Running Head: NURSING PHILOSOPHY

Kyle Taylor
Philosophy of Nursing
Synthesis of Nursing 4142
March 23, 2015
Professor Wilkins

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Philosophy of Nursing

Nursing is a dynamic and rapidly changing field. It can be high tech and very fast paced.
In order to be a successful and efficient nurse, a person has to know why they want to be a nurse.
They must define nursing and then try to live up to that definition. For me, I would define
nursing as the art and science of caring in order to facilitate healing and incorporate optimal
health. Our programs philosophy statement supports my view and definition of nursing. Our
school defines health as a unity and harmony of mind, body and soul. Caring is defined the
application of nursing knowledge in practice, critical thinking skills, interpersonal skills,
assertiveness, curiosity, courage and humor. Finally our school maintains that nurses utilize
evidenced- based practices to deliver individualized care that is sensitive to the clients cultural,
spiritual and diverse needs (BSMCON Handbook, 2014-2015). As a nurse, we must use
techniques that are based on hard evidence in order to heal and care for our patients. We also
treat so much more than merely illnesses and diseases. We treat the entire spectrum of a person;
we help to heal the mind and soul as well as the body. Nursing is using all these techniques in
order to make a person better off. Nursing is caring for a person so their whole being is
operating at an optimal level.
My philosophy is made up from my personal beliefs and values. The single greatest
belief that I hold dear is patient centered care. Patient autonomy is a big part of this belief. The
patient should be the focus point for everything that we do. They have the final say in all
treatment options and must be treated as an equal partner in all interactions. My personal
philosophy is reflected in my nursing practice. I strive to always make the patient a partner in
the nursing process. I give them all the options and tell them what is happening. I ask for their
opinions and when they make a decision, I do my best to uphold it. This philosophy also extends

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into my interprofessional relationships. I always make sure to advocate for the patient no matter
who I collaborating with; whether it is a doctor, case manager or nurse. I strive to always defend
the patient and make sure that the patients views and wants are being considered by all medical
professionals.
On one occasion I can remember I had a discussion with a physician assistant about a
particular treatment option. They wanted to schedule the patient for an operation but the patient
did not want it. The patient got all of the information and made an informed decision. He was
adamant that he did not want the surgery. I acted as a patient advocate during this. I asked why
the patient did not want the treatment and opened a dialogue with him. He told me his reasons
and we had a very frank and informing conversation. Nobody else asked him for his opinion. I
then fought for what the patient wanted and treated them as an equal in the decision making
process. I acted as the patients advocate and he did not have the surgery. Together we changed
the physician assistants mind and he accepted the patients viewpoint.
Overall, my values and beliefs have not changed. If anything they have become stronger.
I wrote in my original philosophy of nursing paper that I held quality care, holistic care,
nonjudgmental attitude, and patient self-determination as core values. Beliefs that I wrote about
include: patient autonomy and the fact that a nurse is the first line of defense for the patient. I
still hold all of these values and beliefs in high esteem. These values have grown stronger the
longer I have been in nursing school. When I originally wrote that paper, I had not had any
clinical experience. Now I have almost nine hundred hours of clinical experience. These beliefs
and values were not tested before. Now that I have experiences, I have been able to try these
values and see if they are as truly important to me as I have said before. I can safely say that
these values and beliefs have been but to the test and have passed. Quality care and holistic care

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go hand in hand for me. Patients should always get the best care; there should be evidence that
the care they are getting truly is the best practice available. Patient self-determination and
autonomy are more important to me now that it ever has been. Before I only had a vague idea of
this value. Now as I have gained more and more experience, I realize that this value might be
the most important value in healthcare. I have learned that patients know more about their body
and their treatment options that we can ever know. They are the final decision makers and
should be treated as equals in the healing process.
Patricia Benners theory is a very interesting and well-rounded theory that is very much
applicable to us as graduating seniors. Her theory includes that idea that nurses travel through
different levels as they learn more and gain more experience. She states that we all start out as
novices, meaning that we have no experience in the situations that we are expected to perform in
(Benner, 2001). Nurses in this stage are taught in terms of objective attributes because these can
be recognized without situational experience. In other words, at first we do not know what to do
and are taught clear-cut black and white rules like vital sign ranges. The next stage in her theory
is the advanced beginner. This means that a person can demonstrate marginally acceptable
performances. These people have had real experiences to fall back on. They are similar to the
novice stage in that they are still reaction based. They react to a stimulus. The next stage in
Benners theory is the competent stage. This is where that nurse has had the same situations for
a good amount of time and develops long-range plans in which they are aware of. In other
words, the competent nurse uses critical thinking to develop a plan of care. This is that stage
where the nurse combines the objective data from the beginner stage and the aspects from the
advanced beginner stage to make decisions. They have enough experience to know what is
important and what is not important. The forth stage is deemed the proficient stage. This is

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where the nurse perceives situations as whole rather than in terms of aspects and performance is
guided by maxims. This is a continuum of the competent stage. The nurse understands and sees
that big picture, they are always thinking in terms of long-term goals. This stage is where the
nurse begins to rely on their gut; they stop thinking things through and instead relay on instinct
and experiences. The final stage is the expert stage. This stage is reliant on experience. They
have an enormous background of information to use no matter what the situation is. This is a
very intuitive stage; it is a continuum of the proficient stage. This is where the nurse relies
totally on instinct; they no longer have to rely on rules or maxims. They know what to do
because they have seen almost everything that the nursing field can throw at them. This is where
the nurse achieves the greatest proficiency of their field; they have reached the apex of the
nursing world.
The stage that I am in now would be advanced beginner. This stage is noted as the one
where nurses can demonstrate marginally acceptable performances. They have coped with
enough real situations to know the recurring meaningful situational components that are termed
aspects of the situation. Aspects require prior experience in actual situations for recognition
(Benner, 2001). In other words, the nurse in this stage uses prior experiences in order to perform
their job marginally well. They also begin to think in terms of abstract thought. They no longer
rely on objective tributes. They can think in subjective ways in order to do their jobs. For me, I
demonstrate marginally acceptable performances because I now have some experiences under
my belt. While I have not seen everything, I have seen a lot. While I may not understand
everything that is happening, I can make some connections and turn in a performance that is
adequate. I also have stopped thinking in objective tributes. For example, I know the correct
ranges for the vital signs of an adult. Now I can use subjective data in order to tell if something

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is wrong. For example, I someone is diaphoresis, I can infer that they are in pain or even that
their blood pressure may be high. If they are breathing faster or have cool extremities, I can infer
that their blood oxygen saturation is low or that their heart rate is too slow. I can use objective
and subjective data to make inferences. This is because I have had experiences in the hospital
and been in these situations.
There are a few things that I can do to move up the ladder from the advanced beginner
stage to the competent stage. The first thing I can do is get more experience. I feel like this is
the most important thing I can do. Benners theory explains that the next stage of nursing is
based on facing similar situations for two to three years. In order to become competent, I will
have to go to work and face these situations over and over again. I feel like this will help me to
become proficient in my nursing career.
The second thing I can do to advance up Benners ladder is to become familiar with
planning out care. I feel like the first two stages are based on responding to situations as they
come up. In order to move up the ladder, I will have to start to thing in long-term ways. I will
have to make goals at the beginning of the day and do my best to reach them. In other words, I
feel like I need to hear report and make a plan of care for the day. I need to stop responding to
situations as they come up; instead I need to plan for them instead.
The final thing I can do to move up Benners ladder is to work with other nurses who are
higher up on Benners ladder. The nursing care of patients needs to be backed up by nurses who
have reached at least the competent level of skill and performance, to ensure that important
patient needs do not go unattended because the advanced beginner cannot yet sort out what is
most important (Benner, 2001). By working with nurses who have more experience and are at
least on the competent level, this will allow me to learn more and grow. It will also make sure

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that the patients are safe. I feel like it would be a big help to have nurses working with me to
help me if I have any questions. I also feel as if this would allow me continue up the clinical
ladder.
Nursing is a complex field that is subject to rapid changes. This is because it is a
technological profession in which we rely on the best possible evidence available. Because it is
such a dynamic field, it is important for us to know why we are nurses. It is important to have
beliefs and values; as well as a personal philosophy of nursing. My personal philosophy of
nursing is patient centered care. This means several things to me. It means that the patient is a
equal partner in everything that we do. We do not tell them what to do; we sit down and discuss
with them their options. Patient autonomy flows from this belief. The patient is the decision
maker. It is ultimately up to them what treatments happen. Finally, patient advocacy flows from
this belief. Being in the hospital is a trying and scary place for a patient. It is up to the nurse to
always fight for the patient and make sure that their voice is the one being heard and listened to.
There are many theories about nursing; Patricia Benners is a very important and
fundamental one. Nursing involves stages of competency, and Benner lists the five stages that
every nurse goes through. Right now, I believe that I am in the advanced beginner stage. I have
some experiences that I can fall back on that allow me to make some connections. I still,
however, have a ways to go before I can be called competent. With experience I will move up
the ladder until I am an expert.

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References:

Benner, P. (2001). From Novice to Expert: Excellence and Power in Clinical Nursing Practice.
Upper Saddle River, New Jersey: Prentice-Hall.
BSMCON Handbook, 2014-2015.