Nursing Philosophy

Lauren E. Hill
Bon Secours Memorial College of Nursing
 My nursing philosophy is a compilation of the personal values Ive cultivated

throughout life, and those instilled in me during my nursing education at Bon Secours. I

utilize these beliefs and tenets as a model from which I can process information and act.

In this way, my nursing philosophy serves as a tool that allows me to monitor personal

development, and ensure congruency between my actions and the values I hold dear.

Bon Secours philosophy serves to guide the practice of those employed or

attending. It promotes consistency of practice and helps to determine compatibility

between the institution and its members. I am in agreement with all tenets of the college,

but most closely identify with three. I believe nurses should provide holistic care to

promote wellness, prevent disease, restore health, and provide comfort. Nurses are

accountable and should be ethically, legally and morally grounded. To provide the best

care, nurses should commit to life long learning and research. In this way they can

contribute to the application of new evidence based practice.

Individually, I nurse with service to others at the core of my interactions. I strive

to provide compassionate care, treat my clients holistically, conduct myself ethically, and

be fully present to provide the best care that I can. I believe strongly in illness prevention,

and aim to empower my clients to aggressively seek wellness, knowledge, and personal

awareness. I maintain reverence toward life in all of its stages. I celebrate humanity by

advocating for the individual needs of my clients and practicing care based relationships.

I wish to dedicate my life to the service of others and the betterment of my community.

My nursing philosophy is reflected daily in my practice through my actions, and

the dialogue I have with my patients. I make a conscious effort to recognize the unique

circumstances each client presents with, and care for them holistically. Their personal
needs transcend age, gender, and diagnosis, so I strive to meet my clients where they are

in terms of support and learning. This helps me to build successful, trusting relationships

with the people I care for.

Establishing trust enables me to motivate and teach my clients, which I am

passionate about. The majority of the patients I care for are hospitalized due to non-

compliance or poor maintenance of preventable diseases. Reaching a state of rapport with

them helps me to effectively communicate the health promotion and disease prevention

lessons I feel so strongly about.

I strive to make the same moral and ethical choices when an audience is present,

as when one is not. This seems rudimentary, but to me, ethics in the work place

encompasses so much more than just doing a good job or not diverting. I believe a nurse

should go beyond what their job description entails, and above all else, advocate

relentlessly for their patients. It is staying late when exhausted because your team needs

you. It is working to improve time management to free up moments you can give to

someone in need of support. It is judgment free listening and tireless education when

faced with end of life decisions. It is doing what is most difficult about the job every day,

without fail, because that is what those in our care deserve. I believe there is always room

to grow and strengthen in this area of nursing, and I aspire to continue to develop in this

way.

The field of nursing is forever changing. It is difficult to keep up and stay

current with best practice and the latest research. As daunting as it is, nurses have a

profound impact on the successful treatment of patients. I feel a strong sense of self-

efficacy, and know that if I commit to life long learning, I can improve patient outcomes.
I participate in continuing education and routinely evaluate areas of my practice where I

can improve. I follow up by actively seeking educational opportunities to strengthen my

weaknesses. Most recently, I elected to take a telemetry refresher course as I noticed I

was not identifying strips as readily at work. I also plan to begin working on my CCRN

as soon as possible, and hope to give back to my unit in this way.

Aspects of my nursing philosophy influence the care I give to all my patients, but

some situations require me to call on those tenets for guidance more than others. I

recently cared for a patient who suffered a brain herniation and was brain dead. Her

family was unable to understand that she was neurologically devastated and would never

recover. I found myself thinking back to my values and personal philosophy as I

struggled to communicate with her loved ones. I cared for she and her family holistically

by providing for her physical needs and the emotional ones of her decision makers. I

provided nursing presence by listening to them and casting my own opinions aside. I held

myself accountable ethically by honoring their wishes long after I think she should have

been kept alive, and I did this along with the interdisciplinary team until the family was

ready to part with her. It was challenging and emotionally taxing, but I found that having

my assertions and my philosophy helped me to process the situation, act in a way that is

congruent with my values, and still be a steward to others.

My values and beliefs have changed only marginally while I have been in nursing

school. I used to believe that all life was sacred and had meaning, but I have refined those

assertions. I still believe that life is sacred and should be respected, but I no longer

believe that all life is meaningful. I personally disagree with extensive life saving
measures and their impact on others. I am able to put my personal views aside to care for

the families of ICU patients who struggle to let go.

Stewart and Hubert Dreyfus proposed a five-step path that nurses follow as they

develop skills and acquire nursing knowledge (Benner, 2001). The five levels include the

novice, advanced beginner, competent, proficient, and expert nurse. The Novice nurse is

characterized by task orientation, and must rely on rules to guide performance. They are

taught about situations in terms of objective data, such as vital signs, and they use these

concrete parameters to enter into nursing situations and gain experience.

The advanced beginner has gained enough nursing experience to notice and

comprehend recurrent situational components, and what they might implicate. Their

experience enables them to recognize when someone is ready to learn, for instance, but

they remain rigid and task oriented (Benner, 2001).

The competent nurse enjoys feelings of mastery and an ability to cope with the

ever-changing demands of the profession. This nurse has accumulated two to three years

of experience, but is still developing time management skills. She lacks the fluidity and

speed of the proficient nurse, and can become side tracked by individual tasks (Benner,

2001).

The proficient nurse has perspective. She can understand a given situation and its

components in terms of long-term goals. This nurse exemplifies the change from task

orientation to goal orientation. Instead of an intense focus on daily tasks, this nurse can

reach forward to decide what she can do that day to get her patient where she wants them

to be in ten days time. This nurse is more energy efficient due to the ability to distinguish

and rank task by their immediate importance (Benner, 2001).

 The expert nurse operates on intuition and a deep understanding of clinical

situations in their entirety. An astute ability to recognize allows this nurse to no longer

rely on analytic principles or rigid rules to guide her practice (Benner, 2001).

The stage of skills acquisition that most represents my stage of professional development

is the advanced beginner. I am task oriented and rule governed, but I have the benefit of a

strong nursing education and a wealth of experiences to pull information from. I am able

to recognize the similarities between new clinical situations and ones I have experienced

in the past. I use that comparison to make appropriate clinical decisions (Benner, 2001).

The experiences I use to make clinical judgments are what Dreyfus and Dreyfus

term, aspects. They define aspects as recognition of information that can only reach the

nurse through prior experience in real life situations (Benner, 2001). The nurse at this

stage combines aspects she learns with guidelines provided to her by the preceptor or

hospital, but she tends to treat all aspects and guidelines as equally important pieces of

data. This plays back into the task-oriented nature of a nurse at this level and I believe I

still fall into this category (Benner, 2001).

I anticipate my progression to the level of competent nurse will take some time.

Truly competent nurses have two to three years of experience, and I will be in a critical

care setting which requires a high skill level. To move on to this next stage, I plan to

work hard with my preceptor, continue my education within the ICU, and practice self-

forgiveness.

I believe that my orientation will help me to continue to gain confidence in the

ICU. I plan to take full advantage of the one on one time I have with my preceptor and
plan to ask questions whenever I have them. In doing so, I know I will deepen my clinical

understanding and protect myself from nursing errors. Continuing my education to a

CCRN will provide me with an even deeper knowledge base and proficiency in the

clinical setting. Obtaining this certification will help me to be a better nurse to my

patients and a more valuable asset to my unit.

 References

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

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