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Jennifer Pierce
On my honor, I have neither given nor received aid on this assignment, and I pledge that I am in
As I am about to graduate from nursing school and enter professional practice, it has been
beneficial to reflect on the questions put forth to our class. What do we value? What do we
believe? What has changed since we first entered nursing school? Going through the process of
writing this paper has increased my self-awareness and helped me to answer these questions in a
meaningful way.
Definition of Nursing
In my first semester of nursing school in NUR 1100, I defined nursing as “an art that
involves transforming science and technology into a meaningful and positive experience for the
patient” (Pierce, 2016, p. 6). However, at its core, as I have learned over the past three years,
nursing is about caring. It is not about “taking care of” patients but rather “caring about patients”
with genuine concern. This care is expressed through kindness, presence, and most importantly,
The tenets of the Bon Secours College of Nursing program philosophy statement
(BSMCON, 2016) that resonate most with my own values and beliefs are caring, health and
Caring
As noted above, I believe caring about patients is at the heart of nursing. As one of the
College’s tenets articulates so well, nurses “facilitate healing across the lifespan by extending a
caring human presence” (BSMCON, 2016, p.39). Self-care is another of the College’s tenets
that I have come to embrace. I did not identify self-care as a driving value in my original
philosophy paper. However, I have learned in what some might term the hard way, the
importance of self-care when enduring the hours, the emotional and mental stresses, and the
Health
influenced by physical, emotional and spiritual factors” (Pierce, 2016, p. 6). I wholeheartedly
agree with the College’s tenet that health cannot be achieved without equitable access to health
care (BSMCON, 2016). Through my immersion experience in the emergency department, I have
seen firsthand how lack of access, most notably due to lack of insurance, has negatively
impacted people and consequently leads them to utilize the ED for primary health care needs.
During my time in nursing school I also have witnessed on many occasions how environments
Service
I believe service is how we care for our community and address the needs of our most
vulnerable neighbors. In my mind, service and nursing are inherently linked. Although nursing
is indeed a profession, there is a reason why we say we are called to serve. Nursing is about
serving others and caring for others regardless of circumstance. To be a good nurse you must
value human dignity and justice, fairness and equality for all people. Healthcare is a social
justice issue and health disparities are just as detrimental to society as economic or racial
disparities. Therefore, I am glad that Bon Secours includes the tenets of service in its philosophy
Personal Philosophy
The values and beliefs that inform my personal philosophy are reflected in my nursing
presence. I practice presence with all of my patients and I always take the time to spend extra
moments with patients who may be scared, sad, or lonely. Oftentimes when I am with patients I
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am not providing medical care per se, but simply listening and demonstrating my interest in them
as unique individuals.
My beliefs about health and human dignity intersect on a regular basis this semester when
Hospital. It would be easy to assume that some of the patients seen there are making bad
choices, not taking care of their health, abusing drugs and are the “dregs of society.” However,
when looking through the lens of my personal philosophy, I see that many of our patients are
living in detrimental environments, with few economic or educational opportunities. I see the
interconnectedness between the patient and his environment. I see that, regardless of how the
patient presents or acts and regardless of why the patient is in the emergency department, the
during one of my rotations on a med-surg unit. The patient was an elderly woman who appeared
non-communicative and was assumed to be a non-English speaker because of her physical traits
(she appeared to be of Asian descent). The nurses on the unit also assumed the patient had some
mild dementia because she was acting confused. The primary nurse came in and out of the room
to perform his nursing duties, but he did not engage in any conversation with the patient.
speaker, I always talk to my patient as if he/she is alert and oriented. I say hello, I explain what
I’m doing, etc. As I was caring for this particular patient, and talking to her, I noticed that she
appeared to be comprehending what I was saying. As I took the time to sit with her, talk and
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assess the situation, I realized that she was hard of hearing. Her apparent confusion and
uncommunicativeness were not due to dementia or not speaking English but those were the
assumptions that were made because no one took the time to be present and truly care for the
patient. She did have some deficits with her speech but after a while, with me carefully listening
and focusing on her, the patient vocalized a few words that I understood.
In writing this paper I have had the opportunity to reflect on the values and beliefs I
articulated in my first semester of nursing school in NUR 1100 (Pierce, 2016). At that time, I
identified the following values as playing an important role in my nursing practice: human
dignity, integrity, autonomy, justice, caring, education, creativity, accountability, health and
wellness, stewardship, courage, and perseverance. These values continue to provide the
Similarly, my beliefs and the convictions that I hold to be true have remained steady
since I wrote my original personal philosophy of nursing paper. One of the beliefs I articulated
in that paper was the belief that all people deserve to be treated with respect and loving kindness.
I also stated that “each patient is a unique person with different physical, emotional and spiritual
needs. Each person brings their own history, family and culture into the patient-nurse
relationship” (Pierce, 2016, p.6). Additionally, I stated that I believe people need to take
responsibility for their own health and well-being but that some people can be vulnerable or
unable to take responsibility for their health and that they need caring support. These beliefs, of
all the beliefs I discussed in my original philosophy of nursing paper, are the beliefs that have
Benner’s Theory
Patricia Benner (2001) is a renowned nursing theorist who developed a model for how nurses
learn and build clinical competence. At the crux of the theory is the notion that nurses learn
through experience and that nurses must apply their classroom and textbook learning to real-life
clinical situations. The model includes five stages that nurses move through as they develop
competence.
• Stage 1 novice, includes nursing students with no clinical experience and/or clinicians
• Stage 2 advanced beginner, includes new graduate nurses. Benner notes that advance
beginners need support in the clinical setting, which is seen in practice through the use of
nurse preceptorships.
• Stage 3 competent, includes nurses with two to three years of experience. Competent
nurses are able to deliver quality care but are still developing their speed and
prioritization skills.
• Stage 4 proficient, includes nurses who have three to five years of experience in a
specific clinical setting or with a similar patient population. Benner notes that proficient
nurses are able to see the big picture and apply the knowledge gained from past
• Stage 5 expert, includes nurses who have “an intuitive grasp of each situation” (Benner,
2001, p.32). Expert nurses can hone in on a problem and take quick action because they
After reviewing Benner’s five stages and reflecting upon my experience to date, I believe
I am in the Novice stage of skill acquisition. Although a second semester senior nursing student,
most of my clinical experiences have been short and/or had limited opportunities for skill
acquisition. Additionally, each new semester I enter a new clinical area, which aligns with
Benner’s description of a Novice. Most notably, Benner states that nursing students “have little
understanding of the contextual meaning of the recently learned textbook themes” (Benner,
2001, p.21). For example, my clinical immersion is in the Emergency Department. Prior to my
first day of immersion, I have only spent a few hours in the Emergency Department and most of
my time was spent shadowing/observing a Registered Nurse. Therefore, I not only feel but also
act like a novice as I have entered this new clinical area. As I write this paper it is still early in
the semester and I recognize that I will be building my skills and confidence with every hour
spent in immersion. If I were writing this paper at the end of the semester I might possibly feel
In order to move to the next stage of skill acquisition, I have identified the following
three action items. First, I will pursue job opportunities with hospitals that offer new graduate
nurse residency programs. Residency programs are typically one-year programs that offer
training, and peer networking. Second, I will seek out a preceptor who embraces the role of
teacher and mentor. Also, I will strive to have a preceptor who is a Stage 4 Proficient nurse. If
my learning needs are not being met by my assigned preceptor, I will speak up and request that
changes be made to my preceptorship. Third, for my first job, I will identify an area of practice
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that interests me at a facility where I can see myself staying for a minimum of two to three years.
As Benner notes, it is only through practice in the same or very similar clinical areas that a nurse
can become competent. Moving around too much between specialties keeps you at an advanced
beginner stage. Therefore, I will approach my job search with a long-term vision of how I want
may arise, but when I pursue and accept a job, I want to at least feel right now that it is the first
References
Benner, P. (2001). From novice to expert: Excellence and power in clinical nursing practice
Bon Secours Memorial College of Nursing (2016). Academic Year 2016-17 BSMCON Faculty
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