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Nursing Philosophy Addendum

Teryn Green

Delaware Technical & Community College

NUR 460: Nursing Capstone

Dr. Wagamon

October 27, 2022

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Nursing Philosophy Addendum

Earlier on in my journey through the RN to BSN program, I recall being tasked with the

assignment of identifying the nature behind my nursing structure. At the time, my nursing

philosophy was heavily centered around autonomy due to my patient population. Working within

an Intensive Care Unit (ICU), proved to be a huge adjustment to my approach for caring for

patients as many of them were in such critical condition they were unable to do even the smallest

of activities. Ensuring I was a strong advocate for these individuals became the forefront of my

profession. I drew from experts within the filed such as Dorothy E. Orem, who established the

Self-Care Deficit theory to better understand patients’ behaviors. Orem’s theory at quick glance

addresses the concept that the majority of patients, when able to, will fulfill their health care

needs as best as they can, and it is the nurse or primary clinicians’ role to fill those gaps. The

most important aspect of my specific nursing technique has always been heavily focused on the

patient and filling the gaps in care that either they are unable to satisfy or may not recognize are

absent.

As I have gone through many transitions since the establishment of my nursing

philosophy, I have found that I continue to value the same aspects today. With the completion of

each course, I have discovered not only that I have been able to build a greater understanding of

nursing, but I have also grown a greater respect for philosophers such as Orem. Each of the

courses within the RN to BSN program are centered around building undergraduate nurses into

experts within their field, helping them provide the highest quality of care for their patients.

Despite the individual course objectives that range from an ability to serve diversified

populations such as in the global health course to some of the more seemingly unrelated courses

such as world history, they have all shared the same end goal.
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I recall many initial frustrations while completing my general education courses, not

understanding why or how these specific additions would benefit me. It was not until my first

experience with a patient of Asian background living in the United States as a newly migrated

citizen that the wheels started to turn. This patient was older and spoke very little English, of

course translators are available to assist in the communication process but the barriers to

understanding this individual’s needs were much greater than the language gap. This man was

quite stoic and did not often report any complaints to me, I remember thinking that I felt quite

useless as I was not providing much care as he did not advocate his current issues frequently and

would refuse my assistance when offered. It wasn’t until sometime after I was able to reevaluate

the situation through a more understanding lens with the help of knowledge gained from my

world history course, as odd as that may seem. I discovered that many individuals of Asian

descent, specifically men, are quite modest and adhere strictly to the cultural norms that men

should present as beings of great strength and endurance. This was an area of improvement now

highlighted within my professional journey.

At the time, the experience with the patient of a different upbringing than my own

provided such a great deal of clarity. I began to piece together the reasons behind why this

specific patient was behaving in the manner he did and how my lack of education into his culture

prevented me from being a true and effective advocate for him during my time of care. During

that time as his nurse, I now know he needed to be shown a level of respect that was different

from what I was taught to best serve him. Alternative approaches may have been necessary to

navigate how to ensure he had all he needed to reach a more positive outcome or hospital stay.

Luckily this man was transitioned to a stepdown unit to await discharge, so my lack of cultural

knowledge at the time did not truly impair his recovery, but I gained so much from the
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experience. These courses have provided me various opportunities to find additional ways to

serve my patients, which completely captures my personal nursing philosophy.

My patient centered nursing theory that focuses heavily on being a primary advocate for

the good of my patients has catapulted me within my career. I have found that even if you take

the smartest nurse with the greatest amount of skill, it is almost wasted if that individual does not

recognize that the center of focus while they are performing their duties is to their patients.

Considering the patient’s wellbeing as the sole focus for my care while advocating for

individualized and optimum treatment plans amongst others within the interdisciplinary care

team has resulted in much more than improved patient outcomes. The passion and dedication to

serving my patients and representing their needs in the absence of their own ability to has been

recognized a great deal by both families and peers. This acknowledgment not only has allowed

me to establish positive and trusting relationships with families and doctors but also given me a

great deal of confidence in my abilities. Prior to all my work within this course and at the

bedside, I remembered being very timid and apprehensive to speak up. After gaining a better

understanding of the ethical principles of nursing and the ANA provisions that guide nursing

care, I was able to realize that my apprehension and lack of confidence would only prevent me

from ensuring the patients had what they needed, as I was the connection of communications

more times than not between patients, their families, and other members of the care team.

One of the biggest correlations to an improvement in autonomy within my practice has

been the increase in leadership roles bestowed upon me within my unit. The more I was seen

addressing the needs of my patients with the higher ups in a confident and respectful manner the

more I was asked to take up projects in which I was a team lead. The leadership course truly

prepared me for these new hats I was preparing to wear as it helped me to better understand what
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these roles meant. When coming into nursing as a newly graduated nurse the primary focus is on

the basics, therefore areas such as precepting, charge positions, and even being a resource for

others was quite foreign. As I learned more about how to communicate more effectively, or work

within groups as an asset to the team I looked upon these new duties with excitement to build yet

another part of my career.

As of late, my attitude and perceptions for how my nursing care is fulfilled is even more

rooted in the aspects of autonomy and Orem’s self-care deficit theory. Having been introduced to

various populations within this program that truth has become even more evident. Through

exposure to the needs of numerous individuals from various backgrounds one consistency I have

noticed relates to the importance of speaking up for one’s needs within their care. Being able to

step up to the role of the advocate helps to build nurses into well respected expects within their

field. When your peers see you step up and demand the best of the best care for your patient,

they also grow to trust your abilities more and utilize you as a resource. Altogether these

combined factors will continue to grow me into the nursing leader that I am on the path to

becoming after just a few short years in critical care. The major takeaway for me is not only how

important being an advocate for your patient’s needs is but also how lifelong learning is the key

to making sure it can be done effectively.