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Running head: NURSING PHILOSOPHY PAPER 1

Nursing Philosophy Paper


Emily Page
Synthesis of Nursing Practice
March 25th, 2017
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Nursing takes a special type of person, specifically one that is able to use a certain set of

learned skills along with critical thinking, compassion and patience. Nursing schools around the

country have tenets that provide foundation for their type of program. Bon Secours Memorial

College of Nursing has many different tenets of which it believes in. The ones that resonate most

with me include promoting holistic care, practicing nursing using the latest evidence based

research and accountability both legally and ethically. A nurse is someone who is able to take

care of the sick or injured and provides holistic care to patients and their families. Being a nurse

is more than passing medications or documenting as all patients deserve to be looked at

holistically rather than just as another room or medical record number.

When I practice within clinicals and within my job, I maintain a high level of

professionalism and punctuality. I greet and shake hands with the patients I have been assigned

too and ask patients what they would like to be addressed as so they feel respected and

comfortable. I take each day of clinical as another opportunity to learn more and connect what I

have learned in the classroom into the practicum site. I have encountered a lot of nurses over the

past 2 years of practicum experience. I always remind myself to focus on my nursing practice

and providing safe, quality, and evidence based care. Other nurses might cut corners or do things

I might not be accustomed too, but at the end of the day it is my responsibility to follow the

guidelines of my licensure and company policies. It is important to always have great integrity

for my work and always maintain a clear view of the reason why I came into nursing.

Since I am in the beginning part of my nursing career, I do not feel fatigued or burnt out

but I can see how this could become an issue later on down the road. I strive to practice my

philosophy of nursing through the end of my career to ensure that all of my patients always get

quality; patient-centered, evidence based holistic care. Achieving this requires debriefing after
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long days at work and allotting time to just focus on myself so that I can take care of others to

the best of my ability.

This semester in immersion I am on the Intervention Cardiology Unit at Memorial

Regional Medical Center. I took on the care of a 70 year old male patient for a period of 3 shifts

and it demonstrates my personal philosophy for nursing. He was wheelchair bound because his

weight essentially prevented him from withholding his own weight. He suffered from coronary

artery disease, chronic kidney disease, hypertension, hyperlipidemia, sleep apnea and diabetes.

They attempted to do a cardiac catheterization through the right wrist and right groin, however,

with a few failed attempts they stopped the procedure and he had a consultation for open heart

surgery. He was morbidly obese and was not the most pleasant patient to work with in the

beginning. Being a student gives some patients a bad feeling, but I assure them that all of my

decisions and work is done alongside a qualified registered nurse. As I went through my first 12

hour shift with him, he became more comfortable with me and even started asking me questions

about medications and the idea of having open heart surgery. At first I was nervous to answer

questions, but I reiterated some of the things that I had heard from the doctor and took into

consideration that he was in poor health. I was supportive and honest in all my responses to his

questions.

The patient was frustrated because of his health and other nurses on this unit didnt want

to be assigned to him. I enjoyed having him as a patient because he helped me grow as a nursing

student. Over the course of 3 shifts, I met his entire family and even sat in while he talked to

chaplain services. He constantly thanked me for being attentive to his care and treating him with

such dignity and respect.


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The interaction portrays my philosophy of nursing in many ways. I gave quality care to

this patient and followed him throughout the end of his care on IVCU. I used my eagerness to

learn to fuel my excitement about having him as a patient because I havent had difficult patients

before. This gave me the opportunity to grow as a student nurse. This patient and I developed a

therapeutic relationship that I will remember and hopefully he remembers for a very long time.

My values and beliefs have changed since the beginning of nursing school. When I first

started my nursing school journey, I placed a lot of emphasis on the passion to please and serve

others. I did not truly understand the importance of giving care based on scientific research. I

have learned in the past three years that providing evidence based care along with being

compassionate is what is truly important. A nurse has a legal obligation to provide safe care and

must follow guidelines to be considered a competent nurse. My job is to keep my patients safe

and give quality care, and being compassionate essentially just makes me a better nurse. While

some people think that nursing is simply catering to others, it involves practicing patient safety,

providing quality innovative care and viewing the patient holistically.

Patricia Benner developed a theory that breaks down stages of nursing into novice,

advanced beginner, competent, proficient, and expert. The novice stage is essentially a nursing

student or nurse that is in a setting in which they have no experience of situations with only

information learned from didactic courses. The advanced beginner stage is a nurse that has been

exposed to real situations and has developed understanding of complex things. For example, a

nurse is able to assess whether or not a patient is ready to learn based on previous experiences,

nonverbal cues and observation of the patient. After about 2-3 years of experience, nurses are

able to cope with many things in the clinical setting and have a mastery of prioritizing what is

important. This is the stage of competency, but it important to mention they do lack the ability to
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being quick and flexible as this comes with along with the next stage of Benners Theory. The

stage of proficiency or being a proficient nurse involves looking holistically at the patient and

hones in on the actual problem the patient has at a faster pace and considers fewer diagnoses and

interventions. The last stage of Benners theory is expert. An expert nurse has a huge amount of

experience and no longer depends on rules or principles to understand what is occurring in a

situation. An expert nurse has an intuitive understanding of any situation and zeros in on the

problem without wasting time on far-fetched what-ifs.

My current professional developmental level is novice. I have only been in the clinical

setting for about 3 years and each semester of nursing school we have rotated to different areas.

This semester I have been on one unit and even though I feel comfortable working under a

preceptor, I will not truly know what its like to be a registered nurse until I am working under

my own license and all responsibility lies in my hands. As I stated before, the novice nurse is one

that has no experience in the clinical setting. Even though I have some experience, it is not

enough to be considered advanced beginner because I have been exposed to so many different

areas of nursing during my program. My confidence level is higher than a novice nursing

student because I feel that I can connect different things I have learned and think critically.

However, the majority of my nursing actions are getting things checked off on what I need to do.

These actions include giving medications, doing vital signs, performing assessments and more. I

have not been exposed to enough real-life experiences in the clinical setting to be able to assess

my current patients while simultaneously using past experiences to help me with my current one.

This is the gap between novice and advanced beginner which is why I am a novice nurse based

on Benners Theory.
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To move forward to the next stage of skill acquisition, I need to gain more experience.

As important as clinical immersion is, the experience that will be most valuable is when I begin

my first RN job at St. Marys after graduation. Each day that I work will give me the experience

I need to move forward since the novice nurse has no experience in a setting. Exposure to

different situations and scenarios will help me build my skillset and help me use those skills in

future situations to come. The next thing I can do to move onto the next stage of skill acquisition

is focusing on the guidelines that new graduates need to get the job done. A nurse cannot go

from novice to expert overnight and apart of the journey is learning with the rules to get to the

next step. The final thing I can do to move forward is continuing education. I have a heard a lot

from nurses that new graduates come in with the idea that they know what they are doing. It is

important to remember that I know what I am doing as a student and not as a practicing nurse. I

do not have a strong nurse skillset yet because I havent even graduated yet. I have a lot to learn

and will continue to focus on gaining more and more knowledge to bridge the gap between being

a novice nurse or an advanced beginner nurse.


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References

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

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