Running Head: MY PROFESSIONAL NURSING PHILOSOPHY 1

Professional Nursing Philosophy

Amanda F. Johnson

Delaware Technical Community College

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What is Nursing Philosophy? By Definition, nursing philosophy is one’s values, beliefs,

standards, and expectations regarding the treatment and care provided to patients in the health

care setting (Nurse Theory, 2019). As nurses, we create our own philosophy as this is what

drives the level of care we provide to our patients. We utilize our personal values and beliefs to

determine the standards by which we practice. We engage in lifelong learning to expand our

knowledge base and prepare us to manage complex patient situations. Nurses also make sure

they address alterations in their own personal wellness because our well-being is paramount to

being able to consistently provide safe and effective care. We often collaborate with one another

to deliver the ideal patient experience and lean on one another to manage conflict. My personal

nursing philosophy believes in healing beyond medicine. In addition to healing the patient and

altering their environment, I believe that values and beliefs, lifelong learning, conflict

management and collaboration, personal wellness, and leadership contribute to delivering the

ultimate patient experience.

Values and Beliefs

My personal values and what I believe in drive the care I provide to my patients. As a

little girl, I grew up in a Christian home. We went to church on Sunday, participated in Christian

extracurricular activities, and we lived by many standards and messages from the Christian

Bible. One of the messages of the Bible talks about honoring others and treating those around

you as you wish to be treated. From a young girl to a mature adult, I lived by this standard. I

believe that what you put out is what you get in return. I adapted this message into the level of

care I provide to my patients. I have been a patient before and received care which felt like it

came from a textbook. It felt scripted as if it were rehearsed and made me feel like I did not exist.

Responses to my questions were robotic and smiles only occurred if I delivered one first. I
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vowed to treat my patients as I wished to be treated, and therefore, deliver care accordingly.

Shortly after introducing myself to a patient as their nurse, I get a feel for how the patient wants

to be addressed. Some patients want the relationship to remain business-like, while others want

you to be more like a family member. Once I determine the type of nurse-patient relationship

they desire, I tailor my care to that and deliver an experience to them as if it were me in that bed.

Establishing and maintaining a solid nurse-patient relationship is vital to healing and ensures

mutual trust amongst both parties (Registerednursing.org, 2019).

Lifelong Learning

Learning as a nurse never ends. I remember one of my instructors saying in school “Be

afraid of the nurse who knows everything”. Initially, I thought that would be an awesome nurse

to know. My thought was that a nurse who knew everything would be an amazing resource and

be able to assist me, especially because I was a new nurse. However, as I began to practice as a

nurse, I realized that knowing everything as a nurse is impossible. No two patients are alike. Two

patients may present to the emergency room with shortness of breath and a diagnosis of

Congestive Heart Failure exacerbation, but their labs, presentation, and treatment plan may be

different. Every patient’s body responds uniquely to alterations in their health; therefore, nurses

have a duty to remain open-minded and ready to change the care they provide and tailor it to the

patient as they see fit. A nurse who knows everything may not be willing to adjust how they care

for a patient and could potentially cause harm. For this reason alone, I believe learning for nurses

is a lifelong process.

Throughout my schooling, I learned most from the instructors who had a wealth of

experience and obtained higher-level degrees. My goal is to become a Certified Nurse Educator.

I have a passion for mentoring and teaching those who have entered the nursing field after me. In
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order to become a well-rounded nurse educator, I have dedicated myself to lifelong learning. The

American Association of the Colleges of Nurses (AACN) proposes that Bachelor-prepared

nurses contribute to decreased mortality rates and better patient outcomes (Nurse Journal, 2019).

Therefore, I am currently in pursuit of my Bachelor of Science in Nursing degree and plan to

continue until I have achieved a Master’s degree. Additionally, I will work to find other bedside

opportunities in the hospital to broaden my horizons on the nursing profession.

Conflict Management and Collaboration

Managing conflict is a technique that nurses need to master. Conflict is something that

we as nurses encounter every day and it has the capacity to effect patients and they care they

receive. Whether it be conflict with management, another nurse, a different discipline like a

hospitalist, or a family member, conflict occurs often. We must effectively deal with conflict to

prevent the effects of conflict from trickling down and impacting our delivery of care.

One of those most prevalent conflicts nurses deal with daily is the nursing shortage.

Often times, we enter our shifts with the expectation that we will have a manageable assignment.

On the unit I work on, a manageable assignment is a 4-to-1 patient-nurse ratio. This ratio allows

us to effectively assess, medicate, communicate, and assist patients with activities of daily living.

However, there are instances where the schedule was finalized by management, and due to the

staffing shortage, there were not enough nurses to fill a particular shift. On the other hand, life

occurs, and nurses have to call out of work which creates an even bigger hole in staffing. In

either situation, there are less nurses to be spread amongst the same number of patients. This

causes tasks to be completed late or left undone, increases the risks of falls and other adverse

events such as medication errors or patient death, and leads to staff burnout because your

workload and number of responsibilities has increased (Bradley University, n.d.). The question
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remains, how do we address this level of conflict and minimize the effect on staff, and more

importantly, our patients?

During the times when staffing is the conflict, it is imperative that all disciplines work

together to ensure patient safety and to decrease the stress levels related to short staffing.

Teamwork is one of the greatest ways to manage conflict, especially when staffing is the culprit.

For example, a few weekends ago, my unit was short four nurses and a patient care technician.

The nurse coordinators were only able to send us one additional nurse from the float pool, so that

meant everyone else’s patient load was going to increase. My assignment, before it increased,

was already a tough load, but I noticed that there were other nurses on the floor with the same

high acuity patients as myself. Instead of allowing the staffing to bring the unit morale down, we

worked together. When one nurse was busy dealing with a Rapid Response Team (RRT)

situation, I pitched in and administered medications to her other patients. While I was medicating

my patient, who had a critical potassium level of 6.2 and was refusing treatment, the charge

nurse and patient care technician chipped in and answered my other call bells. Although these are

just a few gestures that helped when the unit was short during this particular weekend, this

demonstrates how teamwork and collaboration helps to mitigate conflict.

Personal Wellness

Personal wellness is the section of my nursing philosophy that I struggle with the most. I

find myself getting wrapped up in helping and healing those around me, that I often times forget

to assess my own personal wellness. As a nurse, we work in stressful situations. We work twelve

hour shifts, and sometimes longer if our unit is short. We work these long hours serving others

while on our feet and may go days without having an adequate lunch break because of our

patient acuity. We sometimes work these twelve hour shifts three or four days in a row and go
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without seeing our families and tending to our own needs such as doctor’s appointments, social

events, and school work. With the stress of the world and work on our shoulders, nurses have an

obligation to ensure that we have our personal wellness in check.

When I started nursing school, I vowed to become healthier. My thought process was that

I would need to be healthy if I wanted to effectively nurse others back to their optimal level of

health. I became a pescetarian, eating only fish and seafood, in order to lose weight. I went to the

gym three to four times a week and did a few home workouts. Shortly after I started the nursing

program, I realized how intense the workload was and stopped caring about myself. The dieting

and the workouts stopped because I was so involved in my schoolwork, but as a result, I gained

the weight back that I had lost and generally felt bad.

As I become a more tenured nurse, I realize that my personal wellness is just as important

as my patients, if not more. I educate my patients and implement interventions to help them and

my expectation is my patients will have faith in my instruction and apply it to their everyday

lives. Going back to my values and beliefs, though, I have to practice what I preach. I allowed

myself to become completely consumed in the health of others that I lost track of my own health,

and in turn, I suffered. Personal wellness has become a primary concern in my life again, for

personal gain, and to ensure that my patients are receiving true and honest nursing care.

Personal Nursing Philosophy

As aforementioned, values and beliefs, lifelong learning, conflict management, and

personal wellness are major components of my nursing philosophy. Beyond the four components

previously explained, I believe that healing goes beyond medicine. My personal nursing

philosophy supports the manipulation of the environment, but it also uses a holistic approach.

Beyond medicine and the patient’s diagnosis, health care providers need to consider one’s
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environment such as their home, family, occupation, and finances. My philosophy evaluates all

of those elements and believes that addressing barriers in any of those categories, in addition to

the patient’s physical health, provides the optimal healing experience.

Florence Nightingale’s Environmental Theory is closely related to my personal Nursing

Philosophy. Nightingale’s Environmental Theory places emphasis on the patient’s environment.

Nightingale believes that healing goes beyond medicine and that health care providers need to

manipulate patients’ environments in order to promote effective healing (Petiprin, 2016). The

Environmental Theory lists 10 key components: ventilation, lighting, cleanliness of the area and

self, health of the home, bed and bedding, variety, offering hope and advice, food, and

observation (Petiprin, 2016). On a day to day basis, nurses are responsible for assessing all of

these elements, and interjecting when barriers arise, at any given time.

One way nurses assist in altering a patient’s environment is through assessment. An

assessment is greater than auscultating lungs sounds and asking a patient their pain level. Nurses’

duty is to also address their home life. For example, if I have a patient who is going home with a

newly inserted central line for continuous infusion therapy, I need to assess their environment at

home. Central lines are a breeding ground for infections, so I need to address the cleanliness of

the home to prevent infections, the availability of visiting nurses to come and assess the site after

discharge, and educate the patient on how to care for the central line site when nurses are not

available. Our goal as nurses is not only to care for patients while they are in our facility, but to

convey messages effectively in hopes of returning patients back to their baseline level of health

and alter their home environment to achieve their healthcare goals even after discharge.

Leadership
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Many people consider leaders to be someone in an official authoritative role, such as a

Director of Nursing or Nurse Manager. However, a leader is anyone who has the power to drive

change in an individual or group. Nurses are leaders. We define healthcare and have the

dynamism to effectively change the lives of our patients. Patients enter facilities at a vulnerable

time. They sense that something is not well within themselves and seek medical attention for

advice and healing. Nurses lead the way – we assess patients during these vulnerable times, we

address the chief complaint, and educate patients to get them back on track with their health.

Being proactive when providing care is an effective way to display leadership (Jennifer Thew,

2018). By anticipating the needs of your patient, nurses guide patient care and make the patient

feel secure because they know you have their health under control.

On the Heart Failure Unit, we have many patients who are newly diagnosed with Heart

Failure. They require a lot of education, reassuring, and reiterating. Often times, they receive the

news of the diagnosis later in the course of the disease process. This is life-shattering because the

life they once knew needs to be completely changed in order to fit their new level of health. As a

nurse on this unit, it’s imperative to lead the way. These patients are admitted under our care and

sometimes know very little about what is happening to them. It is our roles as Heart Failure

nurses to assess what they already know and give them the tools to be experts in their care. I

recently had a patient who was diagnosed with Heart Failure and spoke very little English. In this

patient’s culture, showing signs of distress or pain is frowned upon, which may have been the

reason he did not seek medical attention sooner. He came to the hospital because of excessive

weight gain and dyspnea. I realized what this diagnosis could do to his family dynamics, but I

wanted to make sure he fully understood everything there is to know. I quickly utilized hospital

resources (i.e. the blue language phone and interpreter services) to complete his admission and
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explain his plan of care. I anticipated the need for understanding his new diagnosis and used my

resources to be sure he was up to speed with this his health. Ultimately, being a leader does not

require an official title, but one must be compassionate, caring, attentive, assertive, and

proactive.
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References

Bradley University. (n.d.). The Nursing Shortage and How It Will Impact Patient Care.

Retrieved from Bradley University: https://onlinedegrees.bradley.edu/blog/the-nursing-

shortage-and-how-it-will-impact-patient-care

Jennifer Thew, R. (2018, June 26). 3 Ways Nurse Leaders Influence Change In Healthcare.

Retrieved from HealthLeaders: https://www.healthleadersmedia.com/nursing/3-ways-

nurse-leaders-influence-change-healthcare

Nurse Journal. (2019). Retrieved from Social Community for Nurses Worldwide:

https://nursejournal.org/bsn-degree/top-9-advantages-of-a-bsn-degree/

Nurse Theory. (2019). Philosophy of Nursing. Retrieved from Nurse Theory:

https://www.nursetheory.com/philosophy-of-nursing/

Petiprin, A. (2016). Nightingale's Environmental Theory. Retrieved from Nursing Theory:

http://nursing-theory.org/theories-and-models/nightingale-environment-theory.php

Registerednursing.org. (2019, July 6). The Importance of the Nurse-Patient Relationship for

Patient Care. Retrieved from registerednursing.org:

https://www.registerednursing.org/importance-nurse-patient-relationship-care/