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Philosophy of Nursing

Kasey Mitchell

Bon Secours Memorial College of Nursing

Marcella Williams, DNP, RN, CNE, CMSRN

NUR 4140: Synthesis for Nursing Practice

October 30, 2020

“I Pledge”
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Philosophy of Nursing

As I am coming to an end of my nursing school journey, I feel as if it is extremely

beneficial to reflect on my own personal value system prior to entering the workforce as a

Registered Nurse. In this paper, I will reflect on how my personal philosophy has changed

throughout this program and incorporate what I have learned from Patricia Benner’s book “From

Novice to Expert: Excellence and power in clinical nursing practice” (Benner, 2001).

Definition of Nursing

If you ask someone what nursing means to them, chances are the definition will be

completely different than what you are thinking. To me, nursing is so much more than handing

out medications and following doctors’ orders. Nursing is my passion. I believe that nursing is

providing a service of taking care of someone holistically in times of illness and wellness. In my

opinion, nurses should be considered a “jack of all trades”. We are educators, advocators,

problem-solvers, supporters, healers, leaders, innovators, and so much more.

My definition of nursing is very similar to Bon Secours Memorial College of Nursing’s

(BSMCON) philosophy statement. The three tenets of BSMCON’s philosophy statement that

stick out to me are: nursing education, health, and service (Bon Secours Memorial College of

Nursing, 2020). As life-long learners and researchers, the initial nursing education plays a vital

role in shaping the foundation of our nursing career. Bon Secours Memorial College of Nursing

(2020), states that this curriculum “fosters personal, spiritual, and professional growth” that

serves as the foundation for life-long learning” (p.53). Additionally, this nursing curriculum

allows students to provide “safe, competent, spiritually-oriented care across the lifespan” (Bon

Secours Memorial College of Nursing, 2020, p.53). The nursing education tenet directly relates

to my definition of nursing, as I will be an educator for all my future patients.

The second tenet, health, can be defined as “a state of complete physical, mental, and

social well-being and not merely the absence of disease or infirmity” (Black, 2017, p.161). The

philosophy statement of BSMCON believes care must address multiple aspects for individuals,

families and communities in order to restore the highest level of health (Bon Secours Memorial

College of Nursing, 2020). This philosophy statement mirrors my personal definition of nursing,

as I believe that nursing addresses the patient holistically.

Lastly, Bon Secours Memorial College of Nursing (2020), states that a fundamental

aspect of nursing is a call to service while providing care to good help to those in need,

particularly the poor, dying, and underserved. I believe that nurses directly impact those they

come into contact with. Nursing is not just taking care of someone who is sick. It’s also taking

care of someone even though they appear free of illness. Bon Secours is known for taking care of

the community that surrounds the hospitals. We take care of those who are in need no matter

who they are.

Personal Philosophy

Philosophy can be defined as the “study of principles underlying conduct, thought, and

the nature of the universe” (Black, 2017, p.171). My personal philosophy of nursing is to provide

safe, compassionate, and holistic care to individuals that I serve. I believe that my patients are

not just room numbers, a diagnosis, or even a paycheck. I believe that my patients deserve

individualized and personalized care with all aspects of their needs.

My philosophy directly corelates with my current nursing practice. For example, I had a

patient with elevated blood pressure despite being given multiple medications. The patient was

stressed and going through a difficult time in their life. I knew that if I addressed the stress, the

blood pressure would more than likely go down. I channeled my problem-solving skills and
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provided an atmosphere that was conducive for healing. That day, I sat in a room with blankets

covering the windows to reduce light, played calming music, and took time to mediate with my

patient. The blood pressure decreased. I cannot say for certain that the blood pressure decreased

directly because of my actions, however, I did everything that I could possibly do for my patient

to achieve the goal. By taking five minutes out of my day to do that, I provided safe,

compassionate, and holistic care that was extremely individualized and personalized for the

patient.

Values and Beliefs

As I have progressed through this nursing program, my values and beliefs have changed

slightly. I have grown as a person and as a nurse tremendously throughout my time at BSMCON.

Life experiences often change one’s values and beliefs- either positively or negatively. Change is

not always a bad thing.

When I say that my values and beliefs have changed slightly, it’s in regard to social

issues. On my first personal philosophy paper, I mentioned that I had a strong viewpoint

regarding abortion due to my religious beliefs. I knew that my viewpoint did not alter my ability

to provide care to that patient population. However, I feel as if my experience working in the

Neonatal Intensive Care Unit (NICU) and doing clinicals have allowed me a better

understanding of why individuals get abortions. While I still disagree with abortions for myself, I

no longer hold others to adhering to the same standard that I have. Now that I have a better

understanding, I am able to empathize more with that patient population. Most of my other

values and beliefs have not changed other than this one aspect. With that being said, my personal

philosophy of nursing has remained the same throughout this program.

Nurse Patient Encounter

There have been many encounters through my program and work experience that relates

to the Bon Secours Professional Practice Model. However, there is one particular encounter that

stands out to me. In my Competencies II class, I had the pleasure of working in two different

Emergency Departments. Unfortunately, we were called to a room where a patient was actively

coding. As the team was coding this patient, the family walked into the room and saw

everything. The family had not had the chance to be informed of the situation yet. They were

absolutely devastated.

Among the madness of a code, the team did not realize the family walking in. Working in

a patient care technician role in the NICU, I am accustomed to keep watch for family members

that are near. I noticed what was happening and informed the clinical instructor of the family

standing out there watching. Immediately, we notified the chaplain to see if someone could come

down and be with the family. While waiting for the chaplain, I decided I needed to stand with

the family and be there for them. I knew that they needed to be supported and they were not

getting it at that present moment. By doing this action, I provided person-centered care, ministry

leadership, compassion, respect to the patient’s family members which aligns with the Bon

Secours Professional Practice Model (Williams, 2020).

Change Agent

As this class is coming to an end, I feel as if my role as a change agent has become more

defined for myself. For my project, my group and I decided to address Memorial Regional

Medical Center (MRMC) and their significantly decreasing Hospital Consumer Assessment of

Healthcare Providers and Systems (HCAHPS) score. Our role as a change agent is to investigate,

advocate, encourage, and facilitate a change within the Bon Secours Mercy Health System.
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My group identified that only 61% of patients feel as if staff “always” explains

medications prior to giving them (U.S. Centers for Medicare and Medicaid Services, 2020). This

score is three percent lower than Virginia state average and five percent lower than national

average (U.S. Centers for Medicare and Medicaid Services, 2020). After conducting research

from literature and personal interviews, we concluded that excessive nurse workload serves as a

significant barrier to providing medication education.

After identifying a root cause, we proposed to implement a “badge buddy” that will be

given to nurses that states the top three side effects of the top 20 medications given on the floor.

Additionally, we proposed to create a “hard stop” that requires physicians to state the indication

the prescribed medication. By having easier access to side effects and requiring physicians to

state the indication of the medication, nurses will have easier access to pertinent medication

information. By providing easier access, nurses’ workload will decrease, which in turn will allow

more time for medication education to be completed. I will be able to take the knowledge of this

practicum experience into my future nursing career in hopes to implement change in the future.

Benner’s Theory and Skills Acquisition

Benner’s Theory identifies five stages of proficiency which includes novice, advanced

beginner, competent, proficient, and expert (Benner, 2001). These five stages reflect changes that

occur in aspects of skilled performance. As the nurse transitions from stage to stage, they will

move from relying on abstract principles to becoming an involved performer (Benner, 2001).

Most new graduate nurses start as a novice. These nurses have no experiences in the

environment that they are going in (Benner, 2001). Benner (2001) reports that these nurses are

often considered to be significantly limited and inflexible. Novice nurses strive on rules and
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regulations to be successful in their work (Benner, 2001). The novice nurse will then transition to

an advanced beginner.

Advanced beginners are individuals who have had real life experience which allow them

to become acceptable in their performance (Benner, 2001). Benner (2001) reports that these

nurses can define principles in terms of attributes and aspects; however, they lack the ability to

identify differential importance. The lack of differential importance indicates that the advanced

beginner considers everything equally important and cannot prioritize effectively.

Transitioning from an advanced beginner, the individual will then move onto stage three:

competent. Competent individuals have been in the same environment or situations for two to

three years (Benner, 2001). The competent nurse is able to identify care and create a “plan that

includes conscious, abstract, and analytic contemplation of the problem” (Benner, 2001, p.26).

Individuals transition from competent to proficient. A proficient nurse can assess the

situation in its entirety instead of seeing the situation in terms of aspects (Benner, 2001). Benner

(2001) identifies that the individuals experience allows them to recognize and identify when a

plan of care needs to be changed as a result of a change in health status.

The final stage of Benner’s Theory is expert. An expert now utilizes analytic principle,

which includes rules, guidelines, and maxim, to assess the situation and implement an

appropriate action (Benner, 2001). Experts are considered to have a deep understanding of the

whole situation and can manage complex clinical situations according to Benner (2001).

After reviewing the stages of Benner’s Theory, I feel as if I am considered an advanced

beginner. While I am graduating in December to be a Registered Nurse, I am not coming into the

field of nursing with zero experience. By the time I take my NCLEX, I will have had almost five

years of being a Licensed Practical Nurse (LPN). However, despite being an LPN, I know that I
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have a significant amount of growing left to do. I feel as if my experience allows to me to

adequately address clinical situations, however, I still need guidance. I am sometimes unable to

identify what should be prioritized further concludes that I am considered an advanced beginner.

Action Plan for Moving Forward

It’s no joke when people say that the first year of nursing will be the hardest in your

career. Transitioning into a new role is always difficult. However, this career is unlike any other.

After my orientation, I will be on my own taking care of individuals. That is extremely scary to

me. It is easy to get lost in the world of nursing. With that being said, self-care is crucial in

maintaining optimal health.

As I transition, I plan on utilizing a lot of self-care techniques that will help me manage

my stress. In nursing, you are always moving and lifting. It is so important to take care of your

body. My biggest self-care technique that I am going to do is to get a membership to a massage

therapy office. I have gotten massages dozens of times throughout nursing school to relieve

stress and help my body; however, it is important to me that I continue to do so.

For professional development, I plan on creating an evidenced-based project that will

allow me to transition from a Clinical I nurse to a Clinical II nurse. Additionally, after one year

of practice, I am planning on obtaining my RN-BC certification in cardiovascular nursing. I see

myself in the future working in a Cardiovascular Intensive Care unit so this certification will be

especially important for me in the future.

Conclusion

Reflecting on my personal philosophy and my nursing school experience has been very

eye opening to me. I feel as if this has allowed me to truly see how my thoughts and experiences

has changed throughout this program. As I continue to work in nursing, I’m sure my philosophy
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and values will change. I hope to utilize this paper in the future to see how much I have

transitioned in my role as a nurse. I am so thankful for this program and everything that it has

done for me!

References

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

(commemorative ed.). Upper Saddle River, NJ: Prentice-Hall.

Black, B. P. (2017). Professional nursing: concepts & challenges. St. Louis (Missouri): Elsevier.

Bon Secours Memorial College of Nursing. (2020). 2020-2021 College Catalog. Richmond.

U.S. Centers for Medicare and Medicaid Services. (2020, October 21). Hospital Care: Memorial

Regional Medical Center survey of patient experiences.

https://www.medicare.gov/hospitalcompare

Williams, M. (2020). [Soft chalk]. Soft chalk lesson professional practice models.

https://bsmcon.blackboard.com/webapps/blackboard/content/contentWrapper.jsp?content

_id=_375854_1&displayName=Soft+chalk+Lesson+Professional+Practice+Model&cour

se_id=_6227_1&navItem=content&href=%2Fwebapps%2Fblackboard%2Fexecute%2Fb

lti%2FlaunchLink%3Fcourse_id%3D_6227_1%26content_id%3D_375854_1