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Running head: PHILOSOPHY OF NURSING

Jamie Underwood

Philosophy of Nursing

Bon Secours Memorial College of Nursing

Dr. Turner

NUR 4140 Synthesis for Nursing Practice

3/29/2020

“I pledge.”
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When I first began nursing school, I viewed it as a great job field to get into. Now that I

am nearing the end of nursing school and have worked with patients in both the clinical and

work setting, I view it much differently. Nursing is not just a job, it is so much more than that.

Nursing is an art in which we care for the sick and the dying. By usually unfortunate

circumstances, we have the chance to encounter numerous people, whether it is the patients, their

family, or friends. Nursing also incorporates a continuing education, which takes science and

evidence-based practice and using your own art to find a way to best help your patients. While

trying to do what is best for your patient, it also includes involving your patient and their wishes

to get the most desirable outcome. Having said this, care for patients should be individualized.

No two patients will be the same; they will each require different ways to be cared for, so

flexibility and creativity are essential.

My personal philosophy is reflected through my practice in many ways.

Interprofessionally, I am always willing to help out my coworkers. That saying it takes a village

could not be more true in the nursing profession. Not only do we have to work together as

nurses, but we also need to collaborate with physicians, nurse aids, x-ray, lab, as well as many

other personnel both in and outside the hospital to provide our patients with the best possible

options. Each and every one of these roles are essential. Recognizing the importance of each of

the roles and working together towards a common goal is absolutely necessary to get our patients

the best care that we can.

No matter how busy I get, I always make it my goal to build some type of relationship

with my patients. Unfortunately, there are days when I am swamped with work and do not get to

really dive into this as much as I would like. I enjoy getting to know my patients on a more

personal level, so that I do not just see them as a patient, but instead a person and so they can feel
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more comfortable and trusting of me to take care of them. When a patient is more comfortable

and trusting, they immediately have a more conducive environment to their healing which is

essential. I enjoy asking about families, hobbies, work, among many other things. Personally, I

love the geriatric patients and enjoy seeing them talk about their grandchildren and how long

they’ve been with their significant other. I love seeing how they perk up when asked about these

things and how animated they get telling me stories.

I went into nursing school with the intent to help others; it is something that I have

always enjoyed. Over the course of the past three years, working with patients has solidified this.

From a young age, my parents instilled me with the values of compassion and integrity. During

my years of working, especially being in the hospital and interacting with patients, I have come

to appreciate it more and more every day. I have held my job as a patient care technician for

nearly the past two years and many of the things that I have seen has really solidified this for me.

This is true for any profession, but especially when it comes to working in healthcare, I feel as

though having compassion for your job and your patients is a necessity. Being able to care for

your patients on a deeper level is more therapeutic, which creates a more healing environment.

The bond between a patient and their caregiver when this compassion is present is like no other.

As caregivers, we are supposed to be there for them in their time of need. Those are the moments

that someone will carry with them. I have seen first-hand some great, knowledgeable nurses. Not

all of them have been as compassionate as some others and it is noticeable in their patient care.

Integrity is also important to keep us honest and to uphold our moral principles. Often

times in healthcare, things are not always so black and white. It is important to find the balance

of doing the right thing for your patient, as well as keeping their wishes in mind. I also strive to

do for others as I would want done for me if the roles were reversed, while keeping it within
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ethical practice guidelines. We have to be consistent from patient to patient. It is unfair to go

above and beyond for one patient, but not for others. I strongly feel as though all of my values

aligns with the Bon Secours values and mission statement. I strive to be good help to those in

need.

I have encountered more patients and been able to interact with them more in the patient

care technician role than as a nurse, so far. I had the opportunity to care for a patient for weeks in

a row since they were in the hospital for an extended period of time. One of my last weeks of

caring for her, she was stressing out over her hair. She kept saying it had been so long since it

had last been washed and she could not wait to get home to take a shower. Her children were

coming in town as well, so she wanted to look more presentable, but never asked anything of me.

That afternoon after everything had slowed down, I rounded on all of my patients to make sure

that they were all okay and asked my coworkers to keep an eye on them for a little bit. I grabbed

all of the supplies that I needed and went into my patient’s room and told her that I was going to

help her get washed up. Over the weeks of taking care of her, I had never seen her so talkative

and animated. A few weeks later, my clinical care lead came up to me and gave me a letter that

the patient had written. She had listed many of the staff from our floor, including me, thanking us

for taking care of her. It is amazing how a small act of kindness can go a long way. As I continue

my career and transition over to the nursing role, I hope to have more opportunities such as the

one stated above. I hope to care for people and make an impact on them by doing small acts of

kindness. I feel as though the small things are what separates a good nurse from a great nurse.

Working on our quality improvement project in synthesis, I have a new and better

understanding of healthcare. We have always learned about evidence-based practice and that it is

what drives policies and changes made over time. Evidence-based practice is crucial in
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healthcare and research is constantly being conducted to implement improvements in everyday

practice. I can now say that I know that it is a long, and time-consuming process. First, an issue

has to be identified. Once our group was assigned our topic, we each took time to do an initial

research on the issue. After conducting some research, we went to the clinical site to do an

interview to help us gather more information. We looked at the issue on both a larger and smaller

scale to see if there were any consistencies or discrepancies. Once we gathered all of this data,

we decided to focus on one aspect of it, then continued to do more research to help us come to a

conclusion in which we could improve practice.

Throughout the course of completing this project and as we continue to work on it, I have

learned many things. For one, research is essential and crucial in healthcare. Throughout my

three years of schooling, we have learned about how much research goes into finding better and

more efficient ways to care for our patients. I have found it to be really interesting and eye-

opening to be a part of it though. It is a very long and time-consuming process. If the change that

you are trying to implement is unsuccessful, then more research needs to be done to tweak the

process or to come up with a new solution. All in all, research and working as a change agent in

healthcare is a never-ending job.

Patricia Benner’s novice to expert theory describes how a nurse starts their career, then

advance over time as they learn the trade, becoming more knowledgeable and confident. As a

novice, the nurse is inexperienced, or new to the practice. They have a lot to learn as they first

come in to practice and have to apply what is learned in the classroom to an actual patient. Not

only that but learning policies and procedures which are imperative to know to remain

consistency from patient to patient. A novice still needs more guidance. The next step up is an

advanced beginner. This person has a little bit of experience or has seen situations which help
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them to make decisions better. Both the novice and advanced beginner are more schedule driven

and need more practice and experience to be able to think better on their toes without having to

consult others. Both need guidance when situations arise in the work day that requires a more

critical level of thinking to sort out which task should be accomplished first.

Once a nurse has a couple of years of experience under their belt, they can be described

as competent. When in this stage, the nurse is a little more forward thinking in planning their

day. Their planning is more organized so that they can carry out the work day in a more efficient

manner. A nurse becomes proficient when they are able to apply previous situations to a current

one to know the best course of action to take as a situation progresses. Experts no longer rely on

rules or guidelines when making decisions or recognizing a change. They are able to work more

independently, and others may rely on them for guidance since they have a vast amount of

knowledge.

This theory not only works for new graduate nurses entering the workforce, but for a

nurse stepping into a different area of nursing. I feel as though I can apply this theory to myself

and my new career in nursing. Currently, I would say that I am in the advanced beginner stage. I

have been working in the hospital for nearly two years as a patient care technician, so I have

experienced many different patient situations, even though I was not in the nursing role myself. I

have also been exposed to patient scenarios through my numerous clinical hours that I have

completed for school. Immersion has been the most helpful for me. Working alongside a nurse

with all of their assigned patients for twelve-hour shifts has really helped me to get the hang of

working with patients in the nursing role. I can even tell a difference from when I first started

immersion up until the last shift that I worked as I have transitioned to the advanced beginner
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stage. Although I have been able to learn some patterns, I still relied on my preceptor to guide

me along and to prioritize tasks throughout the day.

I have accepted a position on the unit that I completed my immersion on, so this

familiarity will help once I begin my training as a new graduate nurse and eventually to working

on my own. My plan for practice is to stay on this unit for a couple of years or so to be able to

get to the point of competence. I plan to achieve this with the guidance of Patricia Benner’s

theory. Through experience on the unit, I will sort through what is pertinent information and

information that is not as pressing when it comes to making plans. I will utilize this when doing

tasks such as planning out my day. By thinking ahead and planning, I can work to be stay on top

of the tasks that need to be completed, so I can stay on track for the day to the best of my ability.

Organization is a key factor in this. Mainly I feel like I need to be able to successfully learn time

management and thinking through the tasks that need to be completed during the time of my

shift.

Time management in this type of work is the best way to incorporate self-care. When

glancing at the medications, procedures, dressing changes, and so on that each of the patients

will need throughout the day, it is imperative that breaks be included so that we do not neglect

our own needs. Nurses spend their whole day caring for others, but they need to make time for

simple things such as food or restroom breaks. This concept can also be applied to life outside of

the hospital, as well.

My plan for my future in nursing is to take each of the steps one at a time. It is

overwhelming as a new graduate nurse to think about becoming an expert, so it is important to

tackle individual steps instead of looking at the whole picture. Taking the time to master each of

the steps before moving on to the next can ensure that a good, base knowledge of experience is
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acquired so that I can get to the point of critically thinking without having to rely on other

clinical judgement when making decisions.