Running head: MY NURSING PHILOSOPHY

My Nursing Philosophy/Self Reflective Journal

I wrote this in NUR 300, and it still holds true today, “My nursing philosophy is

embedded in me as a person. My nursing philosophy truly evolves from the way my parents

raised me, to all my mistakes, lessons I’ve learned.” I also wrote in 2019 “Through all of these

experiences I have realized how I want to be treated and how I will treat others. I have always

taken care of someone. It is just who I am as a care giver. I am a very compassionate person, and

I feel what others feel. I am fulfilled when I leave work feeling that I have gone over and beyond

what was asked of me. My personality has gotten me in tough situations with feeling bad about

saying no to more hours or staying late. I am not content until my plate is full.” After I read this,

I am so thankful none of this has changed. I have become a strong leader, being the supervisor.

Because of the way that I am, and this attitude not changing, I am fulfilled in my role at work. I

have become more confident, trusted and a go-to for my other nurses and administration. I am

continuing to learn every day; I have been given the opportunity to be trusted by my patients and

staff, given more responsibility by my administration.

My nursing theory belief: Madeleine Leiningers’ theory of Transcultural nursing (also

called Cultural Care Theory) states that it “helps strengthen a nurse’s commitment to nursing

based on nurse-patient relationships and emphasizing the whole person rather than viewing the

patient as simply a set of symptoms or an illness.” (Petiprin, 2016). I felt that this Nursing theory

was going to benefit me when I became a Hospice Nurse. Unfortunately, I believe I would not be

satisfied as a hospice nurse. Where I work today, I hang IV’s, do wound care, wound vac’s, I am

now a supervisor with tremendous responsibility. I also have been a Hospice nurse by being

there for my patients and loved ones during their passing. I am able to pronounce, and my name

and license number is on the death certificate. My nursing career is so fast paced, and rewarding
Running head: MY NURSING PHILOSOPHY

when I see them go home, and I have a great relationship with my long term patients. I am

fulfilled where I am in my career. Yes, I do believe I would be an amazing Hospice Nurse, I am

just not ready to be one now. Transcultural Nursing is a huge part of my nursing now. During

NUR 300, I wrote that I did not see any cultural desires in my facility. I was very naive, and

apparently didn’t pay as much attention as I do now. That is all I see, in my nurses, in my

CNA’s, and in my patients. I have become more confident when I do the admissions, I make sure

I ask them if there is anything we can do to provide them with meeting their cultural needs.

Being culturally sensitive has helped me improve my patient’s outcomes, by providing them with

respect and compassion, and placing their culture in their care plan. By doing this I have gained a

trusting relationship with the patient and families. I am able to integrate their wishes, desires and

beliefs into their care plan, providing them autonomy.

My Health as a nurse: According to Dolores VanBourgondien she states that “diet,

exercise, mind-body and medicine alone don’t work, we must combine all elements into a

synergistic plan to create optimal health and wellness” (2015, slide 32). I try to do my best for

me, it has been a struggle, being in school, becoming the supervisor (very stressful), and doing

up to at times 4 admissions on my shift. I forget to eat, or I just don’t have the time. Now with

the Coronavirus, I am taking better care of myself, not just for me, but my patients and staff also.

I wear the mask at all times, I stay away from everyone as much as I can. Thankfully I live alone.

I realize how much we have taken loved ones for granted, not being able to give them a hug, I

miss the smell of my mom’s perfume. My heart is breaking not being able to see everyone on

Easter, and I pray everyday that this horrible disease doesn’t affect my family. I have to follow

protocol for them also, I need to stay safe. That means taking care of myself and being away

from them.
Running head: MY NURSING PHILOSOPHY

Patient Safety: QSEN is to address the challenge of assuring that nurses have the

knowledge, skills, and attitudes (KSA) necessary to continuously improve the quality and safety

of the healthcare systems in which they work. QSEN is a national movement that guides nurses

to redesign the ‘what and how’ they deliver nursing care so that they can ensure high-quality,

safe care (Dolansky & Moore, 2013). The BSN program has allowed me to learn how to dig

deeper into things, I find myself looking up things; a diagnosis, a medication, the way treatments

are done and wound care. I don’t want to just do something; I want to know why we are doing

this something. I do a lot of admissions where I work, and if something or an order doesn’t look

right or I question it, I will, and I have called the doctor who wrote the order to find out the

“why”. I have learned so much with this attitude, I am able to talk with our MD and/or the NP,

explain why it is being done this way, ii will get an order to keep it or to change it. We all are

learning things almost daily, and I am glad that I am able to educate on how and why things are

changing when they are coming out of the hospital. I have grown into a strong leader with this

attitude, I don’t shy away from educating anyone, even the MD’s and the NP. During my shift

there are no MD’s or NP’s after 5pm, if anything is going on or being questioned, I gather up the

nurses and we brainstorm and/or get all the information together before we call a MD or NP.

After hours the on-call does not know who we are talking about, so I make sure that the nurse

who is doing the call has all the information to draw out a picture for the MD/NP. This has

helped our patients get the right order and/or treatment. My clinical experience at the Middle

School has also helped me to not be so shy, the kids there were not shy, they had no problem

telling me something and asking millions of questions, just like everyone else they wanted

honesty. The EBP that I saw at the school was that the school gave the kids their medications in

the morning and before they went home. This is because they would not get it at home. That is
Running head: MY NURSING PHILOSOPHY

scary, I was continually asking what about the days off??? We can’t be responsible for that time.

I am wondering how they are getting their medications with this LONG time off. The

medications were mostly for ADD, asthma and insulins. I am glad the nurse was teaching the

diabetics how to do their individualized formulas so that they could give themselves insulin

independently. The kids on the ADD medications were a handful getting to take them in school, I

can only imagine what they are like at home. The BSN course have allowed me to build on

leadership, the Informatics class was at the same time my facility went from paper to E-MAR (it

helped tremendously), leadership class has helped me become a strong supervisor in my facility.

I will continue to learn, the medical field is never going to stop improving, and I will keep up

with it to give my patients the best care and educate my co-workers on the improvements.

Increasing use of consistent assignment. “The effort is to have the same staff taking

care of the same individual each time they work, when you do that, the people know the

residents, they know their likes, their dislikes. They know early, subtle changes when someone is

getting ill, they know their routines. When you do the consistent assignment, you’re able to

better achieve … person-centered care planning and decision-making” (Bowers, 2013).

My patients are in my facility for rehabilitation to go back home. Now with the

coronavirus we are getting patients sooner than we would like, there is no longer a 3 day period

that they stay in the hospital before coming to us. Some of these patients are critical. I understand

they need the beds, but it puts in a scary situation. My struggle the most being a supervisor is we

have agency nurses (no consistency), I have to make up the assignments for the shift. My

struggle is I like consistency with my nurses, they catch more, they can see a change

immediately, they learn their baseline in mental status, vitals, and personality. This is also a

benefit for my CNA’s. The patient outcome is so much better, things are caught immediately and
Running head: MY NURSING PHILOSOPHY

acted on. It puts more work on me; I go behind the agency nurses to check up on the patients and

believe me the nurses get upset and feel I am inappropriate going behind them. But because of

me doing this I have caught many things and do not feel bad that they are angry. My supervisors

support me in every way when the nurses come to them offended by my actions. Being the

supervisor, I am responsible for 120+ patients and 6+ nurses and 15-20 CNA’s during my shift.

My personality and conflict style: As a nurse with a personality as a defender, I will give

all of myself unselfishly. My defender personality allows me to give myself with compassion

and empathy and my compassion for others allows me to fulfill their desires and needs (16

Personalities, 2020). According to 16 Personalities “a defender personality is known for having

a strong work ethic, going above and beyond all that they do, being reliable and loyal to

everyone they know.” A defender’s personality weakness is that they are more concerned for

other people’s feelings than they are of their own. “They are known to become overloaded by

trying so hard to please everyone by going over and beyond expectations and in turn leading to

being overwhelmed and frustrated” (16 Personalities). As a new nurse I am trying to find my

way of doing things, I am still not comfortable with being an aggressor when it comes to

jumping in and doing. Once I learn to do something and am comfortable and then I am very

confident in doing the skill that is presented to me. My accommodating style of how I react to

conflict has allowed me to be cooperative and relied on by my co-workers. There are times that

this has overwhelmed me by being counted on at times that I am not available or am busy. I have

a hard time saying no, I do not like confrontation, so I give in. This has been a hard lesson

learned, I enjoy being a nurse and I don’t want to feel that I am letting anyone down. Every room

and/or patient I am caring for is different in so many ways; I have learned to be flexible to

provide everyone with proficient care.

This is where I have changed the most. Since I have become the supervisor, I have so

much more responsibility on my shoulders. I have to be aggressive; I have to jump in to do

things. My staff, my patients and my administration is counting on me to take care of things

while I am in the building. I have been told by my Administrator and DON that they do not

worry when they know that I am the supervisor for the shift. I have learned to take care of things

with out having to call them. I e-mail them on how the shift ran and if there were any issues what

I did to resolve them. It has built up my confidence to be a strong leader. The BSN program has

taught me how to be a great leader, it has led me to be a strong, reliable and fair co-worker.

Being a nurse has allowed me to find out the “Why’s” because I have learned to question

everything, I have learned so much. I have built a trusting relationship with the MD’s and Np’s

that I work with. They trust what I am telling them, knowing that I have done an assessment, and

tried other things before I call them. MD’s do not like it when you call them expecting them to

have the answers. I have learned and taught my nurses of the importance of having all the

information before that phone call, and to have 1 or 2 suggestions to run by them. Even if the

MD doesn’t use them, it has been an education for that nurse to dig deep, use their critical

thinking and become a stronger nurse in doing so. They are the primary for that patient, they

know them best. I am helping my nurses also become strong and confident in how they care for

their patients.

My Leadership: I wrote this in my philosophy paper, “At times it is overwhelming, but I

watch all the seasoned nurses and wonder will I ever be that good? I will, if I continue with my

lifelong learning, and I keep my nursing philosophy at the forefront of everyone I meet and all

that I do.” This program and having this attitude has allowed me to be a Leader in my facility.

My leadership style is a “Servant Leader and its central meaning was that the great leader is first
Running head: MY NURSING PHILOSOPHY

experienced as a servant to others, and that this simple fact is central to the leader's greatness.

True leadership emerges from those whose primary motivation is a deep desire to help others”

(Spears, 2004). Spears wrote (2004) “the servant-leader is deeply committed to the growth of

each and every individual within the institution. The servant-leader recognizes the tremendous

responsibility to do everything possible to nurture the growth of employees. “In educating my

nurses and having them speak with the MD’s I feel this is true: Spears wrote (2004), “The

servant-leader is deeply committed to the growth of each and every individual within the

institution, the servant-leader recognizes the tremendous responsibility to do everything possible

to nurture the growth of employees.”

“The servant-leader strives to understand and empathize with others, people need to be

accepted and recognized for their special and unique spirits” (Spears, 2004). One assumes the

good intentions of coworkers and does not reject them as people, even if one finds it necessary to

refuse to accept their behavior or performance. I once was told “don’t ever assume the worst

form someone, everyone has good intentions, talk and listen, then you will find out the truth of

why something was done the way it was done.” This is so true, maybe the CNA got busy and

forgot, their reasoning of how they did something most of the time will be different from my

own. I have learned a lot with thinking this way, it has also helped with the way that I

communicate with others, I make sure that I don’t approach them that they were wrong.

Being a Servant-Leader “It begins with the natural feeling that one wants to serve, to serve

first. Then conscious choice brings one to aspire to lead. The difference manifests itself in the

care taken by the servant--first to make sure that other people's highest-priority needs are being

served” (Spears, 2004). I feel that Servant-Leader and my personality of a Defender are the same
Running head: MY NURSING PHILOSOPHY

“that its central meaning was that the great leader is first experienced as a servant to others, and

that this simple fact is central to the leader's greatness and true leadership emerges from those

whose primary motivation is a deep desire to help others” (Spears).

“At its core, servant-leadership is a long-term, transformational approach to life and

work--in essence, a way of being--that has the potential for creating positive change

throughout our society” (Spears, 2004). I am so thankful that I chose nursing for my career, I

started later in life, and it has allowed me to appreciate everything that I do. I look back at

NUR33 to today, and am astounded at how much growth, confidence and knowledge that I

have gained in a very short time. This has excited me in thinking how much better it can get.

I am scared for everyone that I work with now, with the COVID-19, this is a learning lesson

on life, and how we need to appreciate it that much more. I do not know if I will go on in my

career educationally (Masters or Doctorate). I do want to do a couple Geriatric and Hospice

classes. This will benefit me anywhere I go or if I stay where I am at. I look forward to

looking at all these papers in a few years and to see again the growth that I had made in my

nursing career.
Running head: MY NURSING PHILOSOPHY

References

Bowers, L. (2013). 9 new quality goals for nursing homes unveiled by initiative. Advanced

Senior Care. Retrieved from https://www.iadvanceseniorcare.com/9-new-quality-goals-

for-nursing-homes-unveiled-by-initiative/

Dolansky, M.A., Moore, S.M., (September 30, 2013) "Quality and Safety Education for Nurses

(QSEN): The Key is Systems Thinking" OJIN: The Online Journal of Issues in Nursing

Vol. 18, No. 3, Manuscript 1.

Petiperin, A., (2016). Madeleine Leininger-Nursing theorist. Retrieved from

http://nursingtheory.org/

16 Personalities. (2020). Defender personality: ISFJ-A/ISFJ-T. Retrieved from

https://www.16personalities.com/isfjs-at-work

Spears, L. (2004). Practicing Servant-Leadership. Leader to Leader. 34 (7-11). Retrieved from

https://doi.org/10.1002/ltl.94

VanBourgondien, D., (September 21, 2015). Synergist approach to health and wellness.

[PowerPoint slides]. Retrieved from

http://www.slideshare.net/DoloresVanBourgondien/synergisticapproachtohealthandwelln

ess/