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Philosophy of Nursing Education, Advanced Nursing Practice, and Nursing Administration

Philosophy is a system of beliefs and values that direct individuals and groups in achieving organizational goals. Kim (2015) defines philosophy as a reflection on experience and the relationship between the experience and its object. Philosophy does not add knowledge quantitatively, but it creates a better and new understanding of what is already known. Nursing philosophy can be defined as a framework that guides nurses’ thinking, interpretation, and practices. Thus, a philosophy deepens the understanding of the nature of nursing practice and of other components, such as education and administration.

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Philosophy of Nursing Advanced Practice

Advanced practice nursing (APN) promotes holistic care that encourages nurses to apply evidence-based practice and develop competencies needed to make complex clinical decisions. In the rapidly changing healthcare environment, the field of APN requires clinical judgment and critical thinking for the successful development and implementation of the ideas. The art of advanced practice nurses (APNs) actualizes through therapeutic nursing interventions that require the creative application of knowledge in inpatient care. Holistic care is guided by a philosophy of living and is grounded in such aspects as relationship, interconnectedness, and caring (Kim, 2015). APNs use clinical judgment and critical thinking to deliver care based on the current knowledge in order to achieve an optimal level of patient outcome in a highly diverse healthcare environment. Critical thinking is an essential skill in solving clinical problems and making decisions. Papathanassiou, Kleisiaris, Fradelos, Kakou, and Kourkouta (2014) assert that nurses need a high level of critical thinking skills to implement efficient and safe interventions. APNs adopt positions that promote critical thinking to solve cases with neither specific procedures nor clear answers, and they make decisions on complex issues. The combination of critical thinking and creativity helps APNs find solutions to clinical problems. Creativity helps them generate ideas, develop original solutions, and act independently. Nurses demonstrate APN when they combine clinical expertise with critical thinking skills and knowledge learned through nursing education for application in clinical practice.

Nursing paradigms play a central role in the development of APNs’ philosophy because they determine nursing goals and scope of practice. The paradigms require nurses to share values and assumptions on four concepts: human being, health, nursing, and environment. The concept of human being helps nurses treat a person as a whole. Humans are viewed as holistic beings with unique life experiences. The human being consists of several interrelated dimensions that influence individual behavior and health, and they include sociocultural, intellectual, spiritual, psychological, and biological dimensions. According to Kim (2015), the patient-centered approach ensures that advanced practice nurses respect patients and provide care that meets their unique needs. The nurse-patient relationship plays a crucial role in patient-centered care because it improves communication and helps APNs understand individual health needs and factors that shape health beliefs. Understanding cultural diversity and accepting individuals as a whole helps APNs apply a holistic approach in their practice to achieve the optimal patient outcome.

Health is the synthesis of wellness and illness that focuses on the nature of an individual in moral, social, and physical realms. Bahramnezhad, Shiri, Asgari, and Afshar (2015) allude that health care meets not only physical needs, but also spiritual and emotional ones, and it improves health and well-being. Wellness is based on the correlation of caring and illness — it is the experience of dysfunction mediated by caring relationships. APNs apply an integrative approach that uses various treatment modalities to increase patient engagement in learning opportunities, and it focuses on the body, mind, and spirit while taking into consideration the spiritual and cultural differences needed to treat a person as a whole.

The environmental aspect of advanced nurse practice comprises physical, cultural, and social settings in the health care environment where patients stay as they receive care. Implementation of new legislation and knowledge of the healthcare delivery model plays an integral role in the management of individual, families, and community health. APNs must have a sound knowledge of the patients’ environment to develop innovative means for delivery care. Technological advancement provides opportunities for APNs to create an online environment and monitor patients’ health at their homes (Bahramnezhad et al., 2015). These technologies help APNs decrease hospital admissions, readmissions, and emergency department visits through early intervention care and preventive services.

Nursing is another concept of a metaparadigm guided by the values of responsibility, choice, and human freedom. According to Bahramnezhad et al. (2015), the foundation of APNs revolves around human care, enhancing health outcomes, preventing illness, increasing wellness, and restoring health. Nursing education that includes multidisciplinary collaboration, information technology, evidence-based practice, and system leadership helps APNs develop competencies needed to practice in the entire healthcare continuum. Nursing care incorporates nursing therapeutics such as emotional support, health teaching, and comfort measures.

Philosophy in Nursing Education

Nursing education seeks to equip students with the skills and knowledge needed to deliver competent and safe patient care after transitioning from school to a clinical setting. Today’s nurses are challenged to deliver competent and safe patient care to diverse patients with respect to socioeconomic factors, race, ethnicity, and age. High patient acuity combined with continuous technological advancements and an increasingly vast body of nursing knowledge requires nursing students to be equipped with critical thinking skills (Papathanassiou et al., 2014). Nurse educators are challenged to prepare nursing graduates to ensure that they have the skills needed to manage complex patient conditions. Nursing students must be equipped with the skills, knowledge, and competencies needed to provide care in today’s healthcare environment (Botma, 2014). Nursing education can help students develop competencies in critical thinking, system thinking, decision making, communication, and leadership.

The transfer of knowledge gained in the nursing school is a philosophy that guides nursing education. Anderson (2015) asserts that transfer of knowledge and skills must occur for a nursing student to progress from novice to expert. The nursing environment is rapidly evolving and thus students should demonstrate the ability to transfer their acquired knowledge to the clinical setting while making decisions based on critical thinking specific to the situation. Nursing education helps students apply what they have learned in a clinical setting. The inability of new nurse graduates to transfer what they have learned in class into the real world is explained by the failure of nurse educators to use strategies that promote the transfer of knowledge. Nursing education based on practice helps the student learn how to transfer theoretical knowledge into the clinical setting. Clinical laboratories provide a setting that adequately prepares nursing students for practice in a clinical environment and enables them to link the theory with clinical practice. Nursing education that exposes students to a variety of clinical situations ensures the development of competencies and skills needed to transfer learning to the increasingly complex healthcare environment.

The philosophy of nursing education emphasizes the importance of simulation training for enhancing clinical experiences required for the development of professional nurses. Simulation increases nursing students’ motivation to apply the skills and knowledge they have gained in school into practice in order to meet patients’ needs. According to Botma (2014), many nursing education programs have introduced simulation training to help new graduate nurses address complex patient situations in clinical settings. Simulation provides opportunities for experimental learning during which nursing students can apply previously learned information and acquire practical skills. Anderson (2015) reported that simulation equips nursing students with clinical thinking and clinical judgment skills needed to facilitate competent patient-centered care and to accommodate the more competent new graduate nurses upon joining the practice setting. Simulation provides an opportunity to apply theoretical skills and knowledge to a practice setting, and thus it bridges the theory-practice gap.

Nursing education is associated with several outcomes, including knowledge derived from humanities, science, and arts. It also improves students’ ability to think critically, communicate effectively, reason in an ethical way, and integrate learning and practice. These outcomes are necessary for nursing students to practice in a rapidly changing world and adapt to the increased complexity of the scope of practice (Rozier & Scharff, 2013). Nursing students need liberal education to transit from school to clinical settings successfully. Fleeger and Connelly (2012) define liberal education as a philosophy of education that empowers nursing students and liberates their minds from ignorance. Nursing education relies on the expertise of the liberal arts and sciences to help the nursing students become competent, empowered, and compassionate professional nurses capable of meeting the challenges of the increasingly complex health care environment.

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The value of liberal education regards promise as the best way to support the development of critical thinking skills and the nursing profession. The integration of nursing and liberal education helps students develop skills needed to deliver high-quality care, such as communication, collaboration, diversity management, critical thinking, as well as application of knowledge from the fields like sciences and humanities needed to solve complex patients’ issues. Liberal learning helps nursing students understand human wholeness and the complexities of human experiences that influence health (Rozier & Scharff, 2013). A liberal education prepares nursing students for the broadening of their scope of practice by helping them gain a deep understanding of social, economic, political, and cultural issues that affect patients and influence the delivery of health care. Moreover, liberal education helps nursing students make the connection between clinical situations and learning. Integration of nursing education with humanities, arts, and sciences provide an opportunity for the study of the physical world, ethical principles, values, and forum through the application of knowledge gained during the nursing practice.

Another philosophy of nursing education is that it should be student-centered. Nursing education must provide an opportunity for students to learn according to their needs and interests. It must improve their understanding of human experience to enable them to deliver high-quality care. The design of the nursing curriculum is based on several concepts, including nursing process, person, and family (Rozier & Scharff, 2013). Nurse educators need to empower students to understand that human needs are manifested in diverse values, beliefs, and conditions, all of which are essential for humanizing patient care. The nursing education curriculum should increase student engagement in the development of knowledge by engaging in research addressing human issues.

Philosophy of Nursing Administration

Nursing administration philosophy consists of the integrated set of assumptions and beliefs about the management of the healthcare organization. Nurse administrators are the leaders and decision-makers in healthcare organizations. They create these assumptions and beliefs, which may be either implicit or explicit, in order to define the vision of the organization. Nurse administrators are informed through the philosophy of patient-centered care, strong knowledge of the broader health system, and knowledge of the complex issues encountered in the nursing profession (Papathanassiou et al., 2014). Nurse leaders demonstrate competency in the development of strategies aimed to improve patient health outcomes. They believe in cost-effectiveness that ensures delivery of quality care while reducing its costs. Nurses are required to deliver quality and cost-effective health care successfully in order to achieve organizational goals.

The philosophy underlying nursing administration is based on several elements.

First, nurse administration believes in the current knowledge required for the management of healthcare organizations in order to advance the nursing practice (Papathanassiou et al., 2014). Nurse administrators have a deep understanding of the relationship between research, education, and practice. Like APNs counterparts, nurse administrators search for empirical evidence during their research and apply it in their practice. Through education, nurse managers are adequately prepared to systematically record and evaluate decisions and actions and to apply evidence-based practice in making management decisions. Nurse managers’ decision-making practices differ from those of APNs. APNs makes many clinical decisions independently whereas administrators make only several decisions with the help of other nurse leaders and staff through the process of negotiation.

Second, nurse administration believes ineffective communication. In nursing administration, communication is based on interactions that nurses establish with staff when performing management functions in healthcare settings. Some of the functions of nurse administrators include the elaboration of standards, supervision of patient care activities, allocation of resources, and assessment of staff performance (Papathanassiou et al., 2014). Communication is fostered through philosophy established by nurse leaders. Nurse administrators who effectively communicate information and provide timely, considerate and respectful feedback enhance team performance. They make decisions with the input from the nursing staff who feel sufficiently empowered to speak. Effective communication enhances team relations and helps nurse administrators resolve conflicts. Human factors such as the lack of role clarity, misunderstanding, and lack of communication in a clinical setting can interfere with communication and the safe functioning of patient care. Nurse administrators minimize human factors that negatively affect the safety of the patient care by working toward building a just culture.

Third, nurse administration believes in the delegation of authority and responsibility. Much of the work accomplished by nurse administrators occurs not only through their efforts but also with the help of their team members. The delegation process is influenced by various factors. These factors include communication, nurses’ competency level, and role clarity. Empowering the nurses to make a decision based on their clinical judgment and critical thinking increases the effectiveness of delegation (National Council of State Boards of Nursing, 2016). Nurse administrators transfer the authority to perform tasks in different clinical situations to competent nurses who should retain accountability for the delegation. Effective delegation protects patient safety, enhances patient outcomes, provides accountability for nursing care, and reduces costs associated with care. Delegation empowers the nurses to make clinical decisions, and when used appropriately, it ensures safe and competent nursing care.

Another element is human relations where nurse administration applies the principles of social psychology in order to improve the work of the organization, make it more productive, and improve its efficiency. Nurse leaders believe that nursing staff desires to be a part of a supportive team that facilities growth and development. They design techniques and policies to improve job satisfaction and employee morale. Nurses who receive attention and are encouraged to participate feel motivated to improve their performance, resulting in high-quality healthcare.

Conclusion

The philosophy of APNs, nursing education, and nursing administration revolves around the establishment of the collaborative working relationship and effective communication needed for the delivery of competent health care. The set of beliefs and values that guide nursing professionals help nurses manage complex patient conditions in an increasingly complex health care environment. APNs, nurse administrators, and new graduate nurses need critical thinking skills, communication, and evidence-based practice to navigate in a rapidly changing world. Current knowledge and integration of theory into practice play a crucial role in the delivery of competent care aimed to achieve the desired patient outcome. The transfer of knowledge learned during nursing education into clinical settings and management ensures the delivery of care that applies the holistic approach to meet the individual needs of the patients by healing their body, mind, and spirit while addressing all the dimensions that affect their health.

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