WHEN YOU HAVE NONE: I WILL BE YOUR VOICE

When You Have None, I Will Be Your Voice

Susan W. Schultz
James Madison University

I WILL BE YOUR VOICE

Abstract
My nursing philosophy is to ensure that all voices no matter who they come from are heard
equally without prejudice. The basis of my professional nursing philosophy is that patients need
to be treated with respect, heard by their health care providers, and receive individualized care.
Advocacy is ultimately the corner stone of the care I provide for my patients. Advocacy not only
promotes a safe and effective health care environment, but also provides a voice for those who
do not know the language of the health care environment. In this paper I will describe how I have
developed this philosophy from throughout my lifespan of violent oppression, deadly infection,
and clinical application. This paper is intended for nursing students and those in the nursing
profession. The application of my philosophy is corroborated through evidence based practice
studies.
Keywords: advocacy, abusive relationships, Dilaudid, speaking out, safety,
pyelonephritis, equal care, nursing philosophy

I WILL BE YOUR VOICE

When You Have None, I Will Be Your Voice

Nursing has provided me with the ability to fulfill the promise I made to myself as a little girl to
stand up for those who have been silenced. My path to nursing was solidified by a determined
nurse and doctor who saved my life when I was fourteen. Even though I did not have the money
for a four-year institution, I was able to receive full financial aid to attend a community college
where I earned my associate's degree. The nursing school provided me with the knowledge and
tools I needed to be the voice for those whose own may have fallen silent. Now, as a new
graduate nurse, I have developed a personal philosophy that conveys the reasoning behind my
passionate approach to the field of nursing.
My Childhood
As a child, the only refuge I had was every another weekend with my father. Beyond
those fleeting moments, I dealt with cruel pranks from bullies at school and an abusive stepfather. Suicide weighed on my mind often; I just wanted to be free of the pain and despair. When
I was six, I thought I had found my freedom. My school had a guest speaker present on how to
report and get away from abuse. Following the presentation, I decided to talk to the schools
social worker. She did not believe me and called my step-father to inform him of my accusations.
The punishment was not the tools he used to abuse me; it was being allowed to survive. After
that night, I secluded myself from others by locking myself in my room or the attic to hide. I
swore to myself that I would never let anyone feel how I felt. That was when I made the promise
to help protect others. I would not do what the social worker had done to me in silencing my

I WILL BE YOUR VOICE

voice. As a nurse, I will not judge a person on their actions because we have no way of knowing
what has happened in their life that leads them to this moment.
Near Death Experience
When I was 14 years old, I developed pyelonephritis. I had been drinking massive
amounts of water throughout the day which diluted my urine masking the infection. I was first
diagnosed with back pain, but after two months my urine began to look like grapefruit juice, I
felt thirsty all the time, and my kidneys were failing. That is when I was diagnosed with
idiopathic acute kidney disease. I was pulled out of school and given Dilaudid to help ease my
pain. I would see the doctor each morning to have labs drawn and the emergency room each
night to receive intravenous (IV) pain medications to sleep comfortably. Eventually, I was so
weak I could no longer walk and had difficulty eating or drinking anything, and my urine began
to look like coffee. After four months since the onset of my symptoms, an amazing nurse, and a
determined primary care doctor we were able to ascertain the cause. A blood culture revealed I
had bacteremia stemming from a kidney infection. I was immediately admitted to the hospital
and started on IV antibiotics. Within four days I began to regain my appetite and strength.
According to my physician if we had not discovered the bacteremia and sepsis I would have died
within the week. It was this experience that restored my faith in humanity, giving the broken
little girl I once was a purpose in life.
Education Pathway
Once I graduated high school, it was apparent that I could not afford a four-year college. I
was resolute in my decision to become a nurse, leading me to investigate other options. The local
community college offered me a full scholarship, and I was able to graduate with my Associates

I WILL BE YOUR VOICE

in the Applied Science of Nursing (ADN) without debt. Once I began looking for employment, it
became apparent that hospitals would only hire me if I had a plan to continue my education
within two years. During clinical in my ADN program, I had a rotation on a floor that the James
Maddison University (JMU) students were also attending. I was impressed by the quality of
education and care as compared to University of Virginia (UVA) students, leading me to apply to
JMUs RN to BSN program.
Application to Practice
As human beings we tend to form opinions based on the prior knowledge and experiences
in our lives, this allows us to examine and understand how to react to situations we may
encounter throughout our lives. Healthcare is no different. When a patient comes into the
emergency room stating they can only have Dilaudid and are either allergic to or feel no effects
from all other forms of narcotic, most assume they are not in real need but just seeking their next
high. As a person who has experienced the intense chronic pain, I do not jump to those
conclusions. With chronic pain your threshold to handle it increases, and so does the amount of
medication required to diminish the pain (Diatchenko, et. al; 2005). I advocate for these patients
by giving possible explanations as to why other forms of pain control might not work for them
and remind coworkers that it is not our job to judge them but to help in any way we can.
As nurses, we are taught to perform continuous assessments of our patients and apply
critical thinking to determine when further intervention may be necessary. All too commonly I
hear statements where a nurse tried to explain to a physician that something was wrong and
offer them a solution that the doctor belittled based on the nurses title rather than on their
experience (Choi, Cheung, & Pang; 2013, p.1584). According to a study by Choi, Cheung, &

I WILL BE YOUR VOICE

Pang, nurses integrate warning signals, offer guidance to help prevent medical errors and provide
learning opportunities to continue the refinement of knowledge and skills of their peers (Choi, et.
al; 2013, p.1591). With these situations, I am quick to step up and assist the nurse or staff
member to pursue the situation further in order to ensure that the patient is receiving optimal
care. As pointed out by Bernice Yee-Shui and Engle Angela Chan, nurses have reported feeling
unsafe about speaking up or being unable to be heard, despite the administrative emphasis on
patient safety and the expectations of professionals to provide safeguards by having many safety
tools and checklists. To combat the silence, I show support by offering to speak to the proper
personnel for them if they do not feel comfortable doing so. Mary Ellen Patton, a nurse,
recognized by the American Nurses Association for being an advocate states that as a nurse, you
have, to be honest, and not afraid to share what you know and be able to encourage others to be
involved, (Patton, 2015 p. 1). I aim to meet this goal every day both at work and in my personal
life.
Conclusion
Every day we are given the opportunity to make a difference in someones life. We can
choose to add to the negativity or we can give them hope and a reason to strive to be more. I had
lost all hope in humanity before my life had even begun. It took the devotion and dedication of a
nurse and a doctor to fight for me to have a better life to not only restore my hope but give me a
reason to live. My philosophy is to ensure that every patient is treated with dignity, respect
without judgment, and above all else, always be heard.

I WILL BE YOUR VOICE

7
References

Choi, S. P., Cheung, K., & Pang, S. M. (2014). A field study of the role of nurses in advocating
for safe practice in hospitals. Journal Of Advanced Nursing, 70(7), 1584-1593.
doi:10.1111/jan.12316 Retrieved from
http://eds.b.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=15&sid=1de4d1e2-165149e3-bfb9-c0c6554669e9%40sessionmgr107&hid=117
Diatchenko, L., Slade, G. D., Nackley, A. G., Bhalang, K., Sigurdsson, A., Belfer, I., ... & Max,
M. B. (2005). Genetic basis for individual variations in pain perception and the
development of a chronic pain condition. Human molecular genetics, 14(1), 135-143.
Chicago. Retrieved from http://hmg.oxfordjournals.org/content/14/1/135.short
Law, B. Y., & Chan, E. A. (2015). The experience of learning to speak up: a narrative inquiry on
newly graduated registered nurses. Journal Of Clinical Nursing, 24(13/14), 1837-1848.
doi:10.1111/jocn.12805 Retrieved from
http://eds.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=1de4d1e2-1651-49e3-bfb9c0c6554669e9%40sessionmgr107&vid=13&hid=117
Mary Ellen Patton: Groundbreaking advocate, change agent for staff nurses. (2015). American
Nurse, 47(2), 12. Retrieved from http://eds.b.ebscohost.com/ehost/pdfviewer/pdfviewer?
vid=10&sid=1de4d1e2-1651-49e3-bfb9-c0c6554669e9@sessionmgr107&hid=117