​Purpose of the Assignment

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 The purpose of this assignment is for the student to compare her initial perceptions during her first semester of nursing to her perceptions of the nursing career as a nursing student in her final semester. My philosophy of nursing at the beginning of this program is still very reflective of my philosophy as we near completion of the program. I have seen how each patient who has sought medical care is in need of nurses in one form or another, and that is why I prefer the holistic care of all patients through the nursing profession. Throughout this essay, I will communicate my own personal definition of nursing, what I believe to be my purpose as a nurse, and my assumptions and principles when it comes to developing as a nurse outside of nursing school.

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Student Approach to Assignment

 

It is important to be aware of my own approach to nursing so that I can be the most empathetic, educated, and motivated nurse so that I can provide the best holistic care for my patients. This essay allowed me the opportunity to define my own beliefs about nursing, to examine my strengths, and to identify my weaknesses so that I can continue to improve upon them. For example, in my first clinical shift at the Children’s Hospital of the King’s Daughters in the Emergency Department, a two-year old girl was brought in because a dog had bitten her face, leaving a 1.5-inch laceration on her nose with two puncture wounds above on the bridge of her nose. My nurse preceptor advocated for hours for the attending physician to call plastics because the wounds to her face were so extensive, because the patient was so young, and the parents so frightened for their daughter. Although the plastics surgeon did not come in and the attending physician sutured the girl’s lacerations, I learned a valuable lesson about my responsibility to advocate for my future patients. Although the girl’s parents were present, they did not know to ask for the plastic surgery team, therefore, it fell to us to do our best to get their daughter the care we felt she deserved.

 

Reason for Inclusion of this Assignment in the Portfolio:

 

Being able to define my own nursing philosophy will help me to provide care for any type of patient, even those with whom I may be totally unfamiliar. The following objectives for my portfolio were highlighted throughout this essay.

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Critical Thinking

• Uses nursing and other appropriate theories and models to guide professional practice.

  • I elaborated upon how I started my nursing career based on Leininger’s Culture Care: Diversity and Universality Theory. Leininger’s theory was the perfect foundation from which to build my own philosophy of nursing, which I expanded upon in this paper. Of all the tools that I feel it is most important for nurses to have, empathy ranks as the highest.

 

Nursing Practice

• Implements traditional nursing care practices as appropriate to provide holistic health care to diverse populations across the life span.

  • I worked to provide culturally competent care while volunteering at Sentara’s Ambulatory Care Clinic (ACC). I demonstrated awareness that nurses and nursing students play a vital role on any interdisciplinary team, since the students at the ACC were very influential on behalf of the gentleman for whom we interceded so that he could keep his oxygen tanks. I personally demonstrated this culturally competent care by leading the conversation with this patient, establishing rapport, and then identifying his areas of largest need for the rest of my interdisciplinary team. The gentleman had no insurance and no other oxygen supply; if he had lost those oxygen tanks, he would not have been able to breathe. The ACC connected him with another resource to ensure that he could get new oxygen from another provider. In addition, they intervened with the Sentara ED to get permission for him to keep the tanks for an additional week. Lastly, the student nurses worked to find a primary care physician who could see him for his COPD while the patient waited for his Medicare application to clear. All of these components would have taken a very long time to find a solution for, had it not been for the interdisciplinary team at this patient’s disposal.

 

Communication

• Uses therapeutic communication within the nurse-patient relationship.

  • I was able to comfort the elderly woman while she was a stroke  alert and while we waited for the nicardipine to bring her blood pressure down by being an affirming presence for her, even though she could not understand me at the time.

 

Research

• Evaluates research that focuses on the efficacy and effectiveness of nursing interventions.

  • I focused on the research that emphasized the importance of dignity, especially when working with patients who had previously been capable of caring for themselves. Nursing can be a frustrating profession, but by treating patients with dignity, nurses solidify their reputations as America’s most trusted professionals. I researched this topic and have linked it to my personal philosophy because I want to ensure the maintenance of my patients’ dignity while they are under my care.

 

Leadership     

• Articulates the values of the profession and the role of the nurse as a member of the interdisciplinary healthcare team

  • I discussed the vital role that a nurse plays within any interdisciplinary team, in the ER, or as a liaison for the doctor and a source of comfort for the patient. Originally, I was inspired by Leininger’s Culture Care: Diversity and Universality Theory. I believe that nurses must have a variety of tools or props in order to provide culturally competent care. First, I believe it is incredibly important for all nurses to be reflective of their practice, perpetually looking to increase their knowledge and to make their practice as culturally inclusive and competent as possible. Nurses must also commit to focusing on the most important medical issues in a patient’s care while also respecting a patient by actively listening and understanding the patient’s mental and psychosocial issues. I believe that nurses are also responsible for teaching patients about their illness, examining all situations through the lens of critical thinking, and provide a firm foundation of support for patients. Some patients may not have families or friends to support them, therefore, the nurse can play a vital role in the patient’s healing process by providing encouragement, comfort, connectedness, and trustworthiness.

 

Teaching

• Provides teaching to patients and/or professionals about health care procedures and technologies in preparation for and following nursing or medical interventions

  • I discussed the patient who was diagnosed with diabetes and how I spoke with him and his mother to reassure them that his diabetes could be well-managed with medication and that he could continue to live a health and active lifestyle.

 

Culture

• Articulates an understanding of how human behavior is affected by culture, race, religion, gender, lifestyle and age.

  • I believe that culturally competent care is an incredibly necessary component of any nurses’ care. I expressed that all patients should be treated with empathy and dignity, no matter their background, race, religion, gender, lifestyle, age, or sexuality. As previously mentioned, I was inspired by Leininger’s Culture Care: Diversity and Universality Theory.  This theory applies to how the human behavior of our patients is influenced based on their culture, race, religion, gender, lifestyle, and age. The ACC serves those who are uninsured or underinsured in this community, so their lifestyle greatly influences their ability and the resources necessary to maintain their health. Before embarking on the last four semesters of nursing school, I assumed that fulfilling each of these requirements of being a “good nurse” would look very similar from patient to patient. However, I realize now that there can be a huge variety of needs when it comes to various patients. The nursing care that works for one patient may or may not work for another, even if they have the exact same symptoms and medical diagnoses. All people are motivated by different things, and what I have learned about nursing is that all patients want to be “well” but that “wellness” presents in varying degrees; some of the acutely ill patients expect to achieve much higher levels of healing and wellness than do many chronically ill patients. I feel that my job encompasses recognizing each patient’s goal for wellness and working to incentivize, inform, and guide those patients along the path that I believe will allow them to reach their wellness goals.

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