PHILOSPHY AND THEORIES OF NURSING

VALUES

INTRODUCTION:

 Nursing is a work intimacy .Nursing practice requires you to be in contact with

patients physically , emotionally , psychologically , and spiritually .
 In most other intimate relationships you choose to enter the relationship precisely
because you anticipate that your values will shared with the other persons
 But as a nurse you agree to provide care to your patients solely on the basis of their
need for your services .

DEFINITION OF NURSING :

 The act of utilizing the environment of the patient to assist him in the recovery.

-Florence Nightingale, 1860

 “ The unique function of the nurse is to assist the individual , sick or well in the
performance of those activities contributing to health or its recovery (or to a peaceful
death) that he would perform unaided if he had the necessary strength, will or
knowledge; and to do this in such a way as to help him gain independence as rapidly
as possible”

-Virginia Henderson ,1973

DEFINITION :

VALUES:

 According to Hall et .al (1982) Values are the standards for decision making that
endure over a significant period of time in one’s life.
 According to King (1982) , values have four parts thinking , choosing , feeling and
behaving.
 A value can be described as an individual rule used in conducting one’s life.
  Values are enduring beliefs or attitudes about the worth of a person, object, idea, or
action. Values are important because they influence decisions and actions, including
nurses’ ethical decision making.

VALUE SET:

 Value set is the small group of values held by an individual.

 People organize their set of values internally along a continuum from most important
to least important, forming a value system.

VALUE SYSTEM:

 Value systems are basic to a way of life, give direction to life, and form the basis of
behavior , especially behavior that is based on decisions or choices.
 According to Rokeach (1973) Value system is an enduring set of principles and rules
organized into a hierarchy.
 According to Hall. et.al (1982) , Attitudes , beliefs and behavior are often linked with
values , but not the same values.

BELIEFS:

 Beliefs are interpretations or conclusions that people accept as true.

 They are based more on faith than fact and may or may not be true.

ATTITUDES:

 Attitudes are mental positions or feelings toward a person, object or idea.

 Typically, an attitude lasts over time, whereas a belief may last only briefly.
 Attitudes are often judged as bad or good, positive or negative, whereas beliefs are
judged as correct or incorrect.
 Attitudes have thinking and behavioral aspects.

MAJOR CATEGORIES OF VALUES:

 They are three categories of values:

 Operative Values.
 Terminal Values.
 Moral Values.
OPERATIVE VALUES:

 These are those values that are indicated by a specific behaviors , which may be
response or a performance.
 For example: Honestly sharing one’s observations indicates that honesty is valuable
to that persons.

TERMINAL VALUES:

 These are those values that are regarded as good in themselves . they transcend
immediate needs and shape long term goals.

MORAL VALUES:

 These are those values that are regarded as good in themselves , they transcend
immediate needs and shape long term goals.

TYPES OF VALUES:

 We can speak of universal values, because ever since human beings have lived in
community, they have had to establish principles to guide their behavior towards
others.

 In this sense, honesty, responsibility, truth, solidarity, cooperation, tolerance, respect

and peace, among others, are considered universal values.

 However, in order to understand them better, it is useful to classify values according

to the following criteria.

 It be classified into seven types of values:

 Personal Values
 Professional Values
 Family Values
 Socio cultural Values
 Material Values
 Spiritual Values
PERSONAL VALUES:

 Personal Values are learned values from society and perceived and internalized by an
individual as his own.

 These are valued in a family and are considered either good or bad.

PROFESSIONAL VALUES:

 Professional Values are acquired during socialization into nursing from Code of
Ethics, nursing experiences, teachers and peers.

FAMILY VALUES:

 These derive from the fundamental beliefs of the parents, who use them to educate
their children.

 They are the basic principles and guidelines of our initial behavior in society, and are
conveyed through our behaviors in the family, from the simplest to the most complex.

SOCIAL-CULTURAL VALUES:

 These are the prevailing values of our society, which change with time, and either
coincide or not with our family or personal values.

 They constitute a complex mix of different values, and at times they contradict one
another, or pose a dilemma.

 For example, if work is not valued socially as a means of personal fulfillment, then
the society is indirectly fostering “anti-values” like dishonesty, irresponsibility, or
crime.

MATERIAL VALUES:
 These values allow us to survive, and are related to our basic needs as human beings,
such as food and clothing and protection from the environment.
 They are fundamental needs, part of the complex web that is created between
personal, family and social-cultural values.
SPIRITUAL VALUES:
 They refer to the importance we give to non- material aspects in our lives.
  They are part of our human needs and allow us to feel fulfilled.
 They add meaning and foundation to our life, as do religious beliefs.
VALUES IN PROFESSIONAL NURSING:

 Professional values are the guiding beliefs and principles that influence your work
behaviour.

 Professional values are usually an extension of your personal values such as honesty,
generosity and helpfulness.

 These values may change over time and around different life events, your core beliefs
should stay the same.

 Nurses professional values are acquired during socialization into nursing from codes
of ethics, nursing experiences, teachers and peers.
DEFINITION OF VALUES IN PROFESSIONAL NURSING :
 Professional nursing values were defined as important professional nursing principles
of human dignity, integrity, altruism, and justice that serve as a framework for
standards, professional practice, and evaluation.
 Schank and Weis stated that these are “standards for action that are accepted by the
practitioner and/or professional group and provide a framework for evaluating beliefs
and attitudes that influence behavior”.
PROFESSIONAL NURSING CORE VALUES :
 American Association of Colleges of nursing (AACN-1998) in essentials of college
and university education for professional nursing identifies seven core values for
nurses:
 Altruism
 Autonomy
 Human dignity
 Integrity
 Social justice
ALTRUSIM:

 Altruism is a concern for the welfare and well being of others.

 In professional practice, altruism is reflected by the nurse’s concern for the welfare of
patients, other nurses, and other health care providers.
PROFESSIONAL BEHAVIOUR:

 Understands cultures, beliefs, and perspectives of others.

 Advocates for patients.
 Take risks on behalf of patients and colleagues.
 Mentors other professionals.

AUTONOMY:

 Autonomy is the right to self determination.

 Professional practice reflects autonomy when the nurse respects patients’ rights to
make decisions about their health.

PROFESSIONAL BEHAVIOUR:

 Plans care in partnership with patients.

 Honors the rights of patients and families to make decisions.
 Provides information so patients can make informed choices.

HUMAN DIGNITY:

 Human dignity is respect for the inherent worth and the uniqueness of individuals and
populations.
 In professional practice, human dignity is reflected when nurse values and respects all
patients and colleagues.

PROFESSIONAL BEHAVIOUR:

 Provides culturally competent and sensitive care.

 Protects patient’s privacy.
 Designs care with sensitivity to individual patient needs.

INTEGRITY:

 Integrity is acting in accordance with an appropriate code of ethics and accepted

standards of practice.
 It is reflected in professional practice when the nurse is honest and provides care
based on an ethical framework that is accepted within the profession.
PROFESSIONAL BEHAVIOUR:

 Provides honest information to patients and the public.

 Document care honestly and accurately.

 Seeks to remedy errors made by self or others.

 Demonstrates accountability of own actions

SOCIAL JUSTICE:

 Social justice is upholding moral, legal and humanistic principles.

 This value is reflected in professional practice when the nurse works to ensure equal
treatment under the law and equal access to quality health care.

PROFESSIONAL BEHAVIOUR:

 Supports fairness and nondiscrimination in the delivery of care.

 Promotes universal access to health care.

OTHER VALUES IN PROFESSIONAL NURSING :

 The values every nurse or midwife should work to, known as the 'six Cs'.
 The six Cs are :
 Care
 Compassion
 Competence
 Communication,
 Courage
 Commitment -are the other core nursing values.

CORE VALUES OF NURSE ADVOCACY

 Three core values help form the basis of nursing advocacy:

 Preserving Human Dignity
 Patient Equality
  Freedom from suffering.

VALUE CLARIFICATION :

 Value clarification is a method of self discovery by which people identify their

personal values and their value ranking .
 This process does not evaluate the values as such , but rather helps people identify
their own values.
 Values Clarification is a process by which people identify, examine, and develop their
own individual values.
 A principle of values clarification is that no one set of values is right for everyone.
 It promotes personal growth by fostering awareness, empathy, and insight.
 A method whereby a person can discover his or her own values by assessing,
exploring, and determining what those personal values are and how they affect
personal decision making.

GOAL OF VALUE CLARIFICATION:

 The goal of "values clarification" is for you to become fully conscious of their
influence, and to explore and honestly acknowledge what you truly value at this time
in your life.
 This promotes personal growth by fostering awareness, empathy and insight.

THEORY OF VALUE CLARIFICATION:

 One widely used theory of values clarification was developed by Raths Harmin, and
Simon (1978).
 They described a “valuing process” of thinking, feeling, and behavior that they termed
choosing ,prizing, and acting.

PHASES AND STEPS IN VALUE CLARIFICATION:

STEP-1:

 Choosing one’s Belief and Behaviour

 Choosing freely without any outside pressure.
  Choosing among alternatives.
 Choosing after reflecting and consideration of consequences.

STEP-2:

 Prizing one’s beliefs and behaviour

 Chosen beliefs are prized and cherished.
 Chosen beliefs are affirmed to others.

STEP-3:

 Acting on one’s beliefs

 Incorporated into one’s behaviour.
 Repeated consistently in one’s life.
 Acting upon choices.

CLARIFYING THE NURSES VALUES:

 Nurses and nursing students need to examine the values they hold about life, death,
health and illness.

 One strategy for gaining awareness of personal values is to consider one’s attitudes
about specific issues such as abortion .

CLARIFYING THE CLIENT VALUES:

 To plan effective care, nurse needs to identify clients values as they influence and
relate to a particular health problem.
 For Example:- A client with lose of eye sight will place high value on the
ability to see.
 When clients hold unclear or conflicting values that are determined to their health, the
nurse should use values clarification as an intervention
 The following process may help clients clarify their values:

1. LIST ALTERNATIVES:

 Make sure that the client is aware of all alternative actions.

  Ask “are you considering other courses of action? ” “tell me about them”

2. EXAMINE POSSIBLE CONSEQUENCES OF CHOICES:

 Make sure the client has thought about possible results of each action.
 Ask “what do you think you will gain from doing that”

3. CHOOSE FREELY:

 To determine whether the client choose freely.

 Ask “do you have any choice? ”

4. FEEL GOOD ABOUT THE CHOICE:

 To determine how the client feels.

 “Some people feel good after a decision making, some others feels bad. How
do you feel? ”

5. AFFIRM THE CHOICE:

 Ask “What will you say to others about this?”

 “How will you discuss with family or friends? ”

6. ACT ON THE CHOICE:

 To determine whether the client is prepared to act on the decisions made. 

 “Will it be difficult to tell with your wife? ” 

7. ACT WITH A PATTERN:

 To determine whether the client consistently behaves in a certain way.

 “How many times have you done that before? 

 When implementing these seven steps to clarify values, the nurse assists the client to
think each question through, but does not impose personal values.

BEHAVIORS THAT MAY INDICATE UNCLEAR VALUES:

 Ignoring a health professional’s advice.

 Inconsistent communication or behavior.

  Numerous admissions to a health agency for the same problem.

 Confusion or uncertainty about which course of action to take.

MORAL PRINCIPLES IN HEALTH CARE:

 The moral principles in health care:

 Autonomy
 Veracity
 Beneficence
 Non Malifecence
 Justice
 Fidielity

AUTONOMY :

 It comes from the Greek word autos meaning self and nomos meaning governance.
 It involves self-determination and freedom to choose and implement one’s decision,
free from deceit, duress, constraint or coercion.

VERACITY :

 Veracity is to maximize the efficiency of health care, the patient and the health care
providers are bound to tell the truth.

BENEFICENCE:

 It promotes doing acts of kindness and mercy that directly benefit the patient.

NONMALIFECENCE:

 Non malifecence is the duty to do no harm to the patient .

JUSTICE :

 Justice is the right to demand to be treated justly, fairly and equally.

FIDELITY:

 Fidelity means to be faithful to agreements and promise.

CONCLUSION:
 Nursing is an ethical job that is needed throughout the world.
 It exists in the modern age as a way to care for and to help people, and to maximize
the way we treat people.
 Nursing is also very ethical, each patient is taken care differently and have different
choices according to their ethics.
 Nursing is very controversial, both for the patient and the nurse.
 In this ever-changing society, Nursing is both a profession and a requirement, and it
has fit to society and technology by far.
 In the needs of the world today, nursing is needed more than ever and its
responsibility to care is missing from parts of the world.
 Many are dying, yet they still push through to advance and help others live through
technological advances and the help of others.
JOURNAL REFERENCES:
TOPIC:
 The importance of professional values from nursing students’ perspective

AUTHOR:
 Batool Poorchangizi . et . al.
PUBLISHED ON:
 05-JULY-2019.
ABSTRACT:
INTRODUCTION:
 Professional values of nursing students may be changed considerably by curricula.
 This highlights the importance of the integration of professional values into nursing
students’ curricula.
 The present study aimed to investigate the importance of professional values from
nursing students’ perspective.
METHODS:

 This cross-sectional study was conducted at the Kerman University of Medical

Sciences, Iran.
  Data were gathered by using a two-section questionnaire consisting of demographic
data and Nursing Professional Values Scale-Revised (NPVS-R).

 By using the stratified random sampling method, 100 nursing students were included
in the study.

RESULTS:

 Results showed that the mean score of the students’ professional values was at high
level of importance (101.79 ± 12.42).

 The most important values identified by the students were “maintaining

confidentiality of patients” and “safeguarding patients’ right to privacy”.

 The values with less importance to the students were “participating in public policy
decisions affecting distribution of resources” and “participating in peer review”.

 The professional value score had a statistically significant relationship with the
students’ grade point average (P < 0.05).

CONCLUSIONS:

 In light of the low importance of some values for nursing students, additional
strategies may be necessary to comprehensively institutionalize professional values in
nursing students.
BIBLIOGRAPHY:

 Lakhwinder Kaur and Maninder Kaur, A Textbook of Nursing Foundation, published

by S. Vikas and the company,2nd edition. Page No:57-58

 Shebeer, P.Basheer, S.Yaseen khan, A Textbook of Advanced Nursing Practice,

published by EMMESS Medical Publishers , 2nd edition Page No:344-346

 Potter and Perry”s , A Textbook of Fundamental of Nursing , published by Elsiever ,

Page No:123-124

NET REFERENCES:

 https://www.scribd.com/document_downloads/direct/85029553?
extension=pptx&ft=1621650606&lt=1621654216&user_id=544476359&uahk=GDv
Lto_SJTe7VShnj5sIcXoBcoM

 https://slidetodoc.com/download.php?id=1902759

 https://www.slideshare.net/babithadevu/note-nursing-as-a-profession-
2#:~:text=Human%20dignity%3A%20Nurses%20values%20and,of%20all
%20patients%20and%20colleagues.&text=Provides%20culturally%20competent
%20and%20sensitive%20care.&text=Protects%20patient's
%20privacy.&text=Designs%20care%20with%20s%20sensitivity%20to
%20individual%20patient%20needs.