Abstract In nursing, my attitudes, values and beliefs will be the frameworks that guide the actions I will take, and encompass the rationale for why I am doing them. In this paper I discuss my own philosophy of nursing and how it will influence my practice. My personal theory is influenced by the holistic approach of Betty Neumans Systems Model and the practice of prevention in Penders Health Promotion Model. There are certain traits nurses must possess to be able to apply these theories, such as empathy and authenticity. I also discuss the importance of a nurses roles as a patient advocate, educator and decision-maker. A nurse must use these skills and the application of these theories to counter the negative issues in health care, such as decreased quality of care, barriers to access, and rising health care costs. Health promotion and holistic interventions are the keys to reducing health care costs and providing effective patient care.
My Professional Nursing Philosophy
My Professional Nursing Philosophy According to Dictionary.com, the definition of philosophy is the rational investigation of the truths and principles of being, knowledge, or conduct. Every discipline has its own philosophical foundations, and nursing is no different. Developing a nursing philosophy is an important process that every nurse should explore. It helps to guide the type of nurse they will become, along with the important theoretical principles to will follow while practicing. Our beliefs affect our actions, so as nurses we need to analyze our personal values and how they will influence our patient care. My own personal nursing philosophy is one that stresses the importance of authenticity, encourages health promotion, and creates plans of care that incorporate holistic interventions. My philosophy is mostly influenced by the health promotion model of Nola Pender and the holistic approach of Betty Neumans Systems Model. According to Betty Neumans model, a person is a client system that is composed of physiologic, psycholocial, sociocultural, and environmental variables (Craven, 3009). A patient should be seen as more than just their disease process. Each person has unique personal characteristics and experiences that affect their behavior (Saleem). These behaviors in turn influence their health. Health is far more than the medical definition of the absence of disease. Neuman defines health as the condition in which all parts and subparts (variables) are in harmony with the whole of the client (qtd. in Saleem). Health is measured by the balance of the four contexts of physical, psychological, social, and spiritual well-being. If one of these areas is lacking, a person will not be able to reach optimum wellness (Craven, 2009). I believe it is a nurses role to examine all four of these contexts and encourage interventions that benefit every aspect of a persons being. My Professional Nursing Philosophy
There are few key characteristics and roles that a nurse must be in order to be successful in applying these theories. A nurses role has expanded to be far more than that of just a caregiver. Todays nurse is a decision maker, educator, manager, patient advocate, and much more. A nurse must be able to prioritize interventions, think critically and communicate effectively all while building a partnership with the patient for their plan of care. A nurse must practice and refine superior therapeutic communication skills to in order to build a positive rapport and level of trust with the patient. To reach and impact the patient the nurse must portray, what I believe to be the most important attribute, authenticity. Patients will react to our interventions positively if we can demonstrate a truly genuine desire for their well-being. Once a nurse is in possession of these qualities, they can effectively apply the theories of Neuman and Pender into practice. By using the aforementioned techniques, the nurse can determine underlying barriers that are contributing to a patients negative health behaviors. According to Penders theory, perceived barriers can constrain commitment to action (Saleem, 2011). We must inspire our patients by illustrating the reasons they should want to help themselves and how positive health behaviors will improve their quality of life. It is wonderful that we care for patients while they are in the hospital setting, but we need to take the steps to ensure health promotion behaviors to reduce their risk of them coming back. A nurse spends the most time interacting with the patient over any other healthcare personnel. There are many opportunities to educate patients about their health status and learn about their personal health beliefs. I can use the time during changing dressings, bathing or while performing assessments to use therapeutic communication and to learn more about their perceived stressors. My Professional Nursing Philosophy
Many people believe that health promotion services are a waste of time and resources, but I believe the opposite to be true. Pender argues, Major emphasis on health promotion has the potential long-term benefits of extending longevity, enhancing the quality of life, and reducing health care costs (Pender, p.798). I am personally reminded of the old saying give a man a fish and he will eat for a day, teach a man to fish and he will eat for a lifetime. In order to be an effective teacher the nurse must ensure that the teaching techniques being used are effective and that the plan is individualized to meet the patients learning needs. A nurse must also evaluate the patients comprehension of the information. One of the propositions of Penders theory is that the Perceived competence or self-efficacy to execute a given behavior increases the likelihood of commitment to action and actual performance of the behavior. The patient is more likely to comply if they fully understand the behavior and believe they can do it. In order to make preventative healthcare a reality nurses have to do their part to advocate health promotion and do their part in controlling rising healthcare costs. As a nurse I will do this by advocating for healthcare for all individuals regardless of their prior condition, social standing or economic status. I will follow Penders model of health promotion because primary prevention is more economically feasible than tertiary care. In order for this model to be successful, we need healthcare administrators that will take responsibility for their actions and make educated decisions about quality control and allocation of resources. The current practices of hospitals and insurance companies reinforce the bottom line and profit margins, instead of being concerned with the quality of patient care. Rising health care costs is a hot political topic in our country as we face an ominous need for health care reform. The Neuman Model incorporates the concept of client wholeness, the goal of optimal health and utilization of primary prevention strategies to maintain wellness (Neuman 111). A My Professional Nursing Philosophy
positive aspects of the Neuman System Model is that it is open to interpretation and is still relevant today. An idea I relate to in Neumans Theory is idea of stability, a state of balance of harmony requiring energy exchanges as the client adequately copes with stressors to retain, attain, or maintain an optimal level of health thus preserving system integrity ( Saleem). While Neuman defines stability in her model, her theory itself is contradictory as it is constantly being interpreted and updated. In 1989 Neuman added the idea of a spiritual variable to her holistic paradigm. Neuman explained why she added it, Although a new approach for medicine, nursing has integrated spiritual care into nursing since the days of Nightingale. Research is demonstrating the importance of the spiritual variable to recovery of health (p.111). Adding spirituality truly emphasizes the importance of holistic care. We must not only be concerned with the physiological, sociocultural, phychological aspects of our patient, but also their spiritual well-being. Neumans basic theory of holistic medicine still holds true today with ability to be open to interpretation and adapt to the times. Both Neuman and Peders theories emphasize the importance of nurses continuing their education. This is an ideal that I will strive to achieve during my professional career. It is imperative that nurses be informed on the latest evidenced based practices and newest research findings in order to provide the most efficient and effective care possible. While technology is a blessing it can also be a curse as well. As nurses, we need to do our part to avoid any unnecessary expensive and invasive interventions. Many extraneous tests can be avoided just by a nurse having the proper assessment skills. I think nurses need to get back to the basics. Instead of a heavy reliance on technology, we need to promote the importance of proper evaluation techniques and good therapeutic communication skills. Technology should be used in conjunction with proper assessment technique, and not in place of it. My Professional Nursing Philosophy
While we have a profession responsibility to patients, we also have the opportunity to be role models. As a nurse I recognize the potential influence of my own hypocrisy. In the research paper written by Esposito and Fitzpatrick, one can see firsthand the influence of a nurses own personal behaviors and how they can affect the health promotion education to patients. In the study it was confirmed that nurses who believed and engaged exercising regularly were more likely to recommend it in their patients treatment plan. Nurses that did not exercise regularly were less likely to do so (Esposito, 2011, p.352). It is not fair to ask things of our patients that we are not willing to do ourselves. In conclusion, a nurse has to advocate for the rights of patients, educate them on positive health behaviors, and manage their care through the effective utilization of available resources. As nurses we need to be adaptable to different patients and situations and be willing to cater our approach to every individuals needs. The philosophical ideals of Pender and Neuman will guide the foundations of how I approach patient care. I will always have the primary goals of prevention, health promotion and holism in the forefront of my mind. I will also remember that my own personal behaviors have an influence on my patient and how I practice.
My Professional Nursing Philosophy
References Craven, R., & Hirnle, C. (2009). Fundamentals of nursing. (6th Ed. ed.). Philadelphia: Lippincott Williams & Wilkins.
Dictionary.com. (2011). Definition of philisophy. Retrieved from http://dictionary.reference.com/browse/philosophy
Esposito, E., & Fitzpatrick, J. (2011). Registered nurses' beliefs of the benefits of exercise, their exercise behaviour and patient teaching regarding exercise. International Journal of Nursing Practice, 17, 351-356.
Neuman, B., & Reed, K. (2007). A neuman syestems model perspective on nursing in 2050. Nursing Science Quarterly, 20(2), 11-113.
Pender, N., & Pender, A. (1980). Illness prevention and health promotion services provided by nurse practioners: Predicting potential consumers. American Journal of Public Health, 70(8), 798-804.
Saleem, T. (August, 22 2011). Health promotion model. Retrieved from http://nursingplanet.com/health_promotion_model.html