My philosophy of nursing is based on core beliefs that include compassion, empathy, person-centered care, advocacy, respect, professionalism, accountability, self-care, and life-long learning. Nurses have the responsibility to promote and protect the health of all of the patients in their care. In that regard, they should engage in life-long learning in order to deliver the best, most up-to-date, and appropriate care. Through evidence-based practice, nurses will be able to consistently deliver this type of care. I believe that nurses should be compassionate towards their patients and advocate vigorously for them. Each patient is unique and their particular needs will vary greatly. The nurse will need to treat the whole patient in order to deliver patient-centered care. Self-care is also a necessity for nurses as it becomes increasingly difficult to provide for others if they are struggling to maintain their own health. Nurses should always conduct themselves within their code of ethics and standards and be able to effectively work alongside, and collaborate with, a multidisciplinary team.

          My nursing philosophy can be applied in my current nursing practice in various ways. First, it can be used to carry out my job duties and responsibilities aimed at achieving the best possible health outcomes for my patients/clients. For example, the accountability, respect, and advocacy aspects can be used as the foundation for service delivery. Second, it can be used to enhance my knowledge and ability to provide the most up-to-date care and can be used to manage the direction of my continuing education. Third, the compassion and person-centered care concept can be used to improve the quality of care offered to my patients/clients by understanding their specific, unique needs and avoiding a “one size fits all” perspective.

          Lifelong learning gives nurses the necessary skills to address, treat, and resolve issues that they may encounter while taking care of their patients. When nurses are up-to-date on new techniques, policies and procedures, they are able to influence healthcare in several important ways. Improving patient outcomes and decreasing mortality rates are two of the most important issues that are improved when a nurse uses the most current information. As a nurse’s career continues, some of what they learned in nursing school may become obsolete. While nurses accumulate on-the-job experience, it may not be enough to keep up with the rapid and frequent changes in healthcare. Patients and their family members demand exceptional care. Even though many patients educate themselves about their conditions, they expect their nurses to know more about their conditions than they do.

           Over my six years as a nurse, it has become evident to me that nurses play a much greater role than what I thought coming out of nursing school. Nurses are not only responsible for interacting with others within the healthcare system, but also across a multidisciplinary team in the community. Nurses contribute to the development, implementation, and ongoing improvements in many processes. Nurses in a community setting are expected to be able to clearly articulate ideas, earn the trust of others, be accountable, empower others, teach, and advocate. These are a few of the reasons that I believe continuing education will help me as I move forward with my work as a consultative nurse for individuals with disabilities in the community.  Being able to contribute to IEP's (Individualized Education Plan) and LSP's (Lifetime Support Plan) is an essential function of the Consultative Nurse. I routinely work with a team of Social Workers, Behavior Analysts, Patient Advocates, Public Guardians, and families. Inclusion is something that is often talked about in the disability community. A consultative nurse will do their best to remove any health issues as a barrier for the individual "living their best life" and feeling and being included.

          As a Consultative Nurse for adults with disabilities, it is important that the nurse work well with a multidisciplinary team to identify all of the barriers that our clients face and develop plans to help them overcome those barriers. When one of those barriers is healthcare, then the nurse plays a vital role in developing a plan to assist the client and the staff person’s working with the client. Training, planning, advocating, and scheduling become top priorities for the consultative nurse. This overall plan has to be hyper focused on the individual, taking into account their particular disability, challenges faced, comfort level, and sensitivity (emotional and physical). 

          Person-centered care is a way of thinking and doing things that sees healthcare and social services as equal partners in planning, developing and implementing care to make sure it meets individual needs. This means putting individuals and their families at the center of decision-making and seeing them as experts, working alongside professionals to get the best outcome. As a consultative nurse for adults with disabilities, I understand that person-centered care is of the utmost importance. According to Faye Glenn Abdellah’s Twenty-One Nursing Problems Theory, “Nursing is based on an art and science that molds the attitudes, intellectual competencies, and technical skills of the individual nurse into the desire and ability to help people, sick or well, cope with their health needs.” The patient-centered approach to nursing was developed from Abdellah’s practice, and the theory is considered a human needs theory. It was formulated to be an instrument for nursing education, so it most suitable and useful in that field. The nursing model is intended to guide care in hospital institutions but can also be applied to community health nursing, as well (Faye Abdellah: 21 Nursing Problems Theory, 2014). “According to the model, patients are described as having physical, emotional, and sociological needs. People are also the only justification for the existence of nursing. Without people, nursing would not be a profession since they are the recipients of nursing. Abdellah’s typology of 21 nursing problems is a conceptual model mainly concerned with patient’s needs and nurses’ role in problem identification using a problem analysis approach” (Faye Abdellah: 21 Nursing Problems Theory, 2014). “Patient-centered approaches to nursing health are described as a state mutually exclusive of illness. Abdellah does not define health but speaks to “total health needs” and “a healthy state of mind and body” in her nursing description” (Faye Abdellah: 21 Nursing Problems Theory, 2014). This theory is in line with my own personal nursing philosophy. One that is person centered, taking into account the entire need of an individual. This will help in creating a person-centered plan that should produce the best possible outcomes for the individual.

            Patient-centered care is demonstrated through respect, response, and clear communication, and always asking patients their preference for which name they wished to be called (Walton & Barnsteiner, 2012). Patient-and family-centered care was first defined by the Picker Institute as improving health care through the eyes of the patient (Gerteis, Edgman-Levitan, Daley, & Delbanco, 1993). When patients and their families are involved in making decisions about their care, they feel like part of the team and not simply someone that things are going to be done to. Visitation policies are one area where healthcare teams can show to the patient that they are in fact part of the healthcare team and that their wants and needs matter. “Communication and collaboration are at the root of teamwork, but the education of health professionals is by individual discipline, both formally and in continuing education” (Disch, 2012). “Thus, there is little interprofessional contact until new graduates are thrust into practice settings to work closely together, often under stressful conditions. Between 1995 and 2005, ineffective communication and breakdowns in working together was the root cause of 66% of healthcare errors” (Hughes, 2008). “Adverse drug events most often occur at transition points in care or during handoffs, from one provider to another” (Hughes, 2008). Professionalism, respect, and accountability are also important concepts for the nurse. This can include conflict management, collaboration, teamwork, and leadership. Personality differences are a major reason for conflict, as well as the perception of conflict and preference for handling that conflict. Understanding personality types is important to improving communication and teamwork. People are sensitive about engaging in conflict and handle conflict differently because of their personality characteristics. This could easily lead one to believe that they are being bullied by another. “Nurses eat their young” may be born out of a lack of understanding of personality types. One of the biggest conflicts, in considering personality types, would seem to be the difference between operating on an emotional level more than a strict factual level and vice versa. These two differences could easily cause differences in the way a subject is approached. Another conflict would be the ability to be flexible and adjust on the fly. While some personality types seem able, and even willing, to change as things change and are open to new ideas, others seem to be less willing to be flexible. Challenges to deeply held beliefs could also present significant conflicts between personality types.

          Teamwork in the healthcare setting is vital to providing quality care to patients.  When everyone is on the same page and active participants in the care of the patients, goals are met. Being able to communicate and work as a team requires an appreciation and respect for each other’s practice.  Each member of the team has an important role and when that is recognized by all member it provides a sense of responsibility and accountability. Working together will help to ensure that the patient is getting the best possible care.  The patient should also be considered a member of the team and valued as all other team members. In order to deliver quality care, the patient should always be involved.

          Personal Wellness and self-care are also critical for today’s nurse.  There are five components of wellness: physical, spiritual, social, emotional and intellectual. Each one of these contributes to the overall wellness of the nurse and each must be addressed in some capacity. Empathy and compassion are vital components of a nurse’s care. The more stressed and overwhelmed a nurse is, the less likely they will be able to provide these things. We need to practice empathy and compassion for ourselves, as well. When you have anything left to give, care suffers. This puts the nurse and the patients at risk. Self-advocacy is every bit as important as advocacy for others.

          My personal nursing philosophy is based on my personal experiences, values, and beliefs as they relate to the body of work in nursing. I value the importance of patient-centered care and effective communication with the patient and family members. Also, effectively collaborating among health care professionals and a multidisciplinary team to ensure quality care for patients. Additionally, the importance of advocacy as one of the main roles of the nurse to promote better outcomes and increase the level of health in patients. These principles will serve as a guide for my personal standards of nursing practice.

 

                                                                                                          References

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Disch, J. (2012). Teamwork and collaboration. In G. Sherwood & J. Barnsteiner (Eds.), Quality and safety in nursing: A competency approach to           improving outcomes (pp. 91-112). Hoboken, NJ: Wiley-Blackwell.

Faye abdellah: 21 nursing problems theory. (2014, September 29). Nurseslabs. https://nurseslabs.com/faye-g-abdellahs-21-nursing-problems-theory/

Gerteis, M., Edgman-Levitan, S., Daley, J., & Delbanco, T.L. (Eds.). (1993). Through the patient's eyes: Understanding and promoting patient-centered   care. San Francisco: Jossey-Bass.

Hughes, RG. (2008). Tools and strategies for quality improvement and patient safety. In R.G. Hughes (Ed.), Patient safety and quality: An evidence-based   handbook for nurses (vol. 3, pp. 1-40). Rockville, MD: Agency for Healthcare Research and Quality. Retrieved from http://www.ahrq.gov/qual/nurseshdbk

Walton, M.K., & Barnsteiner, J. (2012). Patient centered care. In G. Sherwood & J. Barnsteiner (Eds.), Quality and safety in nursing." A competency   approach to improving outcomes (pp. 67-90). Hoboken, NJ: Wiley-Blackwell.

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