Running head: PHILOSOPHY OF NURSING 1

Philosophy of Nursing

Alexa Shumate

NURS 4140

Dr. Turner

March 28, 2019

“I pledge…”
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Definition of Nursing

The true definition of nursing is very vague. I believe that the term nursing is more than

just a definition. It is a way to uphold values in order to properly care for a vulnerable. It is more

than just passing medications and taking vital signs. As a nurse, I am a natural caregiver. My

main priority is helping that patient get better whether it be physically, mentally, or spiritually.

Nursing is a lot more than just passing medications. I have prayed with families, had parties with

families to celebrate life, consoled families after a death, and many more things to establish a

relationship. Nursing is not only a career but a way of life. Only certain people are cut out to

become a nurse which is someone who is a caring, selfless, a health promotor, and an educator. I

have spent numerous days with patients and some that I just meet for the last hour of the shift,

yet I am always going to care for them in ways that no one will understand. I know that I have

always embodied the saying, “treat others the way that you would want to be treated.” I know

that as a nurse I need to create that deeper connection whether it is helping fully clean a 720-

pound patient or ensuring Ativan is given every hour to an alcohol withdrawal. It is always

important to give respect and go into every room being unbiased.

Personal Philosophy

A personal philosophy in nursing is a way to practice while caring for a vulnerable

patient population. My personal philosophy is always reflected within my nursing practice. I try

to stay as true to myself in all aspects of life. In order to have a patient fully trust me, I must be

able to give my whole during their care. I embody this by being present and truly listening to my

patient’s or the families concerns with care. It is very important to have this built trust when

caring for a patient and the family members because it opens opportunities to get more

information from the individual.

In addition, interpersonal relationships are very important when it comes to nursing. I

have numerous experiences when one of my coworkers had to help me. For example, when my

patient coded while I was on my break, every nurse on the unit was there for us helping her

maintain while we waited for the code team. My whole unit was helping us the entire time. At

one point, one nurse was helping keep our other patients on schedule with medications while

another nurse was admitting a new patient in our empty room. Without these interpersonal

relationships, I don’t know what we would’ve done. It is so important to help coworkers out

when they are struggling because it will always come back around in the nursing career.

Values and Beliefs

I have completely changed my values and beliefs since my original mindset. Although,

there are some values and beliefs that will never change. I am a strong believer in staying true to

yourself and not losing yourself when put into stressful situations. There are so many times that I

can lose myself when it comes to nursing. When my patient coded, all I wanted to do was at least

be present to the family. I didn’t want to or need to say anything I just wanted to be there for

them after she passed. My preceptor didn’t allow me to do that which I really wish I spoke up to

change that outcome. I already felt responsible for this death, then my preceptor didn’t allow me

to cope in the way that I needed to cope. I honestly don’t want that to happen ever again because

I now live with that hanging over my head every day. I think I have felt this way for so long

because I wasn’t able to stay true to myself. I had to follow along with what my preceptor

wanted me to do.

I think that my immersion has made me find myself more than any other point in my

nursing career. The fact that I wasn’t allowed to console a family in mourning was my breaking

point to realize that I needed to be myself regardless of it putting us behind schedule. A huge
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thing with my preceptor is that if it isn’t on time then we aren’t being a good nurse. That isn’t

true in my mind. I believe that being a robot is what makes you a bad nurse. The patient doesn’t

have a clue about medications being on time (except for pain medicine). I think me actually

being there and listening while assessing or passing medications isn’t all the time a patient needs

to open up to me. I don’t want to only be in a room when it is time to do something. That is a

huge a value that will change once I am on my own. I don’t want to be the licensed “medication

passer.” I want to be a nurse that gets nominated for Daisy awards and who truly makes an

impact on my patients.

Nurse-Patient Encounter

I have numerous memorable moments with patients that demonstrate the way that I

practice. Although, each patient is in fact different, so each patient has to have a different

approach when offering your true self. As a nurse, I obviously have numerous opportunities to

really change an outcome and have a great experience. I think the most memorable moment I

have was with a patient who was ambulatory, but she had been using a PureWick to collect her

urine when she could easily get up. When a PureWick is being used, it should not be used in the

chair in order to promote ambulation and get you ready for home where there isn’t anything like

that. Some of the other nurses had been putting it back on her while in the chair but I wasn’t

going to allow it. I had to break the news and the patient was very angry with me. She cursed at

me and even threatened that I had to clean up every mess she makes. I had to step back for a

second and calmly state, “I will be happy to do anything for you, but we have to focus on getting

you better. This will help promote you getting up because at home, you do not have the

necessary equipment.” I left the room to give her some time to process the situation and not too

much later she was requesting me by name. I go in there thinking she had made a mess and was
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calling me out of spite. Come to find out, she was calling me in there to brag about making it into

the bathroom and gave me a sincere apology. She thanked me for knowing what was best for her

even though it wasn’t what she wanted to hear. Sometimes changing something up for a patient

may not be ideal but it is always rewarding. I was confident that the change was what she needed

in order to be successful back home. I think it is very important to always trust my instinct

regardless of the backlash I may receive. There is always a chance for improvement.

Change Agent

A change agent embodies someone who both promotes and allows change to happen. I

think that as a nurse, I am one of the primary members that can encompass a change agent. I

have numerous occasions where patients are in dangerous or potentially detrimental situations

where things can be avoided if the proper rules where implemented. I think it is very important

having a voice because I am taking care of someone’s life. If things are not implemented in the

correct manner, patients can get seriously injured or pass away.

Recently our patient population has been getting heavier and heavier. The majority of our

patients have been total care where we need to help do everything including ensuring turns are

completed and bony prominences are offloaded. In the past month, we have had wound care

identify three deep tissue injuries. One is already too much for a unit let alone three with three

different patients. In order to address the disconnect that had been occurring, we were all asked

to come up with action plans to prevent skin breakdown. The option brought forth by our clinical

nurse leader was to do dual assessments every shift change yet everybody on the unit realized

how unrealistic it was. Our clinical nurse leader gave us the reigns to come up with ideas to

avoid doing dual skin assessments so often. As a change agent, I brought up the idea of creating

an avatar that is laminated in each room of front and back where we can draw on with dry erase
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markers and dating every time something is seen. I think it will be helpful in identifying problem

areas and keeping track of what the body looks like in the hospital. I determined that turn team

was not actually present or turning our patients like they are supposed to do. In fact, turn team

would see who the nurse is and document that “PMT no turn due to RN.” That was actually not

the truth because we audited multiple nurses of which stated that they never were asked. I

brought those audits to our nurse leader and our nurse manager in order to get the appropriate

people on board to address this issue.

Novice to Expert

Overall, I truly believe that learning never stops when it comes to nursing. I don’t

necessarily believe in the concept of truly becoming an expert. I think I am far beyond novice,

but I never think I will become a true expert in nursing. I also do not want to become an expert

because then I further stunt my learning. I will never allow myself to stop learning new

experiences. I will always treat my own knowledge as somewhere in between novice and expert.

I think this will help me in my practice of keeping my patients safe. I have always heard from

numerous nurses that the most dangerous nurse is the nurse that believes they know everything. I

don’t want to think I know everything. I want to take on new learning experiences every single

day of my nursing career.

I don’t believe that even the most “expert” nurse is actually an expert. I think it is

completely fine to have a mess-up because we are all human. For example, our nurse leader who

is always promoting safety had left the needle from an IV start in the bed of a patient which I had

found after an IV push. Luckily, it is the self-safety lock once you successfully put in an IV so it

wasn’t as bad as what it could have been. Although, it was a learning experience for everyone.

Another example is one of our long-term (12+ years) night nurses connected the wrong tubing to
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the patient so half of the potassium run was on the floor rather than in the patient of a 2.7 mEq/L

potassium level. It was a huge learning curve for me as a student nurse to bring up the error to

the nurse privately. With numerous instances, I don’t like to believe that even the nurses you

believe are experts are truly experts.

Action Plan for Moving Forward

Self-care is one of the most important aspects of being a caregiver. Without self-care,

burnout is more prevalent. Some practices that I already utilize for self-care include eating

healthy, going to the gym, monthly massages, face masks, and tub soaks. Every Sunday, I

already do a face mask and a thirty-minute tub soak. In addition, I take an 80/20% take on going

to the gym and eating healthy where I do both 80% of the time with some indulgence about 20%

of the time. I attempt to get a monthly massage depending on my schedule which helps with

standing on my feet for long periods of time. I fully stand behind self-care in order to stay fresh.

I have to care for myself before I care for others.