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Jun 12, 2019 in Review

Concept Synthesis on Personal Nursing Philosophy

Nursing Autobiography

The personal nursing philosophy has become an important element in my approach to the professional development as a nurse, promoting good patient care and quality life, as well as determining my values, beliefs and future directions. As a cardiology medical practitioner, my work involves interacting with patients who are suffering or recovering from various heart problems. Some of the conditions that I come across in my practice include congestive heart failure. Within some period, I had to help the patients from young children to the elderly people, either in ambulatory or surgical settings. Moreover, sick people came from sociopolitical backgrounds. My duties included helping patients to understand their conditions, educate them on some relevant health problems as well as procedures. I advised cardiology persons on lifestyle modifications such as quit smoking, correct nutrition, and involve exercise regimes. My other obligations included planning and making follow-up examinations.

 
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The Four Metaparadigms

The Meaning of the Four Paradigms of Nursing 

The four-domain meta-paradigm was articulated by Fawcett in 1985 as a ground for organizing nursing knowledge and beliefs regarding practitioner’s context and content. The paradigms include person, health, environment, and nursing. 

Person: I believe the nursing profession is basically about people. Thus, I view patients as the individuals first and make every effort to meet them in what I call I-Thou relationships. It is a two-way communication that is based on a dialogue (Hart, 2010). It is a relationship where I engage in encounters characterized by mutual awareness. I acknowledge that care involves a patient as a whole, and not simply only illnesses or health problems being treated. In that regard, I consider sick persons as in their own care. I also believe that they are a complex and multifaceted individuals who are on their life course, in which they are trying to do their best. 

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The overall outlooks take into consideration all the facets of the patient’s life. It is through this that optimum quality life for sick persons can be facilitated. As a nurse, I try to engage in meaningful encounters and as well establish real connections with the health care consumers being under my care (Creasia & Friberg, 2011). I acknowledge the existence of an innate power differential that exists in a patient-nurse relationship. Therefore, I prefer to use the term patient rather than client. 

Health: Nursing, as profession, involves being with health care consumers or communities. Moreover, it requires engaging in the moment. Indeed, health should be more about the quality of life that people live. Nurses encounter different health situations each day. As such, they have to make the meaning out of patients’ situations. For instance, as a nurse, I strive to attach significance to the things that can be felt, heard, observed, smelled, touched or imagined in my subjective interactions with sick people (Austin, 2011). This process requires meaningful relationships where we get involved actively as health care practitioners. In the hospital where I work, I routinely meet patients who have been traumatized in their lives or those who have suffered from multiple physical or mental health conditions. 

Environment: In 1860, Nightingale in her notes noted that nurses had the role of putting a patient in the best conditions for nature to act on him or her. This statement resonates with me. I acknowledge the concept that the environment has both internal and external components (Cribbin, 2011). The surrounding is not a static but dynamic state that exists on a continuum from wellness to illness as well as the shifts that occur in endeavor to respond to some environmental factors. The individual has to work symbiotically with the environment to help maintain it in the appropriate conditions. We have to appreciate that the role of individuals is to keep the state of the surrounding or make it different. The difference has to be positive. The role of nursing is not to cure. On the contrary, the practice is to ensure that people return to a stable or homeostatic state through the adjustments to external factors (Austin, 2011). In the community of health nursing, the concept of environment is broadened to both the natural and constructed surrounding, which plays a critical role in individual’s and population’s health. There is also a sociopolitical aspect of the environment that cannot be ignored in practice. By taking part in local community events and advocacy groups, I intend to create awareness as well as some change at the population level. 

Nursing: Nursing refers to the study of human health as well as the processes of illness. In fact, nursing practice helps to facilitate, support and assist individuals, communities, families or societies in a bid to improve, maintain or even recover from some health problems. In that way, the effects of illness can be ameliorated. Nursing being a relational practice and science is often geared towards explicit health outcomes related to the quality of life within the immediate and larger environmental frameworks. 

I can emphasize, according to this argument, that the notion of nursing as the practice entails collectively performing activities the shared intention of which is to enact things being beneficial. Even though a dual science-art based discussion about the nature of nurse’s care appears restrictive, I tend to think that it should be the way how individuals experience it. It is related particularly to the fact that it is a unifying factor. The concept of good care is extensive because it entails actions, relationships, and attitudes that promote wellbeing as well as dignity in all human aspects (Creasia & Friberg, 2011). I consider nursing the moral practice. The reason is that its purpose is to restore others and not to make profits or personal gains (Austin, 2011).  

Furthermore, I view nursing as a triune embodiment of caring behavior, caring relationships, and good care. Some of important activities include such skills as cognitive, affective virtues, and expert knowledge. Nursing practice is inherently moral because patients and nurses encounter each other in an act of trust, vulnerability, as well as power. The nurse is always concerned with improving the life of another person (i.e. the patient). This act is both humbling and profound.

Two Practice-Specific Concepts

The first concept that is specific to my own practice is the environment. In my nursing experience, particularly in the department of cardiology where I work, demonstrating mental strength is very critical when handling patients. I believe that mental wellbeing goes hand in hand with emotional one (Cribbin, 2011). Patients in the cardiology department require mental and emotional strength to go through their challenges. It is on these aspects where my role as a nurse becomes necessary. I consider emotional and mental wellbeing very important. The reason is that the two ones are the components of any surrounding. They make it a main paradigm among the four. Therefore, manipulating the environment affects the other three metaparadigms. 

In my environmental philosophy, I acknowledge the existence of internal and external surroundings, which I have to maintain at varying degrees of harmony. This belief is derived from the notion created by Creasia and Frigberg (2011). I believe in a nursing approach that is holistic. I also know that both the external and internal factors contribute significantly to the environment. Therefore, a person has to settle on the right choices to make the surrounding remain maintained in the best way possible. 

In my cardiology department, I often integrate small things that influence the environment in a way being conducive for healing. For instance, I always ask patients if there is anything that they need before leaving the hospital. I all the time remain attentive when talking to them and avail myself whenever there is any sick person who needs my help. While providing patient care, I apply critical thinking skills. Indeed, I apply Cribbin’s  philosophy (2011) that little things will always add up to big ones. Therefore, in that way, the world will continue to be a better place each passing day. 

Nightingale’s theory of the environment is a basic concept that states the important role that the surrounding plays in the wellbeing and health of every person. The setting is considered to be ideal if it comprises pure air, ventilation, water, light, and cleanliness. Nightingale emphasizes the need to acknowledge that individuals are in control of their health (Benner, Sutphen, Leonard & Day, 2010). The role of a nurse, therefore, is to ensure that the environment has fresh air, light, and water. The surrounding t must also be clean, quiet, and warm. The preparative processes that nurses perform support the manipulation of the environment. Its components that can be manipulated include light, warmth, diet, noise, cleanliness, and ventilation. My endeavor has always been to regulate various elements of the environment to bring back the homeostatic setting. 

The second concept that is specific to my practice is nursing. As a cardiology nurse, I believe my work experience is related to health, illnesses, and healing. Thus, I also rely on the practical borrowed knowledge from other disciplines such as anatomy, physiology, pathophysiology, pharmacy, sociology, education, and epidemiology. To a large extent, I have noted that the nursing practice in my cardiology department deals with physiological and psychosocial phenomena that are found in the complex persons. Therefore, my belief has always been that nursing must consider interpretive and empirical paradigms. 

The complex human phenomena can be easier understood and treated systematically as well as separately. Empirical phenomena appear more suitable in appreciating and understanding my patients and the type of care that they need. Since I consider nursing as more the practice, I have never been bothered of using borrowed knowledge. On the contrary, my concern is to ensure that it is implemented uniquely in my nursing practice. Nonetheless, my desire is that nursing needs will continue to be developed from the knowledge derived from other conflicting disciplines.  

List of Propositions or Assumption Statements that Connect the Concepts Described

  1. I strive to be authentic with my patients. It is true based on the narratives that I receive from sick persons in the cardiology department. After hearing from them, I endeavor to react depending on different situations that they present. Apparently, aesthetic knowledge has been enabling me to track possibilities through creative thinking. It also contributes to my personal style of nursing.
  2. Working with people from marginalized populations or communities who come to our cardiology department has helped me to recognize the oppressive structures affecting the health of society.
  3. I will continue to work towards meeting the health needs of nursing practice to catalyze the development of nursing knowledge.
  4. Nursing is not just about taking care of sick people that arrive at the cardiology department. For instance, the environment plays an important role in all four paradigms.
  5. Manipulating the surrounding a little bit can make a difference. However, a patient has to make the decision on whether to choose or reject the changes.
  6. By articulating personal nursing philosophy, I have become more confident on my values and beliefs about the metaparadigm as well as where nursing should go.

Conclusion

In conclusion, it is vital that each nurse develops and follows the personal nursing philosophy. In this way, medical practitioners are able to upgrade their profession, promote good patient care, as well as quality life. Personal nursing philosophy is also important in helping the one identify useful values, beliefs, and the direction towards which to develop his/her practice in future. Thus, in this way, health care providers are able to embrace and apply the knowledge of Fawcett’s four-basic meta-paradigm. The end result is the improved effectiveness by nurses even in the provision of services irrespectively of patients’ health conditions and their sociopolitical backgrounds.

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