to take a health assessment and have the knowledge to

interpret their findings.

• Stage 2: Advanced beginner – During this stage, a nurse can use “aspects” from previous

experiences or learning to build on their knowledge. For example, the nurse knowing that
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they should take a patient’s blood pressure before administering a blood pressure

medication.

• Stage 3: Competent – The competent nurse has mastered the ability to cluster her care

and time manage. She can enter a patient’s room, take a quick visual assessment and

move from task to task for that patient before moving on to her next patient.

• Stage 4: Proficient – When a nurse reaches the proficient level, they have mastered the art

of anticipation. They understand their patient’s health condition and anticipate what care

is needed for that patient.

• Stage 5: Expert – The expert nurse uses their skill of intuition. They can look at a

patient’s response to a medication or change in baseline and decide the best and safest

course of action for their patient. They can react based on their intuition and do not need

specifics to help their patient reach the best health outcome or return to baseline. (Benner,

2001)

The immersion process has been challenging but an invaluable learning experience for me.

Depending on a patient’s condition or a nursing task, I can see where I may fall into three of

Benner’s proficiency levels (novice, advanced beginner, and competent). If I had to rate my

performance, I would land at just approaching advanced beginner. I know with certainty that I

have much to learn before considering wearing the title of competent. In most cases, some of the

pharmaceutical medications I administer to patients keep me humbly in the advanced beginner

stage. I Have had clinical days where I used critical thinking without the coaching of my

preceptor, which supports my being in the advanced beginner stage. For example, we had a

hypokalemic patient that had an order for IV administration of potassium. We were to complete

four administrations of potassium over a period of time. After completing the administration, the
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physician placed another order for four more rounds of potassium. When I saw the order pop up,

I asked my preceptor if we needed to draw labs to recheck the patient’s potassium rate before

administering the next round of potassium. She was surprised that the physician had placed the

order, especially since the patient’s lab values had not been rechecked since change of shift. My

preceptor said that was a good catch and that she is sure the physician did mean after the labs

were rechecked but failed to specify that in the order. She said physicians are busy and often rely

on nurses’ critical thinking. Therefore, they do not always restate the obvious. It was good to

catch that another new graduate nurse may have administered the meds without questioning the

order. She did encourage me to follow my instinct when something does not feel right or is

questionable. When I find myself in situations like that, I always reconfirm with the physician.

Action Plan

After reading through Benner’s book, I have decided to use her five stages of

development to help me self-evaluate my performance, especially during the first six months of

my being a new graduate nurse. I found the stages of development to be precise and a great guide

to self-assessing my progress. I know that I am extremely hard on myself. I do not show myself

the same grace that I show others. I had a practicum instructor say that to me my junior year, and

she was 100% correct. I know that nursing is a challenging profession, and I am looking forward

to the challenge, but I also have to understand that it will take time for me to develop the skills to

be the nurse I am striving to be. I have to break down my development in stages, and Dr.

Benner’s book helps me do that. I can also use the stages as a guide during my precepting

experience to ask my preceptor questions or learn new skills from my preceptor.

I rely heavily on the performance review process. The process is about my development.

Utilizing the stages of development will help guide me in discussion with my director on my
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performance and what resources are available to me to help me advance. I plan to get to the

development stage where can be a charge nurse. One of my preceptors is also a charge nurse

during our shift, I have had the opportunity to learn/observe that nursing role while she also has

patients. The developmental stages will also help me decide on career development and

education to help me in my career as a nurse. I recently joined the Academy of Medical-Surgical

Nurses (AMSN) as a student member. I intend to keep my membership post-graduation and

become a certified medical surgical RN (CMSRN). The AMSN also offers various professional

learning modules to enhance your career and a large membership base to help support other

members.

For self-care, I plan to give myself grace and take reflective time. In my first semester of

nursing school, I hated that we had to write reflections after each simulation. Over time I was

used to writing them and chalked them off as assignments. It was not until I started working as a

PCT last year that I realized that those reflections are beneficial. I think I was working for about

two weeks as a PCT, and on my drive home from work, it clicked that I reflected on my day.

Each time I did that, I remembered or thought of another way to improve a task and even cluster

my care. When I work as a nurse, I plan to do that by using a journal and creating a binder that

will help me as I recall new things that I learn. I am a visual and hands-on learner. As I reflect on

my shifts, especially during my precepting time, I believe it will help me organize my thoughts

and find out the best process that works for me. I also plan to get back into my fitness. I was

dedicated to my fitness, but I have been less committed since being in nursing school, especially

during the semesters. I know good health is vital, and I will need to be in good health to be of

any benefit to myself and my patients.

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References

Benner, Patricia E. From Novice to Expert : Excellence and Power in Clinical Nursing Practice.

Commemorative Edition ed., Upper Saddle River, N.J., Prentice Hall, 2001, pp. 47–75.

Fahrenwald, Nancy L., et al. “Teaching Core Nursing Values.” Journal of Professional Nursing,

vol. 21, no. 1, Jan. 2005, pp. 46–51, pubmed.ncbi.nlm.nih.gov/15682160/,

10.1016/j.profnurs.2004.11.001. Accessed 1 Apr. 2022.

Jackson, Angela. Personal Philosophy Paper. 2019.

Labrague, L. J., & de Los Santos, J. (2021). Fear of COVID-19, psychological distress, work

satisfaction and turnover intention among frontline nurses. Journal of nursing

management, 29(3), 395–403. https://doi.org/10.1111/jonm.13168