My Nursing Philosophy
This article is based on a final project I wrote for my Bachelor’s of Nursing degree. I expect to be updating it over time. I have placed this at the top as a permanent tab, but I thought it would be nice to include it here as well.
During my final practicum of my career as a nursing student, my philosophy of nursing has begun to develop. Until this semester, I was more focused on the skills of nursing and did not pay particular attention to how I practiced. This final practicum has lent itself to the development of my personal philosophy of nursing and a resulting framework. This framework looks at the shared reality between patients and nurses, and expands it to suggest that this reality should be shared between an entire team of professionals and the patient. It also imagines healthcare professionals as acting together to create a barrier between patients and illness.
During a night shift at the beginning of the semester I had the opportunity to discuss a patient’s perception of his condition. I realized that he was speaking of his condition in emotions and relationships. He told me how he felt when he was originally diagnosed with prostate cancer and how this had affected his wife. Unlike a healthcare professional’s view of illness, which is very scientific and objective, his was subjective and fluid. In other words, he was creating a reality for his illness that was his own.
As a nurse, I realized that it was my duty to explore these realities so that I can understand a patient’s needs better. Because every patient’s reality will differ, no two will need the same care. All to often, as nurses, we get stuck in the routines of our jobs, acting as slaves to the clock, racing to complete tasks. I realized in this moment of epiphany what the true art of nursing is. To be an artistic nurse, you must work within the subjective realities of your patients, acting creatively to find a place in his or her story.
However, I realized that nurses also bring a certain subjective reality to their practice. Each of us has values and beliefs that are created throughout our lives and cannot be compared to anyone else’s. We also bring the concrete knowledge of nursing to our practice. Finally, nurses bring stories of patients who have been in similar situations and are able to discuss the similarities and differences with the patient. As a result, when we take care of a patient, we are not only on the receiving end of our patient’s information; we are also sending our own information.
In the end, the nurse and patient create a shared reality that is a combination of the patient’s own view of his or her illness and experience in the health care system, and the nurse’s knowledge, values, and beliefs. Together, they must negotiate the best way to improve the patient’s health. It is my belief that this relationship is created nearly subconsciously. However, if a nurse specifically focuses on this aspect of care, they could work toward creating a better experience for the patient.
Nurses are not the only people that interact with patients. Physicians, family members, and all other members of the health care team also individually talk with patients, bringing their own knowledge, values, and beliefs into the situation. Unfortunately, the shared realities between these persons and the patient may conflict with every other person’s. This creates a chaotic and confusing experience for the patient, making it difficult for everyone involved to create goals for the patient.
I decided to build my framework around this concept of “shared realities.” However, I also wanted to use a simplified version of Neuman’s (2002) model. Neuman’s model contains multiple layers of complex barriers between the patient and stressors that cause illness. In my simplified version, I simply see nurses as part of a health care team that, when properly used, creates a solid barrier around a patient. This barrier needs to follow the patient through primary, secondary, and tertiary care.
In figure 1 is a view of a model in which each health care professional is utilized to either a great extent, or not enough. The larger the circle, the better their skills were utilized. The lines show that most of the communication travels from the professionals to the nurse and then to the patient. In this model, it is the nurse who bears the majority of the stress of coordinating the team of professionals. It also makes it difficult for the professionals to work together as they do not understand each other’s subjective reality.
In Figure 2 is a view of what I believe a nursing framework (or more accurately, an interprofessional framework) should look like. It shows the members of a health care team working together to create a shared reality between the entire team and the patient. By creating this reality between the entire team rather than just each professional and the patient, it creates a unanimously agreed upon goal for the care of the patient. Having a shared goal would make it easier to share ideas and creative ideas on reaching this goal. The key to making this work is communication. Each member of the interdisciplinary team must feel comfortable talking with every other member of the team, and in turn must be approachable at all times for discussions regarding their patient.
I spent a lot of time trying to create a complex framework for nursing that would show the intricacies of our professions. However, in the end, I realized that by simplifying the model, it made it realistic and easy to follow. It simply states that a nurse must respect the differences between patients, and tailor his or her care to adequately care for their patients. On a bigger scale, a nurse must work, through communication, to create goals with the entire health care team. By working together, we create a stronger barrier around the patient that works to strengthen the barrier between health and illness.
References
Neuman, B., Fawcett, J. (2002). The Neuman Systems Model (4th ed.). Upper Saddle River, NJ: Pearson Education Inc.
September 21st, 2007 at 01:25
[...] unknown wrote an interesting post today onHere’s a quick excerptThis article is based on a final project I wrote for my Bachelor’s of Nursing degree. I expect to be updating it over time. I have placed this at the top as a permanent tab, but I thought it would be nice to include it here as well. … [...]
October 24th, 2007 at 19:13
I’m a nurse as well and also a teacher to nursing undergrads in Canada. One thing that I try to insist on is to teach students to stop and ask themselves what it is that they do (as nurses) and why; what it is that they knowwhat ; and sets them apart from other professionals. Most often they’re too eager to dismiss the “theoretical stuff” but I hope at some point they’ll reflect upon it before they graduate. It seems you have, good for you.
January 31st, 2008 at 18:45
AS a current nursing student I really enjoyed your work SOme times nursing feels to clinical and rushed where we need to slow down and see what you have written thanks!
February 6th, 2008 at 21:11
I’m currently enrolled in a BSN program and we’re working on our own nursing philosophies. I wanted to read some others and see what their beliefs were. I was really impressed with your view of patient care and totally agree with the model on integrating patient care with all providers involved. What a great concept.
April 16th, 2008 at 00:45
Nice site, please visit http://www.indonesiannursing.com too, Warmest regards from Indonesian nurses
May 12th, 2008 at 22:10
I am a nurse teacher in India. I am distressed by the total apathy of the nurses (and nursing students), when it comes to patient centered care. Materialism has seeped so much into nursing practice that there seems to be no concern for the well being of the client. I have just one thing to say to these nurses and students ..”Would you behave in the similar way with your own kith & kin had they been in the same bed?”. The answer is a flat ‘no’. But the callousness continues
‘Theorywise’, they are all updated. But the knowledge aquied is generally used for self upliftment in the booming business that is the profession of nursing today. It is time we stopped running the (rat) race and paused to think where all this is taking us..
May 12th, 2008 at 22:11
I am a nurse teacher in India. I am distressed by the total apathy of the nurses (and nursing students), when it comes to patient centered care. Materialism has seeped so much into nursing practice that there seems to be no concern for the well being of the client. I have just one thing to say to these nurses and students ..”Would you behave in the similar way with your own kith & kin had they been in the same bed?”. The answer is a flat ‘no’. But the callousness continues
‘Theorywise’, they are all updated. But the knowledge aquired is generally used for self upliftment in the booming business that is the profession of nursing today. It is time we stopped running the (rat) race and paused to think where all this is taking us..
August 1st, 2008 at 07:13
This is beautifully written.
I now need to write my philosophy and am intimidated by it.
As you can tell by my distracting behavior (first time I every commented on web, maybe next I’ll go clean the bathroom LOL).
I always under rated my self at a nurse because the science and machines are not my favorite part of nursing, they are something I have forced myself to learn. But I do have an inborn sense of caring that, I realized of late in my research about the philosophy of nursing, that does make me a good nurse.
So Thanks Sean I think I started my paper.
Brenda
January 10th, 2009 at 01:49
Your ’simple’ model is just that, simple. There is no explanation or description of the interconnected relationships between health care workers as well as their relation to the patients. Ultimately, your concept of ’shared reality’ fails to connect health care workers with each other. After reading your article, I did not gain any philosophical knowledge or expand my perception of nursing reality. If anything, it felt like I was reading some journal entry ranted by a confused first year nursing student. best of luck with you’re perceived realities.
ps. If you recieved a mark higher than C on this project, then you should reconsider the quality of nursing education you are receiving.
January 18th, 2009 at 07:30
@Anonymous
There’s a strong difference between constructive criticism and just being a jerk. If you’re going to be a jerk, we don’t want to hear your nasty thoughts!
January 20th, 2009 at 13:09
@Anonymous
Very sweet. Maybe you can take a course in netiquette?
January 29th, 2009 at 15:58
Anonymous… really…? Really? Who are you to tell the author that his perceived realities are incorrect or simple. Are you a nurse? Are you in healthcare? I pity those around you and most of all pity you for your arrogance, poor taste and bitter soul that lives within you. It is fine to hate yourself or your job, but please for the rest of the healthcare workers who feel that everyone is entitled to their OWN PERSONAL PHILOSOPHY on nursing…shut the hell up and don’t comment if you feel the needs to be an ass.
March 13th, 2009 at 20:25
nice,terrific, I am in BSN Accelerated now, I have write this paper too. I agree with you and admire you.
Anonymous:::::: YOU NEED TO READ MORE ABOUT NURSING AND BE MORE EDUCATED BEFORE MAKING THAT COMMENT.
June 1st, 2009 at 06:43
[...] The Intensive Art My Nursing Philosophy Posted by root 20 minutes ago (http://nursesean.com) Comments 12 trackbacks 1 leave a comment trackback nice terrific i am in bsn accelerated now i have write this paper too Discuss | Bury | News | The Intensive Art My Nursing Philosophy [...]
June 2nd, 2009 at 19:41
I enjoyed this philosophy. I think this shared reality is one of the truths of nursing.
To Anonymous,
If you have ever received a grade higher than “C” in spelling and punctuation, then you should reconsider the quality of your own, apparently substandard, education.
Linda
August 17th, 2009 at 16:05
well done, wish i could write like that. but u r so right they preach to students care is client focused but in reality management of the $$$$$$$ comes first.
July 5th, 2010 at 19:38
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