Personal Nursing Philosophy

It is hard to argue that being a nursing practitioner involves a certain distinct professional standpoint, which determines the entire approach taken in the nursing practice. My personal nursing philosophy is a quite complex set of concepts, standpoints, and beliefs. Such a complicated layout of my professional philosophy is caused by 27 years of professional experience in multiple branches of healthcare and in different clinical roles. That is why my perceptions of basic healthcare concepts are often based on my professional expertise.

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My personal nursing philosophy is based on the delivery of reliable, extensive, flexible, and culturally sensitive care. I am striving for better standards of care and acquisition of the highest profiles in the nursing theory appliance, as long as my professional knowledge and flexible framework of practice will have a positive impact on patients. I also consider the social and environmental pillars of sustaining the patient's health, so that I consider myself a devoted user of holistic approaches to patient care.

Needless to say, my professional expertise has fostered a feeling of a larger context of health, so that the treatment of a particular patient should benefit the community as well. Thus, the following concept synthesis paper gives an account of my personal nursing philosophy in regard to various perspectives in healthcare.

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Nursing Autobiography

The experience of working with kids and their families motivated me to pursue a dream of becoming a family nursing practitioner. I decided to go back to school, and I was admitted to Miami Dade College School of Nursing, Florida. I graduated with honors from the Associate in Sciences Registered Nurse degree program in [insert year]. Following my career ambition, I continued my studies at the same institution where I graduated with the highest honors from the Bachelor of Science in Nursing (BSN) degree program in [insert year]. During the BSN program, I started working at [insert organization], which is a rehabilitation facility where the patients are admitted for treatment based on a surgical procedure and also has a floor for long term residents. For me, working with adults was a completely new experience, but at the same time, it was also an excellent source of learning and practice.

In [insert year] I was looking for a different nursing position, so I started working at [insert organization] as a Pediatric and Obstetric Nurse Case Manager. I currently work as a Pediatric Complex Nurse Case Manager at [insert organization] and I have been working for this organization for the past two years. [insert organization] gave me the opportunity to train many nurses as Case Managers in Pediatrics and OB Programs as well as to assist the fragile complex children with all of their health needs. I have the responsibility of facilitating services, promoting health, educating, and advocating for each patient's health needs and in some cases, for their state of self-sufficiency and independence. I also have the responsibility of being a communicator, coordinator, manager of care, and the leader of the pediatric team.

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Professionally, I have been in the healthcare field for the past 27 years working in different settings with adults and kids and practicing in two different countries; every new experience has become an essential part of my professional mindset. Recently, the experience of working with kids has helped me to realize my dreams, achieve some of my primary goals, advance my knowledge, and assist many people. Since my nursing passion for working with kids and their families goes further than my work as a case manager, I decided to continue my studies to the Master’s degree. I applied to [insert institution] and was admitted for the Master’s program as a family nurse practitioner.

The Four Metaparadigms

As any nursing practitioner, I recognize four metaparadigms: person, health, nursing, and environment. Thus, it is necessary to give a profound account of each paradigm.

  1. Person

A metaparadigm of a person (human) is best described by Dorothea Orem's nursing theory, which depicts a person as a holistic being. Hence, a person should be viewed as a complex of external and internal factors such as culture, personal physiological peculiarities, emotional state, habits, beliefs, social position, occupation, temperament, etc.(The University of Tennessee at Chattanooga, 2014). It is becoming increasingly apparent that a metaparadigm of a person aligns with other metaparadigms, as long as all nursing actions are positively directed towards a person.

The holistic nature of a person as an object of nursing practice suggests that all aspects described should be addressed by a nurse (The University of Tennessee at Chattanooga, 2014). Such scope of activities has already obtained a distinct framework, which is called holistic nursing and can be obviously related to my positioning of a person's metapardigm.

That is why I consider holistic nursing to be an appropriate field in terms of my definition of a person's metaparadigm. Beyond a doubt, holistic nursing is not just a practice framework but also a conceptual model, which includes a set of beliefs related to the positioning of a person in the clinical setting (Smith & Liehr, 2014). Thus, addressing the social, cultural, emotional, and psycho-physiological well-being of a patient is the most distinct expression of approaching a person as a holistic being.

It is informative to note that other nursing theories and approaches can address a person as a holistic being, but my personal belief is based on the fact that holistic nursing is specially designed for approaching a person as a holistic being, meanwhile, other concepts may follow a different philosophy and other frameworks for nursing practice (Smith & Liehr, 2014). At any rate, positioning of a patient as a complex of multiple perspectives and respectively addressing them is a relevant description of a person's metaparadigm.

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  1. Health

The World's Health Organization (WHO) defines a metaparadigm of health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity" (2003). It is worth saying that a social aspect is also mentioned. The presence of a favorable environment for cultural upbringing, education, work, leisure time, sufficient nutrition, hygiene, and accessing the general culture of health facilities the quality of care and basically create a fundamental constraint for quick patient recovery.

It is becoming increasingly difficult to ignore the fact that metaparadigm of health is aligned with metaparadigm of a person, as the definition of health is directly related to the approaching of a patient as a holistic being. The social aspect of health is often the preexisting factor, and this relationship clearly demonstrates it. For this reason, I consider the social aspect to be a strong component of health metaparadigm.

The World's Health Organization explains the above facts by describing specific social determinants of health, which include the conditions of living, birth, upbringing, work, and aging. These aspects are generally influenced by the allocation of financial resources based on local, national, and worldwide processes (World Health Organization, n.d.). Any healthcare practitioner is expected to address these outcomes implicitly as well explicitly in order to reach a standard of health. As a result, it is fair to admit that health is largely determined by the environment, and addressing a certain environment includes the establishment of health (World Health Organization, n.d.).

My vision of this metaparadigm is mainly based on the above argument, but it is also worth saying that health is not a result or a final outcome of nursing practice in its holistic meaning. It is no surprise that health is a constant state, and a fact of positive stability in social, cultural, mental, psychological, and physiological senses is the main determinant of health paradigm.

 
  1. Nursing

According to American Nurses Association (n.d.), “nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, facilitation of healing, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, groups, communities, and populations.” Taking this definition into account, nursing addresses the largest context of health and person metaparadigms.

Nurses are expected to consider their practice from a global perspective. In such a way, treatment of a certain patient presupposes taking his/her community into consideration, so that the community and any other social entities also benefit from their treatment. That is why the main purpose of nursing is to address a patient's health in terms of their communities and social settings. Again, a social aspect can be also traced in metaparadigm of nursing and thus render the best quality of care. Such evidence can be explained by a specific tendency, which is embedded in the metaparadigm of nursing.

To be more specific, a concept of an integrated model of holistic community treatment is traceable in the metaparadigm of nursing. The contemporary social context suggests that a patient should be positioned as a comprising element of a community (Bigbee & Issel, 2012). Nursing is aimed at addressing the health of the entire community through the treatment of its members so that metaparadigm is also aligned with a metaparadigm of person and metaparadigm of environment. My vision of this metaparadigm also includes a consideration that a patient should be approached from the perspective of certain social processes (Bigbee & Issel, 2012).

For example, the persistent popularity of information technologies results in the implementation of Electronic Health Record in clinical settings. Generally speaking, nursing is supposed to utilize current social benefits to approach a patient as a fundamental element of the community (Bigbee & Issel, 2012). Nonetheless, the nursing metaparadigm has to take into account broader terms of health, as the society also belongs to the metaparadigm of the environment, which is also worth discussing.

  1. Environment

According to Florence Nightingale, the environment can be defined as a number of conditions favorable for the treatment of a patient: ventilation, cleaning, lighting, heat, noise, odors, and nutrition. It is certainly true because patients are always present in a certain environment and basically are part of it. That is why the environment is a fundamental requirement to care, and its paradigm is preexisting (De Almeida Medeiros, Enders, & De Carvalho Lira, 2015). Florence Nightingale suggests that nursing itself is not a healing activity, but rather placing a patient in the most favorable environment (De Almeida Medeiros et al., 2015).

As a result, a patient naturally recovers in a favorable environment thanks to the reaction of the organism to the improved conditions of living. I accept such a standpoint, as quality delivery of health care is possible only in specific settings, which are created by nurses (De Almeida Medeiros et al., 2015). My past experience has proved this fact over the years in spite of the fact that healthcare has made significant scientific and technological progress within two previous decades. Henceforth, the environmental metaparadigm is a core determinant of healthcare.

It has become clear that the environment is a particular objective of nursing practice because the creation of a favorable environment for the patient recovery is a duty of healthcare practitioners. This issue has to be addressed in a global context but should not necessarily be added with the creation of a respective global environment for patient recovery (Smith & Liehr, 2014). A patient can undergo treatment in the clinical setting, but the provision of appropriate medication and nutrition, ensuring emotional wellness, specific procedures, and exercises address a holistic perspective of the treatment and hence internal as well as external environment of a patient (Smith & Liehr, 2014).

Such a mindset is entirely accepted from the perspective of my personal vision of environmental metaparadigm. Eventually, this paradigm as well as the perception of metaparadigms described above establishes my personal nursing philosophy and vision of healthcare practice, and I heavily rely on them in terms of the improvement of credibility and quality of extensive care.

Two Practice-Specific Concepts

Two practice-specific concepts that I consider to be persistent in my practice are the ones related to culture and care in nursing. Thus, they should be further discussed.

  1. Culture

To be more specific, I value the concept of cultural competence. This concept is based on the selection of specific behaviors, attitudes, and even methods of treatment determined by the cultural identity of the patient (Smith & Liehr, 2014). It is essential not only to recognize a certain culture but also to provide quality care according to the specific cultural constraints. Cultural competence requires equal treatment of all identities so that each patient should benefit from belonging to their culture throughout the process of receiving appropriate care (Smith & Liehr, 2014).

This concept guides me when I work with patients belonging to the group of ethnic minorities so that I analyze and suggest the most suitable means of treatment. As a rule, consideration of social and financial well-being becomes an important point, as cultural diversity requires a more flexible treatment plan and coverage of expenses due to the social disparities present in this respect.

  1. Care

As a matter of fact, care is an independent concept, so that my distinct vision of using this concept in practice should be discussed. Care consists of two dimensions: the personal peculiarities of a patient and the environment, in which a patient lives and is currently treated (Sapountzi-Krepia et al., 2013). Hence, the choice of relevant treatment, medications, prescription of the specific regime, nutrition, restriction to specific conditions, etc. comprise a response to a patient's state (Sapountzi-Krepia et al., 2013). That is why I consider care as decision-making aimed at addressing the patient's state and facilitating the environment favorable for the patient's recovery. Largely, I utilize this concept for the provision and recommendation of extensive care or suggestion of a particular decision concerning the lifestyle of a patient.

Propositions and Assumptions

In regard to the concepts described above, it is reasonable to outline the following statements:

  1. The concept of cultural competence may require the involvement of alternative methods of treatment, as many ethnicities and cultural groups may find these methods more suitable for their identity. However, scientific and clinical justification of these methods should be confirmed.
  2. Cultural competence is a determinant of the environmental paradigm. Culture can be described as a way of how the objective reality is perceived, which is why consideration of particular environments suitable for a patient is the essence of cultural competence. Any culture involves a culture of health, and its presence should be restored in terms of other cultural constraints.
  3. Care mainly depends on the environment. This statement can be largely observed throughout the entire synthesis of my nursing philosophy, as I strongly believe that the creation of an appropriate environment ensures and facilitates the quality care of patients. For this reason, I utilize care as a concept and rely on the framework of cultural competence, since they suggest a profound understanding and modification of the patient’s environment.
  4. The creation of a favorable environment for patients is essential but not absolute. Despite the fact that my nursing philosophy is mainly based on addressing the patient’s environment, it is fair to say that sustaining this environment as well as its relation to the global context is also crucial aspects of care. A patient may feel healthy in a closed environment, but his/her presence in a community or contact with other environments may still be harmful.
  5. Concepts of both care and cultural competence should be integrated and presented as a single methodological entity. Care and cultural competence are mutually related, but they are still discussed as independent units even though culture is often mentioned as one of the determinants of health.
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Concepts Integrated Into Philosophy

Basically, my nursing philosophy is also comprised of the following concepts, which are generically integrated into my daily practice. First of all, the concept of transcultural nursing should be mentioned. As it has already been discussed, taking a patient's culture into consideration is a key factor in addressing his/her environments in a positive way, which is why this concept plays a significant role in my professional philosophy. The other concept is health promotion. When I analyze patient's cases or address their treatment in any respect, I always attempt to foster a culture of health and acquisition of healthcare accessibility by managing specific means of treatment and scheduling a related medication course. The culture of health is often a crucial aspect to be considered so that it should be included to ensure extensive care.

On a separate note, skill acquisition is also an essential part of my nursing philosophy. Every healthcare practitioner is expected to enhance his/her professional knowledge and skills in order to deliver health care of the best quality (Mitchell, 2013). That is why the planning of professional growth and measuring personal performance is also included in my professional standpoint. These concepts are closely related to the role and change model. Each role serves a particular function in a clinical setting so that organizational change is possible in case each role is changed towards a specific objective without losing its original purpose.

Hence, the enhancement of professional skills and acquisition of new knowledge largely determines the role of functioning and changes within a healthcare organization to achieve positive outcomes. Lippitt's framework is reported to be the best methodological approach for the deployment of these concepts because it takes a proactive approach, which minimizes vulnerability to changes or failure (Mitchell, 2013). In such a way, my nursing philosophy involves numerous concepts and references to healthcare metaparadigms on various levels.

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Conclusion

It is appropriate to make a general comment on the fact that my nursing philosophy consists of multiple concepts and viewpoints, which address various healthcare metaparadigms on different levels. My primary vision of healthcare is based on the delivery of reliable, flexible, high-quality, and culturally competent care. That is why I proactively deploy two main concepts: care and cultural competence. Care is an independent framework that involves consideration of a patient's personal peculiarities and the creation of favorable environments aimed at facilitating a patient's recovery.

Consequently, I perceive the environmental metaparadigm as the most fundamental constraint for healthcare delivery. This statement implies the fact that my vision of nursing coincides with Florence Nightingale's definition, which describes nursing as a non-healing activity. Instead, the creation of a favorable environment for the natural recovery of a patient is the primary objective of nursing in this respect.

Furthermore, my nursing philosophy is profoundly influenced by the perspective of the social determinants of health. Culture, community, and emotional state play a pivotal role in the treatment of a patient, which is why I always try to address the global context of health so that a patient can feel healthy in a community, while the community is protected from the disease. Moreover, I value human attachment to a community due to the fact that the community's progress and achievements can be transformed into an effective means of treatment.

This mindset fosters my passion for modern technologies and approaches in the delivery of healthcare and case analysis. Taking all these aspects into account, it is reasonable to note that I recognize the metaparadigm of a person as a holistic being. Therefore, my performance in terms of holistic frameworks also facilitates the delivery of quality, reliable, extensive, and culturally-diverse care. Finally, I should admit that such complex professional philosophy is a result of expertise gained through the years of working in various segments of healthcare.

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