Nursing Philosophy

Philosophy is defined as beliefs and values that help guide your nursing career in a direction that is ethical and goal oriented (Wayne, 2021). Using philosophy helps nurses to think critically when working with patients. Being able to reflect on how the nurse’s own values influence the way that they practice on a day-to-day basis. Nursing metaparadigm is the concepts and purpose intended to guide nurses. The 4 major concepts that come with metaparadigm include; Person, Health, Environment, and Nursing. Each one of the concepts is essential to nursing theorists. Each nursing theorist that we have learned about during this class has their own take on each one of the metaparadigms.

Person is the most important concept of the metaparadigm. This is really the patient in most instances that you are taking care of. As nurses we are learning that the patient isn’t the only person that we need to consider, we also need to think about the patient’s family when caring for them. In some cultures, we are not only taking care of the actual patients but the entire family which could include elders in their community (Andrews, Boyle, & Collins, 2020). Jean Watson was a pioneer of transpersonal caring, she believed that human beings are to be valued, respected, understood, and nurtured to view as a functional self (Blais & Hayes, 2016).

The health metaparadigm can be defined as your patients’ level of wellness. Health may have many meanings for different people. What I may think is healthy and living may not be what my patient perceives what health is. It is not to just be alive but to be living our best life possible. As nurses we need to make it our responsibility to help patients meet a goal where they feel that they are living their best life. Sometimes when we come in contact with a patient, they may feel that they are just getting by with the illness or disease that they have. We as nurses need to help these patients the most. This may be setting small goals at first and helping our patient to achieve them.

According to Florence Nightingale who was pioneer of The Environmental theory (Wayne, 2021), she believed that the environment was closely related to the patients’ state of health. It is believed that the surroundings of a patient both internally and externally affects what is happening with the patient. For an example, look at a domestic violence patient that comes into the hospital, when they arrive, they are physically beaten up and emotionally broken down. Their environment at home is toxic not only for them but for their extended family as well. Many of these patient cut al ties with their parents and siblings to try to make their home life more bearable. As her nurse we have to help provide her with a safe environment while she is in our care until she decides that she wants more help than we can provide at the hospital.

The final concept is nursing, defined as the nurse’s attributes, characteristics, and actions while improving patient care (Fawcett, 2005). Through nursing we are trying to assist our patients to meet their goals to a healthy life. By using evidenced based practice, we can use measurable outcomes to achieve optimum health.

The central concern of the nursing metaparadigm is the patient. Without the patient none of the other things truly matter. When we as nurses do not keep the patient at the forefront of our practice, we lose sight of the goals that we have created personally for ourselves. I believe that when we don’t put the patient first that is when mistakes happen and we risk an increase in safety issues.

As nurses when we use the nursing metaparadigm, we give better care to not only the patient as a whole but also to that extended family that is with the patient. When we are able to bring all 4 of the concepts together, we offer improvement of health and the quality of life of our patients with positive influences from all of the theorists that have paved the way for new nurses to come (Rector, 2018).

Nursing to me means making a difference in people's lives. Everyday I get to hold the hand of a patient that is scared or unsure of what is about to happen and there is no greater feeling than to be able to comfort someone. Letting them know that it is going to be ok and that we will work together to get through whatever is going on is amazing. Being able to give patients' families a piece of mind during their final breath is no greater reward. As far back as I can remember I wanted to be a nurse. I wanted to be able to help people when they weren’t able to help themselves. After high school I started a nursing program but life took me in another direction for a little bit. I still worked in healthcare but in the billing department. I knew that I would eventually make it back to school but it had to be the right time. My mother-in-law developed lung cancer and moved into our home so that she could spend more time with my boys and husband. We were able to keep her at our home during the final days of her life. It wasn’t easy and I am sure if you ask my husband for him, it was too much to see his mom go through that. She didn’t want to die at a hospital, she wanted to be home with family. I was able to provide care and grant her the final wishes. She had done so much for me and my family it was the only way that I knew I could honor her. Shortly after she passed away my husband came to me and said, “Tara you need to go back to school, you need to finish your nursing, you were amazing with mom, we can’t be the reason you never finished”. I enrolled that day and have never looked back.

Throughout this class I have truly understood how the different theories have impacted nursing as we know it. For example I have always tried to be proactive in my care for patients. Barbara Raudonis’s theory was based on the nurse planning out the care for a patient and then implementing the care in a purposeful and proactive way (Blais & Hayes, 2016). Reading about her theory justified how I was working with patients in a positive manner. During this class we spent some time on patient safety which I feel is so important. This class has made me realize that I need to slow down and go back to the basics of nursing. I have spent my last 10 years of nursing primarily in the Operating Department while moonlighting on the ACU floor and ED. I am a First Assist so I don’t always see the patient’s family before the patient comes to surgery. I always speak with them afterwards but since this class I have started to take the time to meet with the patient while the family is still with them. To reassure or to just answer any last-minute questions they may have. It really is back to basics and putting the patient and patients support system first.

As nurses we are taught to do no harm (non-maleficence). In the operating room we make incisions into the skin to fix whatever problem brought the patient to surgery. We do this with the intent to do the best (beneficence) for the patient (Gains, 2020). Before a patient comes to surgery, they have had many conversations with the healthcare team to answer any questions that they may have regarding the surgery, the recovery and how it may impact their lives. The patient ultimately has to make the final decision to have or not to have the surgery (autonomy) (Ethics and Human Rights, 2021). There are times that the patient has had more questions minutes before we head into the surgical suite. I have sat with patients that have asked me, “what should I do?” I tend to give them the options, the risks for having the surgery and the risks for not having the surgery. By giving them all the information that I have, allowing them to make an informed choice on the care that they are going to receive.

Nursing is about growing and always learning. There is something new to be learned every day. When we stop learning we stop growing. When we stop growing personally and professionally, we stop giving the best possible care that the patient deserves to get. When I started this class, it was only as a means to finish my BSN. Just another class that had to be checked off, what I gained from this class was so much more than I expected. After I complete my BSN, I plan to advance my learning and progress to completing my MSN degree. I feel that I have so much more to offer the patients and families that I encounter. I want to be the change in new nurses when they are starting out learning how to be not only good nurses but great nurses. I leave you with this quote from Stephen Covey, “The biggest communication problem is we do not listen to understand, we listen to reply. This has to start with us first, once we learn to really listen, we can start to really make a difference.

Bibliography

Andrews, M. M., Boyle, J. S., & Collins, J. W. (2020). Transcultural Concepts in Nursing Care 8th edition. Wolters Kluwer.

Blais, K. K., & Hayes, J. S. (2016). Professional Nursing Practice, Concepts and Perspectives (7th edition). Pearson Education Inc.

Ethics and Human Rights. (2021). Retrieved from American Nurses Association: https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/

Fawcett, J. (2005). Contemporary Nursing knowledge analysis and evaluation of nursing models and theories (2nd Edn). Philadelphia: FA Davis Company.

Gains, K. (2020, September 4). What is the Nursing Code of Ethics? Retrieved from Nurse.org: https://nurse.org/education/nursing-code-of-ethics/

Rector, C. (2018). Community and Public Health Nursing 9th edition. Philadelphia : Wolters Kluwer.

Wayne, G. (2021, March 5). Nursing Theories and Theorists. Retrieved from Nurseslabs: https://nurseslabs.com/nursing-theories