Running head: PHILOSOPHY OF NURSING 1

Philosophy of Nursing Paper

Tracey Ann Tran

Bon Secours Memorial College of Nursing

Dr. Christine Turner, PhD, RN

Synthesis for Nursing Practice NUR 4140

October 27th, 2019

“I Pledge Honor Code”

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Definition of Nursing

As I am nearing the end of my student nurse career, I have gained a lot of knowledge and

experiences that helped me develop the meaning of how to serve, compassionate care, and health

and wellness; which has allowed me to establish my own definition of nursing. Through the

clinical experiences I have encountered, and the education I have received at Bon Secours, I

believe that nursing can be defined as the “jack of all trades.” Nursing is hard, and not only are

we expected to know all medical diagnoses, medications, and medical interventions – we also

need to be prepared for any circumstances that come our way – whether that be bringing a baby

into the world, or caring for a patient who is taking their last breath. Nursing, or nurses are

strong, compassionate, caring individuals that provide care to those who are sick and ill. Bon

Secours has taught me how to be the best nurse I can be by instilling their values throughout my

education; such as integrity, compassion, and human dignity. Each and everyday I strive to

provide holistic care to patients and portray compassion, integrity and human dignity into my

care to help and serve others.

Personal Philosophy

When I started my career as a student nurse three years ago, I was confident in my own

personal philosophy of nursing, and how I would portray that into my nursing care. Once I began

my clinical experiences, I quickly learned how valuable it was to instill my beliefs of holistic

care, compassion, and service into my nursing practice. I could see that these qualities can easily

get lost through high stressed environments and burn out. However, I never let that get the best

of me. I have seen many nurses where they are tired, stressed, overwhelmed and burnt out and

can no longer provide the holistic care that they once provided. Although I am tired after

working a long 12 hour shift with difficult patients, I took it upon myself to spend time talking to
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the patients, listening to them, and gathering information that may have been easily missed if no

one has asked them the right questions. Through this practice, I was able to find the root of the

patient’s frustrations, I was able to understand why they were upset, I was able to meet their

needs, and in return – I was able to gain their trust through my nursing care.

I remember one patient specifically; he was recently diagnosed to be legally blind in both

eyes, post laryngectomy and was unable to speak, and he was illiterate. He was angry, frustrated,

and upset because he can no longer communicate his needs effectively. I noticed that previous

nurses overlooked the patient and did not spend the extra time with him because he was being

“unpleasant.” When I was assigned this patient, I spent some time in his room trying to

understand what he was trying to communicate. I pulled out the white board to have him write

his concerns, which was when I learned that he was illiterate. He was unable to point to the

visual board because he was legally blind. He had no family members that could provide me

with any insight on his needs. The only thing I could do was aimlessly attempting to read his lips

to determine his needs. Once we were able to communicate his needs, he grabbed my hand and

mouthed, “thank you.” Although I had moments where I was frustrated and upset, I knew that

just like any other patient – this patient deserved my patience and compassionate care.

Values and Beliefs

I personally do not think that my values and beliefs have changed much since the

beginning of nursing school. I have learned that I will have many patient encounters that will

reestablish the importance of why I carry the values and beliefs that I currently do now. I have

stated in my previous personal philosophy paper that my goal throughout my nursing career is to

leave my shift knowing that I have done everything I could to deliver the best holistic care to my

patients. Some days are more difficult than others, but that is a practice I have instilled in myself.
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I have remained open minded so that I can accept others and their own values and beliefs. I have

found that this practice has helped me better connect with patients, and learn more pertinent

information that might help better their care. Although I was faced with numerous situations

where I did not agree with the decisions, I still remained open minded to understand the patients

view and why they have chose the route they have chose.

Recently I took care of a patient who came in for complications related to noncompliance

to his medication regimen. He is suffering from congestive heart failure and recently stopped

taking his medications. Throughout his care I learned that he required a lot of follow up

education and constant reminders because I learned that he has an attention deficit disorder, and

does not prioritize his health appropriately. He missed his last visit to his primary care provider,

therefore did not get a prescription for his medications, which resulted in him not taking his

prescribed medications. I took care of this patient for three consecutive days, and within that

time, I was able to spend time talking to him, and his family. In turn, I was able to learn a lot

about him and the type of person he was. At the end of the day, he voiced that he was very

thankful for my care and that he appreciated how much time I spent with him. I knew that I was

able to connect with this patient and gained his trust and rapport. He verbalized that he knew

what he had to do in order to get better, and that is all I can ask for. I hope that this patient

returns home and complies with his medication regimen as he verbalized to me. From this

experience – I was reminded of how important it was to build trust and rapport with your patients

in order for them genuinely consider the education you have provided to them. Without building

trust and rapport, there is a disconnection between you and the patient, which may result in

inadequate care.
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Nurse Patient Encounter

Throughout nursing school and throughout my clinical experience, I have strived to build

relationships with my patients regardless of the circumstance. Whether they are angry, frustrated,

upset, timid, or even uninterested in building a relationship with me – I take on the challenges

and find creative ways to approach these patients. I also take on the challenge of upholding my

integrity through my nursing care, as it is one quality that is defined in the Bon Secours

Professional Practice Model.

I remember one patient encounter where the patient came in for a complete work up after

a fall at home. She was never asked past medical history questions, and her history of

hypertension was missed. During evening vitals, her blood pressure was elevated and she

became very anxious and concerned that she would not get her medication. She did not have any

hypertensive medications ordered. I assured her that I would talk to the doctor to get an order for

her blood pressure medications. By the time the medication was ordered, reviewed by pharmacy,

appeared on the MAR, and retrieving the medication from the pyxis, the patient was in tears and

very anxious that her blood pressure will not be managed before shift change. I assured her again

that I would not leave the hospital until her blood pressure medication was under control. I knew

following through with my promises and integrity, I was able to manage her blood pressure and

gained trust and respect from this patient.

Change Agent as a Result of Practicum Experience

As a result of my 4140 practicum experience, we have reviewed the importance of

quality and safety knowledge, teamwork, and communication and collaboration skills in the

nursing field. We have learned to look at the overarching goals of the Bon Secours Hospital

systems, such as reducing fall rates, reduce infection rates, and increase patient satisfaction rates,
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and improving safe and quality patient care. Per the practicum objectives, we were able to

examine a problem within the Bon Secours Hospital system, and implement a proposed solution

to this problem. Through this experience, we learned how to evaluate fall rates, communicate

with nurse leaders, management and other health professions to improve patient fall rates. I also

gained experienced through collaborating with my classmates to evaluate problems and

outcomes, in order to propose a solution that might benefit the hospital in reducing fall rates.

Through this practicum experience, I learned how to communicate with a variety of health

professions, collaborate with classmates on a hospital wide issue, as well as understand the

purpose of researching and implementing new evidence based practice.

From Novice to Expert – Benner’s Theory

In Patricia Benner’s book, From Novice to Expert: Excellence and Power in Clinical

Nursing Practice, she states that based on the Dreyfus Model, a nurse goes through five separate

stages as they advance in their career, which include novice, advanced beginner, competent,

proficient, and expert (Benner, 2001). Each stage describes the level of knowledge and skill that

a nurse acquires from experience as they progress through their career. Based on this theory, I

believe I fall under the novice stage as a soon-to-be new grad. Benner further explains this theory

as an individual who has no experience in the field they are in, and rely heavily on concrete

guidelines and rules to demonstrate safe practices (Benner, 2001). My personal experiences this

far strongly reflects the novice stage of Benner’s theory. I find myself spending a lot of time

researching rules and guidelines throughout my practice. I rely heavily on my preceptor for

guidance and cues as to what steps to take next while caring for patients. I know as a new nurse,

I will have little knowledge and experiences compared to other nurses on the unit. I know that it
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will take a lot of time, patience and personal experiences for me to move through all stages of

Benner’s theory in order to become an expert nurse.

Action Plan for Moving Forward

As I am nearing my student nurse career and transitioning into my role as a registered

nurse, I understand that I am entering the nursing career as a novice. I will make a promise to

myself to seek out new opportunities that will help me grow and become a better nurse, each and

everyday. As I hope the New Grad Residency Program will help me smoothly transition from a

student nurse to a registered nurse once I begin my career, and one day transition from a novice

nurse to an expert nurse.

As for my self-care plan, my goals once I start my career will include setting aside time

each week to do something that is different from my daily routine that I enjoy. Such as traveling,

trying new restaurants, calling an old friend, spending time with family and friends. I will also

set aside time everyday to reflect and have moments of relaxation. I know that nursing will be

hard, and I will have good days and bad days – however I will make a promise to myself that I

will recognize signs of being overwhelmed, burn out, exhaustion and/or unhappiness. When I

notice myself exhibiting any of these signs, I know to take time to reflect on myself in that

moment. From this, I might learn that this might be a time for me to take a break from nursing,

or consider furthering my education. My ultimate goal has always been to work for veterans with

Post Traumatic Stress Disorder, as I feel this is a population that has a special place in my heart.

I know for myself that I want to be a life long learner, and would hope to further my education

by getting my Nurse Practitioner in Psychiatry. Once I transition to the next chapter of this

career, I will stay true to the values and beliefs I have been raised with, as well as the ones I have

learned throughout this journey to be the best nurse I can be for my patients.
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References

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

Upper Saddle River, NJ: Prentice Hall.