Philosophy of Nursing

Philosophy of Nursing Emma Edache Academic Pathway for PN Diploma to BScN Algonquin College PLA 5501 Professor C. Hurst March 2011

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According to Shrock, philosophy is an attitude toward life and reality that evolves from each nurses belief (Edward, 1997, 1089). I generally agree with this statement, I believe that each nurses perspective will be different based on their unique experience. Though many have different views on what Nursing means to them, while doing research to write this paper I found that the following words almost always surfaced in many of the articles on philosophy of nursing that I came across. Caring and compassion, nursing as a science and an art, a passion; to mention but a few. I have decided to focus my attention on effective communication and what this means to nursing. I favour the view of Potter and Perry that helping relationships are the foundation of clinical practice I believe therapeutic nurse/ client relationship must first be established before everything else can follow. The dictionary defines communication as the imparting or interchange of thoughts, opinions or information by speech, writing or signs. There are many forms of communication; and nurses will often use other forms of communication in their professional role. However the interpersonal form of communication is the most commonly used and favoured by nurses. This is because it involves a one-to-one interaction between the nurse and another person that often occurs face to face. It is the level most frequently used in nursing situations and lies at the heart of nursing practice. (Potter and Perry, 2006, p. 261) Nurses are believed to be compassionate and caring persons. Some have described nurses as angels of mercy. There is this need in a nurse to alleviate the suffering of others. Nursing is a highly skilled profession, it consists of a body of knowledge and the application of knowledge. Having said that, nursing goes beyond caring for the physical needs of the client or performing

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unpleasant tasks for the client at a period in their lives when they are not able to care for themselves. According to Florence Nightingale people are multidimensional, composed of biological, psychological, social and spiritual components. In order to promote the health and well being of a client, the nurse has to take into consideration all of this other aspects of the client and not just the disease. The key to achieving this lies in effectively building an interpersonal relationship, which will foster a trusting relationship between the nurse and the client. Communication could be verbal or non verbal. Studies show that 85% of communication is non verbal. Effective communication could be simply listening, showing empathy, nodding at the appropriate time, hand holding or even silence. Nurses often come across clients from different cultural backgrounds as well as diverse values and belief systems. Regardless of the clients, background the professional nurse must be able to create a conducive atmosphere in which the client is comfortable to express their feelings, negative or positive. In other to achieve this, the nurse must be courteous and friendly, show respect and warmth, offer information and explanation, remember to ask for permission and involve the client as much as possible in the delivery of care. For example if the line of communication is not open, during an initial assessment visit the nurse is likely to miss out a lot of important information that might be important in caring for the client. When doing an initial visit for admission I would introduce myself and use the clients last name in referring to him or her, I would encourage the client to call me by my first name then ask permission to use the clients first name. I make sure to maintain eye contact all through

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interaction. I often engage the clients in a narrative interaction. I offer stories of myself, all the while being careful not to cross boundaries. This usually encourages the client to open up and allows me get a glimpse into some of the clients life experiences. In my practice of nursing I work in the community, my job involves going into clients homes to deliver care. I take the time to look out for non-verbal cues that might signal to me a need. This might include paying closer attention to minor details, reading the clients body language or reading between the lines. I am also careful to avoid showing disgust when doing certain procedures such as wound care or bowel routine. I watch out for clients facial expression when I am doing wound care in other to be sure that I am not causing pain. Feelings can be expressed through tone and facial expressions. I also see a lot of cancer patients in my practice of nursing. I provide care for clients who have had to undergo mastectomy due to breast cancer. These clients need a lot of sensitive emotional support. . They have self-image issues due to the loss of a body part; a lot of them are not comfortable speaking to family members. I find myself playing the role of a nurse, teacher, counsellor and advocate. In fact studies show that cancer patients develop an affective disorder within 2 or 3 months of their diagnosis. Communicative behaviours such as empathy, touching comforting and supporting have been identified as essential in providing care for these clients. Many at times I have had to bring to the case manager, the need for a client with a diagnosis of cancer to see a psychiatrist. I was able to see this need as a result of the helping-trust relationship I had developed with the client and clients family. The client and family feel free to trust me with their thought and feelings. They look to me for direction. The clients family is

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usually very anxious, especially the teenage daughters of a cancer patient who now live in fear of the dreaded word cancer. This I believe is what holistic nursing is about, not just focusing on the needs of the client but on the needs of the family as well. To achieve this level of care there has to exist a helping -trust relationship between the nurses, the client as well as client, s family. It is only after this is achieved that optimal caring takes place. Palliative care is another area of nursing that requires emotionally sensitive care. Communication is of extreme importance in meeting the needs of this category of clients. There absolutely has to be a therapeutic trusting relationship between the nurse, the client as well as the clients family. Nowhere is trust more important than in palliative care. The nurse often has to deal with questions from clients family who are anxious and fearful for their loved one. The nurse has to strive to be honest at all times, not withhold information or give false hope at the same time focus on keeping the client comfortable and pain free. Nurses often have to work in collaboration with other healthcare professionals. The importance of timely communication cannot be over emphasized. Timely documentation is very important for continuity of care or for legal reasons. It can literally save a clients life. It is team work between the nurse, the client and their family as well as the other health care professionals involved in clients care. The goal is always the same, to provide optimal care that will produce positive outcomes. Conclusion. A nurse is able to promote health in a client when there is helping- trust relationship between the nurse and the client. Hildegard describes nursing as an interpersonal process

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because it involves interaction between two or more individuals with a common goal (Hildegard, 2011). For optimal caring to take place, therapeutic relationship must exist between the nurse and the client. Effective communication is the key to establishing interpersonal relationship. Active listening is said to be the most critical strategy for communication. Not listening creates barriers to communication. When this is established the nurse is able to offer compassionate care that will lead to positive client outcomes.

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References Potter A., Perry A.G.,Ross-Kerr, J.C., & Wood, M.C. (2006) Canadian Fundamentals of Nursing (3rd ed.).Toronto,Canada. Jean Watson.(2011). Philosophy of Nursing. Retrieved from http://currentnursing.com/nursingtheory/Watson.html Peplau Hildegard.(2011). Theory of Interpersonal Relations. Retrieved from http://currentnursing.com/nurinstheory/Hildergard.html Florence Nightingale.(2011). Theory of Florence nightingale. Retrieved from http://currentnursing.com/nursing-theory/Florencenightingaletheory.htmlKruijver, P., Kerkstra, A., Bensing,J., Van de wiel, H.(2000). Nurse-Patient Communication in Cancer Care. A literature Review. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/10673804

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