Running Head: PHILOSOPHY OF NURSING 1

Philosophy of Nursing

Olivia Small

Christine Turner, PhD, RN

Bon Secours Memorial College of Nursing

Synthesis for Nursing Practice NUR 4142

October 17, 2018

I pledge
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Defining a Nurse

Nurses as a whole remain one of the most visibly invisible servant leaders, with a

commitment to providing compassion, service and quality to their care. My idea of an admirable

nurse is one that provides holistic and dignified care to all. This nurse is in the business of

healing, not just the body, but the mind and the soul as well. Nurses help care for patients

starting from conception with education at moms first prenatal visit, and all the way to the final

goodbye before a patient passes on.

I say that we as nurses are visibly invisible because we are remembered by many of our

patients for the visible things we do and provide. These include administering medications in a

timely manner, educating patients, addressing concerns and helping to perform activities of daily

living. We, as nurses, remember the invisible aspects of care, the actions that we do not always

get recognition for (Canzan, Heilemann, Saiani, Mortari & Ambrosi, 2013). These are subtle

changes that nurses notice in a patient’s mood or condition and then are able to determine a plan

of action based on knowledge and experience. As advocates for our patients, nurses are

responsible for navigating and helping to direct patient care in a way that is most beneficial to

our patients.

Personal Philosophy

In my original Philosophy of Nursing paper, I discussed how I believed in the Golden

Rule as guidance for patient care. This rule being, treat others the way you would want to be

treated. As a new practicing nurse and a human being, I strive to care for and treat all patients

with both dignity and respect. I, as a Black female, have at times been treated differently, just

because of the color of my skin. It can be hurtful and degrading, however, I have to try to break

through it or be broken by it. I have to move past my own biases, as well as the biases of others
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to provide my patients with the best possible care. We cannot always tell who a person is or what

they have been through by just looking at them. As nurses, what they look like or what they have

done should have no weight on how they are treated. We made a commitment to care for all of

our patients and there is an underlying trust that their nurse will keep them safe.

This whole idea of treating others how we want to be treated sounds simple. So simple in

fact that we learn it in kindergarten, if not pre-school. However, nurses become so task oriented

at times, that some end up treating patients as just another warm body. It does not necessarily

mean that these nurses no longer care for their patients. These nurses just become so task

oriented that they forget or have no time to look at the whole person. Every nurse has come

across this and at times there are those who seem to be trying their best to test every fiber of my

being. Working in the Emergency Department, there have been numerous times where my first

encounter with a patient is me walking into a room with a smile and saying ‘hello’, only to be cut

short by a patient yelling and accusing me of something. In these situations, I try to take a step

back, take a deep breath, and think extremely carefully about the next thing I will say.

Since starting my immersion and being in more direct patient care at work, I have been

working hard to practice my strategy of taking a step back, taking a breath and really thinking on

my next move. I always want to be treated with respect and dignity. I also want my voice to be

heard. That is why I have to remember that when a person is upset, and they are taking their

frustration out on me, it is not personal. Me responding in a similar manner will lead us no

where. It is not a personal attack on me because they are releasing a feeling of disrespect and loss

of dignity. Many times, people just want to be heard and feel as though someone is listening to

them.
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My philosophy of nursing has helped me in my interprofessional relationships as well. I

have come to find that there is open hostility at times between nurses on different units or

departments. This is something I have never quite understood because we are all working

towards the same goals. In advocating for one another, nurses are better able to provide nursing

care. I have attempted to call report to different units, or seen my preceptor attempt the same,

only to be left on endless hold. Worse even, I have seen my preceptor be hung-up on or be

spoken to in a ugly manner. This disrespect towards one another does a disservice to our patients

whose best interests we are supposed to be caring for. While some emergency department (ED)

nurses will lament the attitude issues of the floors, I try to advocate for both sides and see it from

their perspective. We are all similarly busy and overwhelmed at times. No one side should try to

“one-up” the other because we should all be on the same side, working together.

Nurse Patient Encounter

While in the Emergency Department, I was performing an EKG on a patient and starting

an IV. The woman was clearly unkempt, disheveled and had multiple wounds and obvious scars

that some would call “track marks”. She had given me a friendly but shy, toothless grin. The

patient was in the company of another woman who seemed to be helping her. I went about my

business and started asking questions to be friendly but also to distract the patient. While I was

finishing up her line and taping her down, I looked up in her face to tell her she was done. That is

when I noticed she had tears in her eyes. She began to thank me and when I told her how very

welcome she was and how it was my pleasure to help her, she said to me, “No, you don’t

understand. Thank you so much for treating me like a person. So many people here and many

other places talk down to me or treat me like I am stupid. Trash. You were so nice and respectful.
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It really means a lot to me”. This broke my heart. Even though my own initial assessment

brought out my own bias, I was able to stick to my personal philosophy of nursing.

By continuing to follow my philosophy, I believe I can succeed in the many other

challenges that might come my way. All patients, from the smallest wounds to the sickliest

individual are important. All patients deserve to be treated with dignity and respect and to be

given the time and energy from their nurse to feel that their pain or complaints are important, no

matter how small. It is not hard to become jaded as a nurse. I have seen it happen and cringe

away from it most of the time. I think that this occurs by losing sight of your core values and

forgetting your own philosophy. Nursing is not a job that can be done well if that nurse resents

the very path she walks on and the people she is supposed to help. By simply conversing with

this patient and talking to her how I, myself, would have wanted to be spoken to, I was able help

make her stressful ER visit a little less daunting.

Values and Beliefs

My values are principles and ideals that are freely chosen, and my beliefs help me to

recognize right from wrong and guide me through the murky grey area of everything in between.

In NUR1100 we were instructed to write about our Personal Philosophy of Nursing and I believe

my values and beliefs have only matured over time.

As I finish up my senior year, I still believe that our values set us apart from one another

but still help to bring us together. As nurses, we are all striving towards the same goal. Although

we come in all shapes, sizes, colors and backgrounds, our goal will continue to be caring for and

advocating for our patients. I still believe that our belief systems allow us the conviction to fight

for our patients’ health and wellness, as well as, to treat our patients with the dignity and respect

they deserve.
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Benner’s Theory

Patricia Benner’s Theory: from Novice to Expert, is a wonderful example of the

multifaceted nature of nursing and the progression of a nurse’s career with time, knowledge and

experience. Benner’s Theory encompasses five stages which include: Novice, Advanced

Beginner, Competent, Proficient and Expert. Each stage of Benner’s Theory builds upon the

previous stage to exemplify brilliant nursing. Using this theory, the expert nurse is the one with

the clinical expertise and the “know-how” (Benner, 2001). All of these stages begin with a strong

educational foundation and snowball into a nurse with both the knowledge and the expertise.

Skill Acquisition

Using Benner’s Theory, I would say the stage of skill acquisition that is best

representative of me at this time would be between a Novice and Advanced Beginner. I am no

longer a wide-eyed new nursing student, but a semi-accomplished senior who will be a new

graduate nurse in the next few weeks. As such, I would consider myself to be a Novice with

some Advanced Beginner skills.

As Novitiates in nursing, we have little to no experience in many of the situations we

come across. We must therefore abide by concrete rules and objectives that do not always

represent the “big picture” in a real-life scenario. As Benner notes in her book, following these

inflexible rules does not always allow for an effective performance. This is due to the reality of

the rules which are incapable of determining the most pertinent tasks to perform in specific

situation (Benner, 2001). I have been taught parameters to measure a patient’s condition in a

universal situation. I have learned to recognize risk factors, safety concerns and dire situations. I

am however, still learning what to do and in what order to do them in many of these situations.
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Being in my immersion this fall has allowed me to develop the confidence that I never

thought I had. It has helped me to realize that in some aspects of nursing I am no longer just a

Novice. My previous experience as an ED technician allowed me to walk in on my first day of

immersion with some skills of an Advanced Beginner. I had previously acquired more skills and

had an increased knowledge of the flow and practices of emergency department nursing. The

principles I have gained through experience have begun formulating into guidelines. These

guidelines are dictated actions in relation to both attributes and aspects (Benner, 2001).

Action Plan for Moving Forward

The next stage of my skill acquisition would have me as a full-fledged Advanced

Beginner. To fully move to the next stage on my journey I will continue to demonstrate

performances deemed acceptable. Beginning my New Graduate Nurse Residency program will

allow me to recognize and use my previous experiences in real life situations. These experiences

will be pulled from my time in immersion, as well as work, so that I am able to at least recognize

concepts that are meaningful and build upon principles I have brought into practice.

To continue moving forward in this stage of skill acquisition I will seek guidance from

my preceptor, as well as other colleagues, during my orientation. As an Advanced Beginner I am

still unable to fully take in all parts of a situation as it emerges. There are things I will miss and

opportunities that arise for me to learn and better myself. Criticism is hard, even when it is

constructive, and the criticizer has our best interests in hand. During this time of learning and

discovery, there is no room for pride to overshadow when asking for help becomes necessary.

The safety of my patients is most important. By recognizing this and taking in constructive

criticism, this will allow my transition into a nurse to go much more smoothly.
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Assuming I am able to work in my dream job as an Emergency Department Nurse, I will

work towards various certifications to continue my education. Attaining an Advanced Cardiac

Life Support (ACLS) certificate as well as passing the Certified Emergency Nurse (CEN) exam

are on my path to moving even farther in the stages of skill acquisition. ACLS and CEN would

be great opportunities to gather more skills and experiences to pull from. In time, I hope to move

forward with graduate school because there is always so much more to learn.

Conclusion

The core of my philosophy of nursing pulls from the values and beliefs that I have gained

through life and through my education. With this foundation I believe I will have the best chance

of success in my nursing career. As Benner’s Theory suggests, I will continue to move through

the stages and build upon previous knowledge to one day be seen as an expert. I hope to continue

to hold my philosophy close when it comes to communicating with patients, coworkers and

providers. My educational background will allow me to implement the skills I learned in the

classroom to my daily work life now and after graduation. This will help me continue on in my

journey from a Novice, to an Advanced Beginner, and even further beyond.

References

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

(commemorative ed.). Upper Saddle River, NJ: Prentice-Hall.

Canzan, F., Heilemann, M. V., Saiani, L., Mortari, L., & Ambrosi, E. (2013). Visible and

invisible caring in nursing from the perspectives of patients and nurses in the

gerontological context. Scandinavian Journal of Caring Sciences, 28(4), 732-740.

doi:10.1111/scs.12105