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Personal Philosophy and Reflection on Nursing Paper

Allison M. Lawson

Bon Secours Memorial College of Nursing

NUR 4140 Synthesis for Nursing Practice

Dr. Marcella Williams

April 2, 2022

“I pledge that I uphold the Honor Code System and policies of Bon Secours

Memorial College of Nursing”

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Definition of Nursing

I define nursing as providing compassionate care for one’s physical, mental, and spiritual

health without judgement, and at any time one needs or could benefit from it. This includes

providing medical treatments such as medications to a patient with a certain disease as well as

providing a kind word or back rub to help relieve emotional pain and anxiety. My definition

relates to the Bon Secours Memorial College of Nursing (BSMCON) program philosophy in

many ways. For example, in the first sentence of the program philosophy, nursing care is

characterized as holistic, which includes the physical, mental, and spiritual aspects of health I

mentioned in my definition of nursing (BSMCON Faculty, 2019). My definition of nursing is also

similar to the BSMCON program philosophy idea that nursing addresses topics such as disease

prevention and wellness promotion through the use of creativity and passion (BSMCON Faculty,

2019). This is because I mentioned that nursing care should be provided when one needs it or

could benefit from it, meaning that care should not only be given when one is ill, but periodically

in order to prevent a decline in one’s health. A final tenet from the BSMCON program

philosophy that correlates with my personal definition of nursing is the idea that the nursing care

taught at BSMCON spans across the lifespan rather than being limited to certain age groups

(BSMCON Faculty, 2019). This correlates with my statement that nursing care should be

provided at any time it is needed whether this is the first day of life, the last day of life, or any

day in between these. Now that I have defined nursing and compared it to the BSMCON

program philosophy, I will discuss how I apply my personal philosophy to my nursing practice.

Personal Philosophy

I believe nursing is about teamwork as well as striving to provide the safest and best

care possible for all patients. This personal philosophy is reflected in my nursing practice

through my interprofessional relationships, nurse-patient relationships, and my ethics. For

example, if I have finished my tasks during my clinical immersion and one of the nurses needs

help with a bath or taking an IV out, my preceptor and I will help them because sometimes the
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workload that nurses have is more than one person can complete during their shift. I also try to

provide the safest and best nursing care possible by consistently asking my preceptor and

clinical instructors questions as well as by welcoming feedback from them to improve my

nursing care. Furthermore, I reflect my personal philosophy through my nurse-patient

relationships.

One way I strive to provide the safest and best nursing care possible in my nurse-patient

relationships is by educating my patients. During my clinical immersion on the Mother/Infant Unit

at St. Francis Medical Center, I educate parents on admission to the unit, throughout their

hospital stay, and before discharge. Topics of teaching include newborn care, unit safety

protocols, and postpartum care. Educating my patients on these topics helps keep them safe

while they are in the hospital, while also helping to maintain their health and safety after

discharge. Finally, my personal philosophy is revealed in my nursing practice through my ethics.

I try to provide the best care possible for my patients by respecting the ethical principles of

nursing practice, which fosters a trusting relationship between my patients and me. For

example, I respect the autonomy of my patients when they refuse treatment such as a Hepatitis

B vaccine for their newborn. Next, I will discuss my values and beliefs including how they have

evolved since my first semester of nursing school in the spring of 2020.

Values and Beliefs

A value is defined as, “a principle, standard, or quality considered worthwhile or

desirable” (Dictionary.com b). Since my previous philosophy paper that I wrote during the first

semester of nursing school, my values have expanded. In my previous paper, I explained that

my values included, “…knowledge, compassion, honesty, confidence, open-mindedness,

health, and spirituality” (Lawson, 2020, p. 2). Along with these values, I have learned on my

journey through nursing school that experience is another important idea I value due to its

impact on nursing practice. Experience greatly impacts nursing practice because it provides a

realistic perspective for what I have learned in my coursework. It also helps me improve on my
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values of knowledge and confidence because having experience with a certain situation or skill

will allow me to not only know what to do, but to also feel adequately equipped to complete the

task or handle the situation (Lawson, 2020). Similarly, since writing my previous philosophy

paper in my first semester of nursing school, one of my beliefs has evolved.

A belief is defined as, “a principle, proposition, idea, etc, accepted as truth”

(Dictionary.com a). In my previous philosophy paper, I expressed my beliefs as follows:

I believe in treating all patients and their loved ones with kindness, despite any

differences we may have. I believe that gaining the patient’s trust by telling them the

truth will improve their mood and healing. I also believe in providing intelligent care at an

appropriate pace that does not make the patient feel rushed. Because it affects the

nurse’s ability to give skillful care and the patient’s ability to heal, I believe in promoting

confidence in myself as well as in my patients. A belief that relates to my value of

spirituality is that the life of a fetus is sacred, just as I believe all human life is sacred.

Along with the sanctity of life, another belief I have regarding my spirituality is my belief

that God can and does perform miracles that defy medical science. (Lawson, 2020, p. 3)

As I reflect on my beliefs, I realize that my first belief has evolved and become deeper as I have

spent more time in the clinical setting throughout nursing school. The rest of my beliefs, on the

other hand, remain the same. After spending more time with patients and nurses, I now believe

that treating the patient and their loved ones with kindness as well as in a way I want to be

treated despite any differences we may have, is the key to ensuring just and compassionate

care (Lawson, 2020). Thus, both my values and beliefs have grown since my first semester in

nursing school over two years ago. Along with reflecting on my values and beliefs, I have had

opportunities to practice my personal philosophy during my clinical immersion experience.

Nurse-Patient Encounter

One example of a nurse-patient encounter I had during my clinical immersion experience

that demonstrates the application of my personal philosophy to my practice occurred last week.
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When assessing one of my newborn patients, I noticed that their temperature was 97.6 degrees

Fahrenheit, slightly lower than normal range. I took the temperature two more times to ensure

an accurate reading, and the temperature remained around 97.6 degrees Fahrenheit. Then, I

asked the parents if one of them could do skin-to-skin contact with their newborn to increase

their temperature. The mother volunteered to do it, and I helped position the newborn. My

preceptor then assisted me with planning further care for this patient. Approximately 30 minutes

later, I reassessed the newborn’s temperature and it was back within defined limits at 97.8- or

97.9-degrees Fahrenheit, which was also within the newborn’s baseline temperature range.

Then, I put the newborn in one of their outfits, swaddled them in two blankets, and then put two

hats on them to help maintain their temperature while in the bassinet.

This situation demonstrates my personal philosophy which is to strive to provide the

safest and best care possible because I noticed an abnormal finding and initiated an

intervention. Then, I asked for help from my experienced preceptor to ensure that an

appropriate plan of care was made and implemented. Thus, my care helped keep my patient

safe by preventing cold stress that can occur in newborns if their temperature decreases

significantly, and allowed me to practice aspects of my personal philosophy. Furthermore, my

NUR 4140 practicum experience has expanded my nursing knowledge and experience by

allowing me to take on the role of a change agent.

Change Agent

For my EBP/QI project, my group and I proposed two small changes that we believe will

help the staff on the Orthopedic Unit at St. Francis Medical Center (SFMC) decrease the length

of stay for their patients undergoing hip and knee replacement surgeries based on our research.

Specifically, we proposed a change to the current preoperative assessment tool to include the

comorbidities of cognitive impairment and frailty as well as a change in EPIC that will

automatically prompt consults to the appropriate interdisciplinary team member based on the

patient’s preoperative assessment. We believe this will decrease length of stay by helping the
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care team know what resources the patient needs prior to surgery and by arranging those

resources in a timely manner after surgery. Throughout this EBP/QI project, I learned about the

role of a change agent, as well as performed the role of a change agent.

A change agent leads and coordinates the change process within the organization in

which the change will occur, while also managing conflict throughout the process (Marquis &

Huston, 2021). Although my project focused on the planning phase of the change process, I

performed the role of change agent in this phase by meeting and communicating via email with

nurses caring for hip and knee replacement patients on the Orthopedic Unit at SFMC. This

communication helped me lead the change by helping my group and I figure out the type of

solution we needed to propose (Marquis & Huston, 2021). It also helped coordinate the change

process within the organization because it allowed the nurses to be informed that a change will

be proposed and to understand that their ideas and data were the inspiration for the proposed

change (Marquis & Huston, 2021). I also led and coordinated the change process during this

project by helping my group meet our deadlines by being the designated team member that

turned in each assignment related to our project as well as the drafts of our project (Marquis &

Huston, 2021).

As a result of my NUR 4140 practicum experience, my understanding of and ability to

perform the change agent role has improved. This is because I now know that leading the

change process takes a significant amount of time, research, communication, and managerial

skills in order to propose and implement a change within a medical facility (Marquis & Huston,

2021). For example, my EBP/QI project only focused on the planning phase of the change

process, and it took approximately three to four months to complete. I also feel that my ability to

take on the role of a change agent has improved because I have been consistently practicing

my leadership and communication skills more so during my NUR 4140 practicum than I have in

previous courses. These skills are needed to perform the many actions that change agents
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perform to coordinate and lead a change (Marquis & Huston, 2021). After discussing my NUR

4140 practicum experience, I would like to discuss Patricia Benner’s nursing theory.

Benner’s Theory

Benner explained in her book From Novice to Expert Excellence and Power in Clinical

Nursing Practice that nurses pass through five stages of acquisition as they gain experience in

the nursing profession (2001). The nurse begins at the novice level as a new nurse or when

beginning a new specialty of nursing (Benner, 2001). At this level, the nurse has knowledge

from school and the experienced nurse has experience in a different specialty. However, these

nurses have no experience in the clinical setting they are currently working in (Benner, 2001).

Thus, the novice nurse provides their care based on policies and what they have learned in

textbooks and academic exercises (Benner, 2001).

Then, the novice nurse becomes an advanced beginner, meaning the nurse now has a

small amount of experience and is noticing that some nursing knowledge and skills can only be

obtained once they are experienced (Benner, 2001). The third stage is the competent stage,

when the nurse has had approximately two to three years of experience in one type of nursing,

and they can now plan their care effectively instead of constantly reacting to patient needs as

they occur (Benner, 2001). After this, the nurse progresses to the proficient stage, which usually

means they have had approximately three to five years of experience in a particular nursing field

(Benner, 2001). In this stage, the nurse becomes less task oriented, better recognizes abnormal

findings, uses clinical judgement more easily, and thinks about their care in terms of the

patient’s long-term health (Benner, 2001). Finally, the nurse may reach the expert level, in which

the nurse has intuition from their large amount of nursing experience that guides their practice

rather than rules guiding their practice (Benner, 2001).

The stage of skill acquisition that adequately represents my most current stage of

development in the specialty of maternal and newborn nursing is the advanced beginner stage

because, rather than having no experience like the novice, I have a small amount of experience
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in this setting now that I have been working in this type of nursing setting with my preceptor for

the past two months (Benner, 2001). Although I am getting slightly more comfortable with the

nursing care for postpartum mothers and infants, I feel that I am in the advanced beginner stage

because I do not have enough experience to adequately identify and treat abnormal

assessment findings independently (Benner, 2001). I also feel that I am an advanced beginner

because I have many of the advanced beginner characteristics Benner mentions in her book

(2001). I am task oriented, I rely on my preceptor to explain concepts and skills that I have not

experienced before, and I rely on my preceptor to give me instructions/guidelines to follow when

I am providing patient care (Benner, 2001). For example, my preceptor explained the process of

Rhogam administration the first time I had a patient who needed this injection, and she helps

me prioritize my care on busy days when there are many discharges that need to be completed

and assessments that need to be documented. Therefore, I am currently in the second stage of

Benner’s skill acquisition theory, but I plan on taking actions as an RN to help me move to the

third stage of development (2001).

Action Plan

At the start of my transition into my first year as an RN, I expect that I will start the year

at the novice level of skill acquisition because I will be working in the specialty of oncology

nursing instead of maternal and newborn nursing (Benner, 2001). However, strategies I will use

to progress to the advanced beginner stage and then eventually the competent stage include

strategies I have used during my clinical immersion experience to progress from novice to

advanced beginner on the Mother/Infant Unit (Benner, 2001). These include asking my

preceptor and/or manager questions to improve my care and expand my knowledge as well as

welcoming feedback from my preceptor and/or manager. Another strategy that I currently use

and plan on implementing during my transition into my first year as an RN is looking up photos

of abnormal assessment findings that are unfamiliar to me on the internet while at work or at

home to learn more about them. Final strategies that I currently implement occasionally, and
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plan on implementing once a week during my transition into my first year as an RN to facilitate

my movement from the novice stage to the advanced beginner stage include taking notes on

information I learn at work, studying those notes to remember what I have learned, and

journaling about my experiences. Along with implementing the various strategies I have

mentioned, I will also incorporate self-care and professional development into my plan for

transitioning from a student to an RN.

I plan on taking care of myself during my first year as an RN by prioritizing my health

more than I have in nursing school. Instead of exercising and stretching once a week and eating

healthy some days of the week, I will exercise more than once a week and start eating a healthy

diet such as the Mediterranean diet most days of the week. I will also incorporate more relaxing

activities such as getting my nails painted, enjoying a face mask, sitting outside, and watching

television with my family and friends into my schedule during my first year as an RN to help me

decompress from work and promote my mental health. As for my long-term professional

development plan, I plan on getting involved in a nursing organization related to the nursing

specialty I am in or even obtaining a certification in my specialty once I feel comfortable with my

RN position. For example, once I feel more comfortable in my RN position in oncology nursing

and if I decide oncology nursing is my passion, I will further develop my career by joining the

Oncology Nursing Society and eventually become certified to administer chemotherapy. If I

decide after working in oncology for one or two years that I want to go back to obstetrical

nursing, I will find and join a professional nursing organization about obstetrical nursing that

interests me to further develop my nursing career. In conclusion, I look forward to ending this

student nurse chapter of my life and beginning the RN chapter by taking all that I have learned

and discovered, applying it, taking care of myself, and continuing to grow along the way.
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References

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

(Commemorative ed.). Prentice-Hall Health.

BSMCON Faculty. (2019). BSMCON philosophy statement [Lecture notes]. Blackboard.

https://bsmcon.blackboard.com/bbcswebdav/pid-457118-dt-content-rid-4921051_1/xid-

4921051_1

Dictionary.com. (n. d.). Belief. In Dictionary.com. Retrieved March 22, 2022, from

https://www.dictionary.com/browse/belief

Dictionary.com. (n. d.). Value. In Dictionary.com. Retrieved March 22, 2022, from

https://www.dictionary.com/browse/value

Lawson, A. (2020). Personal philosophy paper [Unpublished manuscript]. Bon Secours

Memorial College of Nursing.

Marquis, B. L., & Huston, C. J. (2021). Leadership roles and management functions in nursing

theory and application (10th ed.). Wolters Kluwer.