Personal Philosophy of Nursing

Personal Philosophy of Nursing Cindy Dopp Student UIN # 00991839 ODU Distance Learning Site J.S.R.C.C.

Submitted in partial fulfillment of the requirements in the course Course 401: Career Pathway : Assessment Old Dominion University NORFOLK, VIRGINIA Spring, 2014

Personal Philosophy of Nursing Personal Philosophy of Nursing

In December of 2002, I graduated from J. Sargeant Reynolds Community College with an Associates of Applied Science degree. This degree fulfilled the Virginia state licensing requirements to become a Registered Nurse. In February 2003, I passed the Registered Nurse license exam and became a practicing Registered Nurse. Since then, I have worked as a staff nurse, a disease management nurse, a nurse case manager, and presently work as a supervisor for a case management team. My personal philosophy of nursing began forming during nursing school and has continued to grow and evolve into a multifaceted personal philosophy. When contemplating my own personal philosophy of nursing, I realized that I needed to understand the definition of a profession, then define the nursing profession, and lastly, combine these definitions with my own personal nursing values and nursing experiences to then be able to articulate my personal beliefs and describe my reason for actions. This process included reviewing research evidence that broadened my beliefs and values. The activity of writing my personal philosophy of nursing generated much self-exploration, thought about past nursing experiences, and contemplation of how my philosophy was impacted by nursing experiences and education based on scientific research. I thought about my moral responsibilities and how theses responsibilities fit into nursing today. Lastly, I realized that my personal philosophy of nursing included some personal beliefs and values and also included education and nursing experience. All of these facets fit together to make up my personal nursing philosophy. Definition of Nursing The definition of a profession, as defined by Google Online Dictionary, is as follows: "a paid occupation, especially one that involves prolonged training and a formal qualification". The definition of the nursing profession, as defined by Merriam-Webster Online Dictionary, is as

Personal Philosophy of Nursing

follows: "a person who cares for the sick or infirm; specifically: licensed health-care professional who practices independently or is supervised by a physician, surgeon, or dentist and who is skilled in promoting and maintaining health. A more comprehensive definition of the nursing profession is from the American Nurses Association website: "Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations". Both definitions are correct because the nursing profession can sometimes play a minor role in the healthcare continuum or, at times, involve a comprehensive care plan that involves a multidisciplinary team to provide complex treatment to a patient. The above definitions illustrate this point. My belief system incorporates both of these definitions, but also includes the belief that professional nursing care begins at birth and may end at death or continue on to family members still living. Purpose of Nursing The purpose of nursing is not always a response to illness. Nursing is the performance of medical care in an active healthcare system, such as a medical office, outpatient procedure, or inpatient hospital stay. Nursing also provides ongoing care in the form of education, prevention, and support to promote good health in society. Nurses assist people to navigate the healthcare system and also act as patient advocates. The end goal of nursing is for people to attain their maximum potential with both their physical and mental health. Nursing Values and Beliefs Nurses respect patient's wishes and belief systems. It is important to understand cultural and family dynamics when caring for people. Nurses should help patients to maintain their human dignity and care for them with a holistic approach. Patient centered care should always

Personal Philosophy of Nursing

be delivered by nursing whether our own personal beliefs and morals differ. The best outcome for patient care should be the end goal and the nurse should act as the patient's advocate at all times during the delivery of care.

Principles that Guide Professional Practice A large part of my personal philosophy of nursing centers around the concept of patient advocacy. Advocacy "...refers to providing support for a patient's rights or best interests" (Blais & Hayes, 2011, p.67). As a nurse, my views of advocacy have widened and deepened. When I began nursing school and then became a new nurse, I did not have the experience to fully comprehend the different scenarios I would later encounter with patients to truly understand how my beliefs and values may conflict with the patient's beliefs and values and resultant healthcare decisions. For instance, these choices could include smoking, alcoholism, and/or drug abuse. In my mind, the logical solution to these problems would be to quit the problematic behavior. This is a simple answer. The reality I encountered in my clinical practice was that some patients derived pleasure from these behaviors and were not willing to change their choices. When I was a new nurse, this would frustrate me and I could not reconcile my principles to the principles of my patients. Now, that I have a larger base of experience, I realize that while I might not agree with this destructive behavior, my role as a patient advocate is to meet the patient where they are in the healthcare plan and promote good choices while protecting the patient's dignity, privacy and choices. I always provide positive health change education to the member and frame it up as information to consider. Another example of how patient advocacy has become the backbone of my personal philosophy of nursing centers around a patient I cared for in the hospital. This patient was a

Personal Philosophy of Nursing

middle-aged African- American male. He was in the late stage of AIDS and this was before the advances in treatment with anti-viral medications. This gentleman had not disclosed any details regarding his illness to his family and did not want any details disclosed when family came to see him in the hospital, even when he was days from dying. He did not want the stigma of AIDS to reflect on his family and he was ashamed of being an IV drug user. In hindsight, I incorporated the rights protection model which "...places the nurse as defender of patient's rights within the healthcare system. The nurse informs the patient of their rights, makes certain that rights are understood, and protects patients from infringement of those rights" (Blais & Hayes, 2011, p.67). This situation placed me in a scenario where a patient wanted complete privacy and the family was vocal and aggressive regarding the patient's illness and treatment. This case taught me a lot about my values and beliefs regarding patient advocacy and how my daily nursing practice would always revolve around this principle. Another principle that guides my personal philosophy of nursing involves ethical decisions in healthcare, especially end of life care. Ethical decision making "... is systematic and based on ethical principles and civil law. It should not be based on emotions, intuition, fixed policies, or precedent" (Blais & Hayes, 2011, p. 61). Nurses must respect and uphold the medical treatment chosen or refused by a patient. Nurses must be prepared to honor a "Do Not Resuscitate" order or withhold certain treatments such as food and/or fluids when directed. This can be challenging when our first instinct as nurses is to aggressively treat health issues. An example of how an ethical issue changed and deepened my personal philosophy of nursing occurred when I worked on the CCU. It was Thanksgiving Day, and a male patient with advanced COPD was written new orders by his pulmonologist that he could be transferred to a step-down telemetry floor. This patient had been on continuous, compressed oxygen, but

Personal Philosophy of Nursing

would now wear 4L continuous oxygen through a nasal cannula. He had a "Do Not Resuscitate" order in his chart. His family was on the floor visiting when the patient was being moved. Within minutes of removing the compressed oxygen, the patient went into respiratory distress; the pulmonologist was called back to the floor. Soon after, the patient stopped breathing and he had no pulse. The family became hysterical and demanded treatment. The MD, who knew the patient well and understood his healthcare choices, refused to resuscitate. I often think about this scenario for many reasons. I wonder how I, as his nurse, and my coworkers would have treated the DNR for this patient if the treating physician had not been there. It was the correct choice not to attempt resuscitation as per the patient's wishes, but the family was in so much pain, it was very difficult to uphold that decision. This experience cemented my belief that patients have the right to define their own plan of care and to decide their terms of death. Conclusion In conclusion, my personal philosophy of Nursing incorporates the definition of nursing, my definition of the purpose of nursing, and my value and belief system surrounding professional nursing. Patient advocacy and ethical decision making in healthcare are two nursing principles that cement my practice in to a patient centered, autonomous relationship with not only patients, but families, the community and also other members of the healthcare team. As I gain more experience in nursing, I realize that I also gain more insight in to issues that affect the nurse. This experience forces me to further define and explore my personal philosophy of nursing. As a nursing student and new nurse I did have a personal philosophy of nursing, but had not had the real world experience where this philosophy would be tested.

Personal Philosophy of Nursing Reflection

Writing this paper was difficult for me. I struggled with what this assignment was asking me to explain in writing. It was hard to fully describe my personal philosophy of nursing because much of my philosophy is so internalized; it was hard to express it in a written text. I thought about my philosophy and the many clinical experiences that are forever in my memory that help shape today who I am as a nurse. After much thought, I decided that my main principles that guide my professional practice are patient advocacy and the challenge of ethical dilemmas. The benefits of completing this paper are many. I have a deeper understanding of my profession and my personal beliefs and values. I have evaluated my professional practice and the philosophy of nursing that guides it. Overall, this assignment has made me contemplate who I am as a nurse professional and what my personal nursing philosophy entails.

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References "American Nurses Association - About Nursing." American Nurses Association - Home. N.p., n.d. Web. 15 Mar. 2014. <http://www.nursingworld.org/EspeciallyForYou/What-isNursing>. Blais, K. & Hayes, J. (2011). Professional nursing practice: concepts and perspectives (6th ed.). Boston, Mass: Pearson. nursing profession. 2014. In Merriam-Webster.com. Retrieved March 15, 2014, from http:// www.merriam-webster.com/dictionary/nursing profession. profession. 2014. In Google.com. Retrieved March 15, 2014, from https://www.google.com/#q=profession.

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Honor Code

Honor Code We, the students of Old Dominion University, aspire to be honest and forthright in our academic endeavors. Therefore, we will practice honesty and integrity and be guided by the tenets of the Monarch Creed. We will meet the challenge to be beyond reproach in our actions and our words. We will conduct ourselves in a manner that commands the dignity and respect that we also give to others. Honor Pledge I pledge to support the Honor System of Old Dominion University. I will refrain from any form of academic dishonesty or deception, such as cheating or plagiarism. I am aware that as a member of the academic community, it is my responsibility to turn in all suspected violators of the Honor Code. I will report to a hearing if summoned. I have neither given nor received unauthorized aid on the examination (or other material turned in for credit) nor do I have reason to believe that anyone else has. Signature: Cynthia C. Dopp