DISCUSSION: PHILOSOPHY OF NURSING SCHOLARLY PAPER

Assignment Guidelines

As you begin to articulate your own philosophy of nursing, consider the following questions:

What is your definition of nursing?
What do you believe is the primary goal of nursing?
What key values are embedded in your philosophy of nursing? For what reason(s) are these values important to you?
Would you describe nursing as an art? Would you describe nursing as a science? Both an art and a science? Explain your choice.
In what ways does your philosophy of nursing guide your nursing practice? Provide at least one clear and specific example of a situation in which your nursing philosophy guided your nursing practice.
What is the relationship between your philosophy of nursing and the practice standards and codes of ethics/ethical guidelines for nursing practice as outlined by the Canadian Nurses Association and/or the regulatory body for nursing in your jurisdiction (e.g. CARNA, CNO, etc…)?
Is there a relationship between your philosophy of nursing and one particular nursing theory? Please explain the relationship between your philosophy of nursing and one particular nursing theory.

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DISCUSSION: PHILOSOPHY OF NURSING SCHOLARLY PAPER

My Understanding of Nursing

In this 21st century, nursing is an integral part of health care. It is a practice that requires the total attention of all those involved. Nurses are therefore required to work tirelessly, in order to identify as well as protect the needs of the patients. In my understanding, nursing is a profession that encompasses the collaborative care of individuals of all families, groups, ages and communities, whether sick or well, in all the settings. Nursing involves promotion of health, care for the physically and mentally ill, prevention of illnesses, and care for the disabled and the dying, in all healthcare and other community settings (Austgard, 2008). Key to nursing roles are the promotion of a safe environment, the participation in the shaping of health policies, and health systems management. Nursing involves the provision of non-judgmental care, regardless of race, spiritual beliefs, lifestyle choices, disability, financial statuses, or any other barrier (Palos, 2014).

Primary Goal of Nursing

A nurse is tasked with multiple obligations, including recording medical histories and symptoms of their patients, providing support and advice to their patients, collaborating with the nursing team to plan for patient care, educating patients about management of their illnesses and performing diagnostic tests. Nurses also monitor patients’ health and record signs, operate medical equipment and administer medications and treatments (Palos, 2014). However, I feel that the primary objective of nurses in the profession is to advocate for the health and wellbeing of their patients, regardless of their religious backgrounds or ethnic origins, supporting them through illness and health.

To a nurse, the patient is the first priority (Austgard, 2008). The nurse should, therefore, advocate only the best interests of their patients as well as maintain their dignity throughout treatment and care. This also involves suggesting treatment plans to the patients and other healthcare professionals. This is primarily important if the patients are too unwell to the point of not being able to comprehend medical situations as they should under normal circumstances. The nurses, therefore, play the role of being advocates for their patients and represent their best interests at all times, especially is there are treatment decisions to be made (Idczak, 2007). Advocacy also involves giving care to the patients and helping them manage their physical needs, prevent illnesses as well as treat health conditions. This is done by observing and monitoring the patients, recording the relevant information and aiding in the decisions to be made during treatment. The nurse will, therefore, follow the progress of the patient and act accordingly, on the patient’s behalf, keeping their best interests in mind. The advocacy is for the holistic care of the patients, which goes beyond their spiritual, cultural, developmental and psychological needs.

My Philosophy of Nursing

In the nursing profession, everyone looks up to someone or at least some lessons brought by someone in the past. As a person who strongly believes in nursing as an advocacy profession for the patients, I tend to gravitate towards one of history’s icon in nursing. This is the founder of modern nursing, Florence Nightingale. Nightingale was a change agent, who did so without compromise. She tirelessly fought for the rights of the oppressed especially during times of war (Clatworthy, 2010). One of her greatest achievements was when she was the superintendent for the Hospital for Gentlewomen in Distressed Circumstances. At one point, only members of the Church of England were allowed to be admitted, but she made changes to these policies, making it possible for people of all faiths, or none, to be equally admitted to the hospital (Clatworthy, 2010).

In the spirit of Florence Nightingale’s advocacy, so does my nursing philosophy lie. I am a stern believer of using the nursing profession, for advocacy of my and all patients. To me, advocacy starts with having a positive nurse-client relationship to protecting the rights of my patients. I use nursing to support my patient’s call, advise them on decisions in which my input as a nurse would be beneficial, and come up with the best decisions for them in case they are unable to render such judgment on their own. Florence Nightingale revolutionized nursing by focusing on prevention, individualized patient care, and nursing assessments (Idczak, 2007). Individualized care is very critical because every patient is different and should have their care assessed individually and accordingly. Assessing the patient’s situation and then advocating for them, is essential for maintaining their health. This is why I believe that advocacy is the key to success in the nursing profession.

Is Nursing an Art, Science or Both?

Nursing was taken as a science because, in the earlier days, it was not a separate and recognized discipline like chemistry or psychology. It was merely taken as a body of scientific facts and principles, underlying activities prescribed by physicians. Later on, nursing was moved to the university settings and it was, and still is, studied as a discipline on its own. This gave nurses the educational foundation they need, in order for them to apply scientific applications themselves, and not rely merely on faith. It also gave the nurses the basic college education, that could earn them advanced degrees in various bio-psychosocial sciences (Palos, 2014). Nurses, today, practice on evidence, are lifelong learners, serve individuals, families and communities in multiple roles, and are advocates for their patients. They provide direct care to patients in clinics and hospitals, are researchers, educators and administrators. They have become essential members of the healthcare team, collaborating with other professionals from various disciplines, in order to provide quality healthcare. This is why nurses are sociologists, physiologists, psychologists and anthropologists. Through these, nursing is a profession anyone can take up as a career (Pease& Kane, 2010).

Nursing is also classified primarily as the art of caring for the ill, based on the skills and intuition, even before the application of science. Nursing is a calling, as many like to put it. It involves caring, showing compassion, providing non-judgmental services as well as being culturally sensitive. It incorporates elements of soul, mind and imagination, making it an art. Nurses care for the whole person, spiritually, emotionally, mentally and physically. They also have to care for the patient’s family. They, therefore, provide respectful and dignified care to both the patients and their families (Palos, 2014). The profession’s core is interpersonal skills, and therefore involve the nurses’ sensitivity to, perception of, and expression of the patient’s thoughts and feelings. It requires creative approaches to providing care since all patients are not the same (Austgard, 2008). A practical example is where a patient cannot speak, requiring the nurse to use their artistic skills and sensitivities, to understand if the patient is in anxiety or pain.

It is my view that nursing is both an art and a science. A practising nurse has to incorporate the scientific understanding of the profession, as well as practice its artistic side. From the explanation provided above, it is incredibly difficult to classify, let alone practice one without the other. The art of nursing, as well as its science, are both equally important for the excellence of the nursing profession (Pease& Kane, 2010). The application and mastery of skills, as well as the formation of therapeutic bonds with patients and collaboration with other professions and sciences, makes nursing, in my view, both a science and an art.

My Advocacy Philosophy Guiding My Nursing Practice

Advocacy, as I believe, is not only for my patients and their families but also for the communities, for policy change, for the profession itself and for fellow nurses. They play the advocate’s role by being communicators, caregivers, liaisons, interpreters and educators to all those they visit or interact with (Austgard, 2008). Some time back, I had a case that involved one of my patients, who was critically ill and was under certain medication, which he said he did not like. He was uncomfortable with the medication, but he only revealed this to his son. His son, seeing that the father was becoming weaker due to him not taking his medication, approached me and asked me to intervene.

The biggest challenge was having the patient confess to me that he did not want to take the medication any more. As an advocate for my patient, I had to take his wishes and even though I could have been against them, I had to do as he so wished. I told him that the medication was the best in his situation, but if he was uncomfortable with it, we just had to look for other alternatives. I had to investigate further into his medical background and understand him and how well he would fair with a different medication. In the end, we found medication that worked well for him. It took more time for him to heal, but eventually, he became better. His son was advocating for me to force the original medication on his father, but as an advocate for my patient, I had to do what was best for my patient, not his family.

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My Advocacy Philosophy and the Code of Ethics in the CNA and CARNA

The Canadian Nurses Association (CNA) is the professional association that represents all the registered nurses in all of Canada. The CNA’s Code of Ethics for Registered Nurses brings out the ethical values of registered nurses as well as nurses licenced in extended roles, like nurse practitioners. The document informs everyone of the ethical values, endeavours and responsibilities of nurses in the country. It binds the nurses and the nursing profession to a code of ethics, in a regulatory process which protects the public. The 2017 edition of the Code, presents ‘advocating for quality work environments’ as one of the practices through which registered nurses need to adhere to (Canadian Nurses Association, 2017).

The College and Association of Registered Nurses of Alberta (CARNA), is the professional regulatory body for registered nurses, nurse practitioners, and nurses in research and administration and in direct care, in the province of Alberta, Canada. It is mandated to serve the public’s interest. Among the several mandates of the CARNA, one of them is advocacy for a high quality, and cost-efficient health care system, which makes best use of the skills and knowledge of registered nurses in Alberta (‘CARNA’, n.d.). My philosophy of nursing, which generally lies on the policy of advocacy, is therefore covered by both institutions.

My Philosophy and Nursing Theories

My philosophy on nursing is that nurses are advocates for their patients, their families, the communities, and the nursing profession. Although none of the nursing theories directly talk about advocacy as a philosophy, the closest to mine is Virginia Henderson’s Need Theory. ‘The Nightingale of Modern Nursing’s theory emphasizes that:

“The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will, or knowledge. And to do this in such a way as to help him gain independence as rapidly as possible. She must in a sense, get inside the skin of each of her patients in order to know what he needs” (Ahtisham& Jacoline, 2015).

She focused on individual care, where she described the nursing role as assisting individuals with essential activities, maintain health, recover, or achieve peaceful death (Ahtisham& Jacoline, 2015). In essence, although indirectly, Virginia Henderson is saying that the primary role of the nurses is to be the link between the patients and quality health, recovery and peaceful death, in such cases. Guided by this, I am comfortable saying that the advocacy role played by nurses, is more-or-less addressed by Virginia in her explanation of the Need Theory.

References

Ahtisham, Y& Jacoline, S. (2015). Integrating Nursing Theory and Process into Practice; Virginia Henderson’s Need Theory. International Journal of Caring Sciences. Retrieved from http://www.internationaljournalofcaringsciences.org/docs/23_ahtisham.pdf

Austgard, K. I. (2008). What characterises nursing care? A hermeneutical philosophical inquiry. Scandinavian Journal Of Caring Sciences, 22(2), 314-319. doi:10.1111/j.1471-6712.2007.00526.x

Canadian Nurses Association. (2017). Code of Ethics for Registered Nurses. CNA. Retrieved from https://cna-aiic.ca/-/media/cna/page-content/pdf-en/code-of-ethics-2017-edition-secure-interactive.pdf?la=en&hash=09C348308C44912AF216656BFA31E33519756387

Clatworthy, D. (2010). Nightingale’s legacy. Nursing Management – UK, 17(5), 8.

Idczak, S. E. (2007). I AM a NURSE: Nursing Students LEARN the Art and Science of Nursing. Nursing Education Perspectives (National League For Nursing), 28(2), 66-71.

Palos, G. R. (2014). Care, Compassion, and Communication in Professional Nursing: Art, Science, or Both. Clinical Journal Of Oncology Nursing, 18(2), 247-248. doi:10.1188/14.CJON.247-248

Pease, S., & Kane, S. (2010). art & science. The role of the nurse specialist in placement education. Nursing Standard, 24(49), 42-46.

What we do | CARNA. (n.d.). Retrieved from http://www.nurses.ab.ca/content/carna/home/about/what-is-carna/what-we-do.html