RUNNING HEAD: PERSONAL PHILOSOPHY 1

Personal Philosophy of Nursing

Kristen Stroud

NUR 4142 BSMCON

March 20, 2017

On my honor, I have neither given nor received aid on this assignment, and

I pledge that I am in compliance with the BSMCON honor system.

- Kristen Stroud
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Nursing is more than just a profession that takes a specific set of skills

to get the job done; the art of nursing requires certain character traits that

cannot just be learned. My soon to be nurse manager told me during our

interview that, I can teach you the knowledge and skills you need, but what

I cannot teach you is the compassion. This statement stuck with me

because I truly believe that it takes a special and genuine heart to be able to

care for people in some of their lowest moments of life. Nursing focuses on

the full picture of an individual, and treats all of that person, not just the

presenting illness.

The art of nursing requires a person who is devoted to digging deep

into a patients psyche to find out what makes them happy, what they are

afraid of, what drives them, and what shapes their beliefs and values. A

nurse should genuinely care about a patients life outside of the hospital to

truly be able to understand them and provide holistic care. A nurse that

takes the time to get to know their patients is able to be a better advocate,

make better clinical decisions, and as a result will be able to provide better

care. The act of caring does not just extend from nurse to patient; it is also

pertinent for the nurse to practice self-care in order to provide patients with

optimum healthcare. It is important for us as nurses to be role models for our

patients. We cannot assist patients with lifestyle changes to promote better

health if we ourselves are not living a healthy life.

There is only one motivational factor for becoming a nurse; that is the

desire to serve others. A nurse is not in it for the glory or the fancy uniform,
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because lets face it there is nothing glamorous about cleaning up stool in a

pair of baggy scrubs. What is glamorous about nursing is the ability to

protect the dignity of an individual during such a vulnerable time of their life.

It is a nurses job to earn the trust of our patients in order to promote their

health and well being. There is nothing more rewarding than seeing a patient

able to rest because of an intervention you did, or seeing them smile

because for a brief minute you were able to take their mind off of the current

life altering hospitalization.

Before I got into nursing I genuinely cared about all people, so the

compassionate and caring aspect of nursing comes effortless in my practice.

There is no doubt that each and every one of my patients senses the

compassion I have for people. My personal philosophy of nursing is reflected

in my practice by being selfless. I was called to nursing for no other reason

than the desire to care for others in their most vulnerable time of need.

Every patient interaction begins with an introduction that way my patients

know that I am there for them. I take the time to get to know my patients by

asking questions about their families, careers, hobbies, and anything else

that may come up.

By building rapport with my patients I am earning their trust and

respect. My patients gain a sense of comfort when I take the time to get to

know who they are as a person, and not just a patient. When I take the time

to gain the trust of my patients they are more likely to listen to the

knowledge I share with them. Stubborn patients with no will to learn about
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lifestyle modifications to control their new onset pathology suddenly become

willing to listen to what you have to say; all because you took the time to

learn about them. A smile, sense of humor, and therapeutic touch can go a

long way even on the most challenging patients.

During my immersion at Memorial Regional Medical Center, on the

Cardiopulmonary Care Unit, I had the pleasure of caring for a man who

experienced life altering health issues in the last few months. During my first

shift with this patient I never realized the impact that he would have on my

nursing practice. Mr. L was admitted to our unit for bibasilar pulmonary

embolisms and was being treated with blood thinners, however this was the

least of his worries. Back in January Mr. L experienced a brain aneurysm and

had a successful operation to clip the bleed. The patients wife told me that

day-one post op this hardworking sixty-year-old man was already talking

about getting back to work. Two days after the repair Mr. L experienced a

stroke, and then a subsequent stroke a few days later. The second stroke

affected the pons of his brain leaving Mr. L unable to swallow and extremely

weak. At times it was difficult to communicate with him due to his slurred

speech and intermittent confusion.

At night Mr. L would become confused and start pulling on his lines. He

would try to get out of bed stating that he needed to catch a flight in fifteen

minutes. The first night with Mr. L was a challenge. He would become more

disoriented as the night went on and tried to swat at us when we would go in

to give him medications, clean him up, or take his vitals. As we spent more
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time with him we gained his trust. He was able to understand that we were

there to help him.

Instead of treating Mr. L as if he was out of it, and had no idea what

was going on, I took the opportunity to ask him questions and get to know

more about the man before these life-altering events. During the times when

he was more oriented we were able to have conversations. I learned that he

was in the Air Force. He was a husband, father, and grandfather. I spent five

shifts with this patient and was able to build a relationship with him. The

more time he was there with us, the more progress I saw him make. During

his admission Mr. L had a shunt placed in his brain to drain fluid from around

his ventricles to his stomach, and I believe this procedure helped

tremendously with his confusion. He remained more oriented during the

night, he stopped pulling at his lines, and his speech became more

understandable.

The last two shifts I spent with him he was able to verbalize

information about his condition and he asked questions about his vital signs

and medications. Mr. L expressed concern about his condition, and quizzed

us about what certain things meant, such as him spiking a fever. It was in

these moments that I became extremely proud of myself. I never once

treated this patient as a disability. I stayed strong in my values that every

patient should be treated as an individual, and not like an illness.

By using humor, small talk, and therapeutic touch I was able to help

this man relax and ease his mind of the stressors that spiraled from his
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sudden health problems. Even though Mr. L was uncertain of what his future

entailed I was able to help him feel calm and safe while he was in my care.

This man has an extremely long road to recovery, and he is fully aware and

determined to get there. Had I been a nurse who did not take the time to

treat him like a person, I could have hindered the progression he made while

he was in my care. By being a compassionate servant leader in my

profession I was able to foster growth, comfort, and well being for this

patient. I will never forget my interactions with Mr. L. The lessons I learned

while caring for him will forever remain instilled in me and reflected in my

nursing practice.

Throughout my time in nursing school my values and beliefs have

gotten stronger. Three years of clinical experience with various populations,

socioeconomic statuses, cultures, and religions has only helped solidify the

significance of individualized and holistic patient care. Being able to work

with patients for multiple full shifts every week has given me a new

understanding and appreciation for what we as nurses do, and the impact we

have on the people we care for. I believe that it is the nurses role to care for

and treat the entire human being sitting in the hospital bed, and not just

their illness. It is our duty to ensure they feel cared about and taken care of.

All people are people that deserve to be cared for in a way that you would

care for your mother, and I feel more strongly about that now more than ever

before.
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Nursing school has assisted in my growth emotionally, professionally,

and intellectually. I have progressed tremendously in the profession of

nursing over the last three years, however there is still a copious amount for

me to learn and experience. As discussed in From Novice to Expert, by

Patricia Benner, skill acquisition in any profession does not just happen

overnight. The Dreyfus Model of Skill Acquisition in Nursing is described as

the development and transition through levels of competence (Benner,

2001). One does not simply obtain the proficiencies needed to become an

expert in a profession. Skill acquisition in nursing requires experience. The

transition from novice to expert discussed by Benner has five levels. A

student nurse is first a novice, then advanced beginner, competent,

proficient, and finally an expert nurse. This transition requires many years

that has no definitive timeline; it is guided by ones experiences and skilled

performance.

A novice nurse is one whose practice is based on following a set of

rules, which is limiting and constricting (Benner, 2001). This level of nursing

proficiency requires no experience of the clinical scenarios that are faced. An

advanced beginner can demonstrate acceptable performance and has had

experience with real life clinical situations. An advanced beginner is able to

notice pertinent parts of the situation at hand, and works side by side with a

preceptor for additional support. A competent nurse is one who has been on

the job for a few years and is able to plan out actions to reach long-term

goals for patients. A competent nurse is not as efficient as a proficient nurse

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who is able to perceive a situation as whole and notice the parts that are not

matching up to an expected picture. This ability to notice deviations from

normal improves the proficient nurses ability to make decisions. Lastly, the

expert nurse is one who just knows. This nurse is able to rely on intuition due

to the vast background of knowledge in the field of practice. As long as a

nurse is gaining experience in the same or similar practice they are able to

advance through the levels of abilities. A nurse that is transitioning to a new

field of clinical practice will begin as a novice in that field.

Throughout nursing school I have felt like a novice nurse; unsure of

what to do unless I am following step-by-step rules and waiting until

someone tells me what task is next before beginning. We have had the

opportunity to explore many different units through the last three years,

however the brief time we spent caring for patients on these units only

allowed us to graze the surface. This final semester of clinical immersion has

allowed me to fully absorb myself into the experience of a staff nurse on a

Cardiopulmonary Care unit. Having the opportunity to work along side a

registered nurse preceptor has allowed my experiences, nursing skills, and

clinical judgment to flourish. I believe that I am graduating nursing school

and will begin my nursing career as an advanced beginner. I am aware that I

am not fully independent in the clinical setting, but with the support of my

preceptor I am able to function as a nurse and provide adequate patient care

in the clinical setting.

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According to Benner, advanced beginners are ones who can

demonstrate marginally acceptable performance, ones who have coped with

enough real situations to note (or have them pointed out to them by a

mentor) the recurring meaningful components that are termed aspects of

the situation in the Dreyfus Model, (p. 22, 2001). The advanced beginner is

one who still needs support of a more experienced nurse preceptor, but is

beginning to perceive meaningful patterns in clinical practice (Benner, 2001).

The presence of a competent preceptor is pertinent for patient care to

ensure all patient needs are being met due to the inability of the advanced

beginner to identify the needs that are most important. The preceptor is

there for the advanced beginner as a support person and to help point out

aspects of a situation that are beneficial to their education and growth.

In my current clinical situation my patients are admitted for mainly

heart and respiratory issues. Working along side my preceptor I have become

skilled with auscultating and noticing various breath sounds. One way my

preceptor aids my progression is by allowing me to assess patients first and

then going behind me. We discuss discrepancies in our assessments, and she

points out things that I should have noticed and things that I did well. This

allows me to improve my assessment skills and become more confident

when evaluating patients in the future.

Once I transition into my new position as a new graduate registered

nurse on an intermediate care unit I will begin orienting with a preceptor for

several months. This will allow me to continue to expand my knowledge and

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growth as an advanced beginner in nursing practice. The next transition I will

make in my professional development will be a few years down the road

when I become a competent nurse. In order to reach this level of professional

development I plan on remaining a nurse on IMCU. By having several years

of experience with this level of patient care I will be able to perceive the

bigger clinical picture. I will become better organized and able to establish

plans that will focus on long term goals for my patients.

Another goal I have in order to progress my professional development

is fully devote myself to learning. Throughout nursing school we have been

studying and learning to pass the tests and then NCLEX. Once the exams are

done my focus of learning will solely be to improve my patient care and

practice. By becoming experienced in intermediate care and striving to learn

I will be able to achieve the efficiency and organization that a competent

nurse possesses. I look forward to the next few years of growth and

development personally and professionally. Nursing school has facilitated my

personal and professional growth over the last three years, and I am so

looking forward to the continued growth as I practice on my own as a

registered nurse for years to come. The opportunities are endless, and the

adventure is just beginning.

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References:

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

nursing practice. Upper Saddle River, NJ.