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Personal Philosophy and Reflection

Bailey A. Cristian
Bon Secours Memorial College of Nursing
NUR 4140: Synthesis for Nursing Practice
Dr. Christine Turner, PhD, RN
October 30th, 2021
“I Pledge”
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The influence and impact of the nursing profession has evolved extensively through

advances in healthcare innovation, technology, and research. The role of nursing is one that

extends beyond the tasks that are required to maintain the health and safety of patients. Nursing,

to me, is taking on whatever role or responsibility that is required for each individual patient on a

given day, whether that is an advocate, a leader, a safekeeper, an innovator, an educator, or a

support system. Bon Secours Memorial College of Nursing (BSMCON) program is built on the

foundation that human beings are unique and complex, worthy of dignity and respect, and

deserving of holistic care (BSMCON, 2021). In recognition of this ideal, nurses are responsible

for adapting to the individual care needs of their patients and committing to a lifelong journey of

personal, spiritual, and intellectual growth. Another cornerstone of BSMCON program is that

nursing represents both an art and a science (BSMCON, 2021). My nursing practice will embody

creative problem solving, compassion, and self-reflection as well as application of current,

evidence-based research and collaboration with healthcare professionals in developing patient

care plans.

An integral part of my personal nursing philosophy is the development of a nurse-patient

relationship that prioritizes respect, support, and effective communication. Every patient

interaction contributes to a trustworthy relationship, which can lead to better health outcomes,

whether it is physically, emotionally, or spiritually. In my limited experience, I have already

recognized the impact that a positive nurse-patient relationship can have on the entire patient

experience. As a student nurse, it is common to sense discomfort or hesitation from patients due

to the assumption of students’ inexperience. However, I found through multiple patient

interactions that by shifting the focus on the patient—their needs, thoughts and desires—their

confidence and trust in my ability to care for them grew substantially.

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By giving patients the space to be heard and understood, it ensures that their autonomy is

being respect and enables nurses to better advocate for them. Another important aspect of my

personal philosophy is collaboration and teamwork with both the healthcare team and the patient.

Nurses should rely on teamwork, not only for their own mental and physical well-being, but also

for their patients’ health outcomes. Collaboration among healthcare professionals brings fresh

perspectives and solutions to a patient situation and ensures that the patient care plan is

comprehensive and holistic. In addition, nurses need a strong support system to provide

effective, efficient and safe care to multiple patients at a time.

BSMCON program upholds the values of human dignity, integrity, stewardship, service,

compassion and catholic identity, which align with their mission of extending the compassionate

ministry of Jesus by providing good help to those in need. Values govern and motivate people’s

actions and behaviors. They stem from our beliefs and are created based on what people deem

important. Beliefs are the assumptions that are held to be true, which impact how we think about

or experience life. Individuals can have different beliefs, yet still maintain similar values. For

example, two people can both value “family”, but have differing beliefs about how family is

defined and the role that is required of them in a family unit. It is important for healthcare

institutions to have a defined set of values that unify employees and create a standard by which

employees must function in order to accomplish the mission and vision of the institution.

At the beginning of nursing school, I established a personal philosophy based on my

individual values and beliefs about nursing that have since changed and evolved through the

progression of my nursing education. In my initial philosophy, I discussed the importance of

recognizing diversity among patients, creating purposeful interactions through prioritization of

the little moments, and providing holistic care by attending to the body, mind and spirit of each
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unique patient. These are values that I still maintain and recognize as essential to my nursing

practice, however, I have also adopted new values as a result of my practicum and educational

experiences. Most of my nursing education happened during the peak of the COVID-19

pandemic, which quickly revealed the magnitude of the nursing role and presented many

challenges in the healthcare environment. The pandemic brought different meaning to the nurse-

patient relationship—communication changed due to isolation precautions, there was relative

uncertainty about how to care for and treat patients affected by the virus, the patients could not

have any visitors, and the hospital was completely overwhelmed and understaffed.

During this season, I observed several nurses adapt in the midst of adversity and

transform into leaders. Patients relied almost exclusively on nurses for comfort, support,

guidance and advocacy. Nurses risked being exposed to COVID-19 on a daily basis and were

asked to accept patient responsibility far beyond what is required of them. Some nurses

experienced extreme burnout and demonstrated courage by taking a step back to focus on self-

care and mental health, while other nurses remained on the frontlines—crying alongside their

patients, filling the place of family members, working tirelessly to help find the answers that no

one had yet. This display of leadership altered my perception of the nursing role and inspired me

to strive for the same transformative quality in my nursing career. The other value that has grown

throughout my nursing education and will continue to be a key aspect of my nursing career is my

faith. It is essential for me to prioritize my relationship with God in order for me to serve my

patients in the best possible way. I also believe that prayer is a powerful tool of healing and hope

that I can provide for my patients if requested. The pandemic led to a surplus of death and

hopelessness that medicine and technology were not immediately able to solve. Faith and
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spirituality became a life net to patients and nurses when they were at their lowest, and it can be

used in countless other difficult circumstances.

I have realized and established these values during every opportunity I had in the

practicum setting as a student nurse, and as such, there are many examples of nurse-patient

encounters that shaped my philosophy. One particular example that has stuck with me occurred

during my practicum experience on the Oncology unit. I assumed the care of a patient who was

in hospice and was not expected to survive the shift. He was nonverbal, immobile, and agonal

breathing. At this time of the year, the hospital was allowing family visitation only in the case of

end-of-life situations, but the patient’s family was not present. As a student, I was always

looking for opportunities to practice and improve my skills, but this was a moment in which a

different skillset was needed. I asked the primary nurse if the family was notified about the

patient’s health and she stated that the nightshift nurse had called and left a message. After

administering the patient pain medication to provide comfort, I asked my instructor if I could

make some phone calls to the family and then sit in the patient’s room, so that he would not be

alone during his last moments. I was able to get in touch with a family member who lived 2

hours away and was so grateful for me reaching out. They immediately left to come be by the

patient’s side.

I spent the next few hours giving the patient a bath, clean sheets and warm blankets. I

prayed for him quietly and held his hand while waiting for his family to arrive. As a nurse, I felt

that it was my responsibility to preserve human dignity in the end-of-life stage and assume the

role of a family member by providing a quite presence. I prioritized his emotional and spiritual

needs above his physical needs based on what I felt was required of me in that moment. I applied
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my philosophy by creating a purposeful nurse-patient interaction, caring for the patient

holistically, instilling faith, and adapting my responsibilities to the specific needs of the patient.

A key component of the BSMCON philosophy is nurse participation in medical

innovation and lifelong learning. As such, it is essential that evidence-based practice (EBP)

research and quality improvement (QI) projects are performed to optimize patient outcomes. The

EBP/QI project on which I participated was focused on the use of bedside handoff report on the

medical-surgical unit at St. Francis Medical Center. The proposed solution was to create a

standardized SBAR checklist to improve the consistency and compliance of giving shift report at

the bedside. Bedside shift report is an important safety and quality measure that nurses are

responsible for performing, however, there are barriers such as time constraints and distractions,

that discourage the practice of handoff at the bedside. The SBAR checklist that we created

includes a script that the off-going nurse iterates to the patient before beginning shift report, so

that the patient is familiar with the bedside shift format and knows what to expect. The checklist

also ensures that an exhaustive report is given—even if distractions arise while the nurses are in

the room.

Designing this project has helped me to understand the process by which healthcare

challenges are addressed and patient outcomes are improved. It has also helped me realize the

impact that nurses can have on both a unit and system scale. Nurses see the implementation of

quality improvement and evidence-based practice firsthand and are reliable sources for receiving

feedback. In my nursing career, I will maintain an innovative, creative and curious spirit in hopes

of being a catalyst for significant changes that improve healthcare. Overall, the practicum

experience, from which we produced the QI project, elevated the nursing role beyond what is

done at the bedside and established our responsibility in building a better healthcare experience.
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There are many methods and strategies for achieving nursing excellence in the healthcare

world, but it is important to recognize the stages in which a nurse develops in order to produce

realistic standards and expectations for nursing practice. These developmental stages are

presented chronologically in the book, “From Novice to Expert” (2001), by Patricia Benner who

explores the narrative accounts of experiences in nursing practice through the lenses of five

developmental stages: novice, advanced beginner, competent, proficient and expert. She

theorizes that there are major aspects of the nursing role that are not objective or practical, but

instead, are based in experiential learning from which perceptual clarity and nursing judgment

develops (Benner, 2001, p. ix). This experience results when “preconceived notions and

expectations are challenged, refined, or disconfirmed by the actual situation” (Benner, 2001, p.

3).

Throughout my nursing education, my experiences have challenged my previous nursing

philosophy and have helped me to develop a more sophisticated and holistic philosophy. The

same trajectory can be applied to my clinical knowledge and nursing practice. Using the Benner

Theory, I would classify myself as an advanced beginner at this point in my nursing career

because I have gained some aspects of recognition from prior experience in actual situations

(Benner, 2001, p. 22). In other words, I have applied the objective principles learned in nursing

school to individual patient situations that are rich with subjectivity and nuance. I am beginning

to “perceive recurrent meaningful patterns,” but will continue to need guidance in setting

priorities and judging the relative importance in clinical situations (Benner, 2001, p. 24).

Before self-reflecting and analyzing the strategies that I can use to move up on the ladder

of nursing excellence, it is essential to recognize that expertise is only acquired through years of

experience and situational discovery. However, it is the responsibility of the nurse to put forth
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effort in developing the critical thinking skills that are necessary for becoming an expert. In order

to achieve the next stage—the competent nurse— I need to seek guidance from more

experienced nurses who can help address patient acuity and discern patient needs based on their

relevance. A competent nurse is always consciously aware of the long-range goal or plan for

their patients so that their nursing care for that shift can be organized accordingly (Benner, 2001,

p. 27). I can practice this skill by ranking patient acuity and their needs after receiving shift

report and checking it with an experienced nurse to ensure that my thought process is on the right

track.

In the long-term, I will be intentional about setting goals for myself, taking opportunities

for growth and development within my role and taking time for self-care to prevent compassion

fatigue. By involving myself in educational courses and leadership teams on my unit or in the

hospital I will be more directly involved in enacting change to improve both nurse and patient

experiences. When I am not working, I will take part in stress-relieving activities such as

mindfulness practice, yoga, journaling, and exercise. I will also dedicate quality time to my loved

ones and try to ask for help when I am struggling. For nurses who spend their days caring for

others, it is difficult to allow others to care for them. However, it is necessary for our mental and

physical health, and gives us the ability to serve our patients with the utmost compassion and

care.
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References

Bon Secours Memorial College of Nursing. (2021). BSMCON nursing philosophy statement.

Benner, P. (2001). From novice to expert: Excellence and power in clinical nursing practice.

Prentice-Hall International.