Integrity and Leading by Example

Integrity and Leading by Example: A New Nurse’s Philosophy

Veronica A. Payne

Delaware Technical Community College

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For the past six weeks, I have been thinking about my own nursing philosophy,

overwhelmed by every aspect and characteristic that I wanted to include. In the readings for our

RN to BSN transition course, I came across a quote by Carolyn Jarvis, “The character of the

nurse is as important as the knowledge she possesses.” This quote, so short and simple, summed

up exactly what I wanted to include in my own nursing philosophy. After further research, I

discovered that, Carolyn M. Jarvis, PhD, APRN, is the author of, Physical Examination and

Health Assessment, a health assessment textbook that was in my possession every single day

during nursing clinical. I consider it to be the Bible of nursing assessments. It is this quote that

helped me frame my own nursing philosophy. My philosophy is that, as a nurse, I will

demonstrate integrity in all aspects of my nursing care, and I will lead by example. I will

practice safe, competent and holistic nursing care. I will demonstrate compassion, kindness and

respect at the bedside. I will be a fierce advocate for my patients and their families. I will end

each shift knowing I have cared for them to the best of my ability. I will strive to learn from my

experiences, to build upon my educational foundation and to grow professionally and personally.

In thinking about my personal values and beliefs, a phrase my mother has always said ran

through my mind. Do the right thing, because it is the right thing to do. To this day, I have

followed my mother’s advice in all aspects of my life, and incorporated the quality of possessing

integrity into my nursing philosophy. Integrity is the quality of being honest and possessing

strong moral principles. A nurse of integrity does what is right in all situations, regardless if

someone is watching. Nurses often work autonomously, and possessing integrity is key to

always doing what is right for your patients. I believe nurses should lead by example, not only

for their patients, but also their coworkers. In my opinion, there is nothing more irritating than

someone having a do as I say, not as I do, attitude. For example, as a nurse, it would be belittling

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to educate a patient on smoking cessation, while smelling of cigarettes yourself. Nurses will at

some point in their career find themselves fulfilling the role of educator and mentor to a new

nurse. Leading by example will encourage other nurses to practice with integrity.

General nursing education courses have provided me with a strong foundation on which

to build my nursing career. My hope is that the RN to BSN program will assist in achieving my

professional goals of becoming a more proficient critical thinker, a stronger communicator and

leader, as well as a more confident nurse. The health care industry is consistently changing to

promote efficiency and patient satisfaction. By necessity, the industry encourages an

environment of personal growth and life-long learning. Life-long learning is not only

completing what is required of you, but also seeking out new opportunities, setting goals,

planning, and not getting discouraged or giving up. Although required by my current position at

Christiana Care, my intention has always been to earn my BSN. I then plan on continuing on the

professional advancement clinical ladder, the foundation for which is based off of Dr. Patricia

Benner’s nursing model, “From Novice to Expert”. My familiarity with the clinical ladder and

my nursing philosophy goal of learning from experience and building on my educational

foundation, is what first attracted me to Dr. Benner’s nursing theory.

Dr. Patricia Benner’s nursing model, "From Novice to Expert" explains that, "The

complexity and responsibility of nursing practice today requires long-term and ongoing career

development. This, in turn, requires an understanding of the differences between the experienced

nurse and the novice" (Benner, 1984). Her model includes five levels of professional growth and

assesses the nurses needs at each level. These five levels correspond with the clinical ladder and

identify a nurse as novice (RNI), advanced beginner (RNI), competent (RNII), proficient (RNIII)

or expert (RNIV). Dr. Benner's theory proposed that a sturdy educational foundation, as well as

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clinical experience over time, allows nurses to advance through these levels of professional

growth. Dr. Benner’s model highlights that learning happens through experience, which is part

of my nursing philosophy. Every new situation has the potential to be a learning opportunity to

improve on my practice. After obtaining my BSN, I plan on earning my RN III. This level

recognizes RN’s as being mentors, unit leaders, and practicing with excellence. After achieving

my RNIII, my plans are malleable, however I know I will continue to learn and grow

professionally throughout my entire career.

I have often said to patients and their family members that you can’t take care of

someone else, if you are not taking care of yourself. Often times, care givers and health care

professionals forget the importance of self-care. In an industry where burnout is prevalent, it is

important to prioritize personal wellness, which is not just avoiding illness, but achieving your

full potential as an individual. Personal wellness includes physical fitness, nutrition, adequate

sleep, mental health, safe living arrangements, healthy relationships, intellectual stimulation and

so much more. In my first year as a nurse, my entire existence revolved around my new job and

adjusting to midnight shift. I neglected self-care and ended up out of work for two weeks with a

shingles outbreak. Without taking care of myself first, I will not be able to achieve what I stated

in my nursing philosophy. Dr. Benner’s model “From Novice to Expert” is unique in that it

focuses on gaining knowledge and skill through experience, rather than learning through the

study of theory. Nurses can apply knowledge gained through their own personal wellness and

experiences, to better care for their patients in the professional setting.

Part of my nursing philosophy is to end each shift knowing I have cared for a patient and

their family to the best of my ability. In training new nurses on my unit, I always tell them that if

you do right by your patient, you can’t go wrong. The bottom line for me is that patient care

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always comes first, regardless of any type of conflict that may arise. I identify most with the

style of compromising conflict management, which focuses on moderation and reasonableness.

There have been multiple instances where a patient has refused something or been uncooperative

to the point where their care has the potential to be compromised. Examples include, a patient

refusing a prophylactic Lovenox injection, or a patient declining to participate in physical

therapy. In taking the time to compromise, the patient who refused the injection agreed to

ambulate around the unit, thus decreasing the risk of developing a blood clot. The patient who

declined physical therapy, did so because he was in pain and agreed to participate after

administration of a pain medication. I would much rather give a little and take a little to achieve

a goal, while maintaining a positive relationship with the others involved. This style of conflict

management also allows me to be well liked as a professional by my coworkers. For example,

coworkers frequently ask me to draw their patients lab work because of my phlebotomy

background. I am happy to do this and ask my coworkers to assist me with my patients in other

ways. Everyone wins and patient care and safety is the top priority.

My first semester of nursing school, an instructor said that the buck stops with you, and

that phrase has stuck with me. Nurses who practice with integrity are following approved

protocols, providing evidence-based care and promoting patient safety. Safety is, “preventing

errors and negative outcomes that happen unrelated to the patient condition being treated”

(Sherwood, Zomorodi 2014). In my practice, I try to adhere to the culture of safety and always

be on the look out for potential safety issues. It is in the best interest of the patient to prevent an

adverse event, rather than having to react to one. Practicing safely becomes second nature to

nurses as they gain experience in the clinical setting. Simple examples included setting a bed

alarm for an older adult who has to use the bathroom multiple times every night. Making sure

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every patient wears non-skid footwear and has access to their personal belongings and call bell.

More complex examples include anticipating potential adverse events and practicing safe,

respectful nursing care to prevent them. For example, I recently had a non-ambulatory,

incontinent patient with mild dementia. Practicing with integrity and respectful nursing care, I

turned this patient and toileted her every two hours, despite her telling me she felt dry. This

prevented skin breakdown and kept the patient comfortable.

As stated earlier, a core aspect of my nursing philosophy is to practice with integrity and

lead by example. I wouldn’t say that I actively seek out leadership roles in my nursing practice.

However, the leadership position of charge nurse for midnight shift has been appointed to me. I

continue to practice my nursing philosophy in this leadership role, applying my philosophy to

not only my own patient assignment, but the entire unit as well. As a charge nurse, I prefer to

work along side my fellow nurses and assist in anything that needs to be done for our patients,

rather than sit back and wait for an issue to arise. I lead by demonstrating compassion, kindness

and respect at the bedside, with the hope that it will encourage other nurses to do so as well.

In conclusion, I could apply my nursing philosophy to everyday life. Possessing

integrity, leading by example, showing compassion, kindness and respect are all admirable

qualities to possess outside of the nursing practice. Learning from your experiences and

continuing your education is going to make you a wiser and better person.

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References

Benner, P. E. (1984). From novice to expert: Excellence and power in clinical nursing

practice. Menlo Park, Calif.: Addison-Wesley Pub. Co., Nursing Division.

Sherwood, G., & Zomordi, M. (2014). A new mindset for quality and safety: The QSEN

competencies redefine nurses’ roles in practice. Nephrology Nursing Journal 41(1), 15-22.