Running head: PERSONAL PHILOSOPHY OF NURSING 1

Personal Philosophy of Nursing

Donald A. Leon

Bon Secours Memorial College of Nursing

Dr. Marcella Williams

NUR4140 – Synthesis for Nursing Practice

October 31, 2020

“I pledge”
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Personal Philosophy of Nursing

Definition of Nursing

I ventured into the profession of nursing in my mid 30s as a second career with little

more knowledge or motivation than that I wanted to work in something in which I can help

others. Throughout my time at Bon Secours Memorial College of Nursing (BSMCON), in

my class lectures, assignments, labs, and clinical experience I have come to an understanding of

nursing as a discipline, vocation, calling of serving others through compassionate care that

involves a balance of art and science, the individual and community, and theory and practice.

I have learned the importance of using evidence-based practice. As students me and my

colleagues have studied and imitated the practices that have been shown over the years to

have effective, beneficial outcomes for the patients. Those practices are passed down through

the generations through nursing school curriculums and clinical practice. As importance as

correct execution of skills and practices are, they are limited in their effect if not animated by

passion, compassion, and caring on the part of the nurse. The art of nursing manifests with

thinking of new and creative ways to care for our patients, their families, and other care team

members. We commit to read and learn about theories of nursing and understand that

commitment to mean not just while we are formally students but also for our entire lives. We

put our hands in motion to deliver care. We treat every individual, holistically as a unique

individual, understanding that they are part of a family, neighborhood, and community

(culture) that informs their individuality.

Personal Philosophy
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The above concepts that define nursing for me also play a crucial role in my nursing

practice. Although I have not always perfectly lived up to the principle in my life or in my

practice, one thing that I strive towards is the golden rule. Service is to others is only possible

when keeping this rule in mind whether its outside of nursing or, especially in nursing.

Maintaining a humble spirit and commitment to serve others serves well for my interaction

with patients and their families as well as my colleagues. It is important to keep in mind the

reason we as nurses are there, and that is for our patients.

Having a strong work ethic and a sense of personal responsibility is part of providing the

best care for your patients. If due to tiredness, personal issues or whatever the reason may be I

slack on my responsibility not only do my patients not receive the quality of care that they

deserve, but also other staff members may be affected, and in turn their ability to take care of

their patients may suffer as a result. When I am on the floor I strive to continuously work hard

for the patients under my direct care and to assist my co-workers as much as possible realizing

that I am part of a team. An added benefit of this is that when I need the assistance of a co-

worker in order to provide the best care for a patient, I can ask them confidently and with a

clear conscience knowing that I’ve been doing all I can and helping out my teammates.

Values and Beliefs

In considering my values and beliefs when I started the program at BSMCON and how

they’ve changed and evolved over the nearly four years that I have been in the program I did a

lot of reflection. After that I revisited my personal philosophy paper from NUR1100 for the first

time since completing it almost 40 months prior. Considering the number and variety of

challenging and great experiences that I’ve had in the interim, I was somewhat surprised that
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my fundamental values and beliefs and how I would articulate them in this formal setting have

not changed significantly since that time. That is not to say that I have not grown as a person

and as a soon to be Registered Nurse. On the contrary, I think that my experiences at BSMCON

have confirmed for me that I made the right decision for my life to pursue nursing and have

imparted to me the skills and mindset to be a successful, compassionate nurse.

In my first philosophy of nursing paper, I reflected that my values are informed by the

Christian faith and include compassion, humility, mercy, and grace. I was raised with those

values and have internalized and maintained them throughout my life. Similarly, as a Christian I

believe that humans are made in the image of God and that we are commanded to love our

fellow men as we love ourselves and are admonished to not judge. This aligns perfectly with the

values of beneficence, justice. A large part of the reason that I chose to pursue my education at

BSMCON because it is a values-based program and health system that aligns with my values

and beliefs. With my BSN largely in the rearview mirror I can happily say that BSMCON has not

only promoted those values, but I have seen them modeled by faculty, administration, and

clinical staff.

There are too many experiences at BSMCON to list that have challenged my

assumptions and expanded the breadth and depth of my compassion. The most impactful have

been the various clinical experiences that have exposed me to vulnerable populations. In my

Global Population Practicum, I had the honor of participating in the Bon Secours Care-a-Van.

This experience exposed me to a patient population that for the most part consisted of

undocumented, uninsured immigrants. Prior to this experience I had unintentionally, but

effectively been sheltered from seeing the challenges that this population faces in human
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terms, as opposed to a point of political argument. The experience broadened my perspective

by allowing me to see health challenges that many individuals in this population face from a

physical, social, and economic point of view.

In this, my final semester at BSMCON I have my clinical immersion at Richmond

Community Hospital (RCH). This hospital is unique in the Bon Secours Richmond system in that

it is located in an urban setting. A windshield survey of the Churchill area in which RCH is set

reveals abandoned, boarded-up houses, housing projects, and minimal community resources. I

have not looked at any data for the demographics of the area or of the hospital, but from my

experience there this semester it serves primarily a local, predominantly African American

population. Aside from RCH, a DaVita Dialysis, and a Planned Parenthood clinic that I pass on

the way, I would consider it an underserved area.

Many of the patients that I have cared for during this experience are admitted for

complications from DKA, uncontrolled DM2, or from cocaine or heroin use. I have seen more

injection site infections, abscesses, and endocarditis resulting from heroin needles this

semester than I have in my prior three years of clinical at any of the other Richmond Bon

Secours hospitals. Aside from the sadness of these cases, the experience has been very

rewarding. It has been humbling experience, and I have developed a stronger bond with my

patients than in any clinical experience previously. Some of that can be attributed to the fact

that I am with these patients for an entire 12 hour, sometimes multiple 12-hour shifts. Some of

my most fond memories have been advocating for my patients and encouraging them to

ambulate in the hallway and even outside.

I have been fortunate in my life to not have had any challenges personally or with close

family with drug abuse or misuse. Sometimes, it is easy to look at someone in that situation and

judge them, or to think critically about their choices rather than with compassion and

understanding. I admit that this has been a shortcoming of mine at times. This experience has

broadened my compassion and changed the way I consistently see persons with these

challenges. I would say that one of the biggest and what will likely prove to be one of the most

enduring impacts that this experience has had on me is to look at individual’s with drug

challenges immediately with compassion and understanding instead of judgement. Rather than

look at them as having made bad choices and to have in the back of my mind that “they put

themselves in this situation,” I look at them as fellow humans who may have had different life

experiences to myself, have different upstream factors to contend with, and need and deserve

love and compassionate care.

Nurse Patient Encounter

One of the most poignant and emotionally challenging patient interactions that I’ve had

thus far in my career as a nursing student or a PCT occurred recently in my immersion. This

patient was admitted for alcohol withdrawal and was on CIWA protocol. Receiving report in the

morning I learned that this adult patient was currently in a physically abusive home situation. In

report I also learned that she had told the night-shift nurse that she has been abused since she

was eight years old and that every man that she has been with has abused her. This patient was

choosing to stay in that situation she stated because she loved her abuser and that her abuser

had a son and did not want him the abuser to get in trouble. The night shift nurse reported that
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she had asked the patient how she copes with the abuse and the patient reported that she does

so by drinking.

Due to the sensitive nature we did that background portion of report away from the

patient. When we walked in the room for the bedside shift report portion, I noticed that the

patient looked disheveled and exhausted. Considering what she has been through I was

impressed that she is still functioning at all. Along those lines I noticed that the patient had a

very low self-image, which is also very understandable given the circumstances. I made extra

effort during this shift with her to practice therapeutic communication, establish trust, and do

caring rounds to see if she needed anything. At one point as I was administering one of her IV

push medications, she began sobbing. I was initially concerned that maybe her site was

infiltrated. It was not. When I asked her what was wrong she said that she felt like a burden and

she was taking up our time that we could be spending on “real patients.”

I was taken slightly aback at the suddenness of this emotion, but I did not show it. I was

able to pause for a moment, but also quickly and confidently respond by reassuring her that not

only was she a real patient, but she is just as important as any patient on the floor or even the

CEO of the hospital. Given her history, I’m not sure that she had ever heard anything like that

before to affirm her intrinsic value. Based on her reaction, I believe that the statement had an

impact on her. My strong belief in the statement allowed me to say it confidently, without

rehearsing, and with authenticity. That statement, though small coupled with my practice of

loving kindness throughout the shift encapsulates my values, beliefs, the ethical nursing

principle of justice, and the tenet of serving those who are vulnerable in the category of

Ministry Leadership in the Bon Secours Professional Practice model.

My Role as Change Agent

I opened my first personal philosophy of nursing paper in 2017 by articulating my lack of

confidence that I can make a difference or bring about meaningful change in the profession of

nursing. At that time, it seemed like such a big undertaking especially when compared to my

lack of knowledge, skill, and experience in the field. Since, then throughout my time at BSMCON

and especially this semester in NUR4140P I have learned a great deal that has made me see this

in a whole different light. Not only have a gained valuable skills and experience but also a

greater understanding that by using the principles of Quality Improvement (QI) I can leverage

my own knowledge and skills with the help of a team to effect significant change. My role as a

new to practice RN is to learn, communicate and collaborate, commit to self-improvement

personally and professionally, and apply the tools of QI to challenges on the unit. Whether I

happen to initiate an idea or play a supporting role in a colleague’s idea as part of the

interdisciplinary care team I can have an impact.

Skill Acquisition

In her 1982 book From Novice to Expert: Excellence and Power in Clinical Nursing

Practice Patricia Benner adapts the Dreyfus Model for Skill Acquisition to the profession of

nursing. She develops a theory that traces the professional development of nurses through five

stages. The initial stage, novice, occurs when a nurse is performing a task for the first time and

has no prior experience with it. Expert is the final stage of progression in her model and involves

the nurse having command of the knowledge, skill, or situation at hand can connect the dots in

complex patient situations. In this stage the nurse is able to quickly eliminate possibilities that

aren't correct in order to arrive at the correct conclusion (Benner, 2001). In between the novice

and expert are three levels of competence: advanced beginner, competent, and proficient.
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In performing a self-assessment of my overall nursing skills at this stage of my career I

would rate myself and advanced beginner. For the last 3 years I have had the opportunity to learn

academically, as well as to observe and practice a wide variety of nursing skills. Benner

identifies the validity of both academic knowledge and experiential knowledge, which she

describes as theoretical and practical knowledge respectively, in helping the progression through

the stages (Benner, 2001). She describes the advanced beginner of exhibiting "marginally

acceptable performance" and that nurses in this category "can take in a little of the situation: it is

too new, too strange … and they have to concentrate on remembering the rules they have been

taught (Benner, 2001). I think that this encapsulates my skill acquisition at this point in my

career as a student and soon to be RN.

Action Plan

I am looking forward to the challenges ahead as I start my nursing career and strive to

advance from novice to expert. One critical aspect to advancing is to apply a concept that I have

learned at my time at BSMCON and that is to be a lifelong learner. From my first day on the job

as a new graduate and continuing through my career I can learn theoretical and practical

knowledge both informally and formally.

I plan to work hard at my job. To provide the best patient care possible and to be a good

team player at my unit and hospital. With that being said I am aware of the possibility of burn-

out and understand the importance of self-care. My plan for self-care is to exercise, spend a lot

of time with my family, and to be outdoors. I have also found that per therapy is also very

effective for me at lowering my cortisol and bringing me joy.

References

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

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