This document is the author's nursing philosophy paper. It discusses the author's views on caring, definitions of nursing, assumptions in nursing practice, and principles for practice. The key points are: 1) The author's views on caring have evolved to incorporate treating patients with honesty, building relationships, and remembering what it is like to be a patient. 2) The author agrees with the American Nursing Association and Sentara hospital definitions of nursing which emphasize health promotion, building relationships, evidence-based practice, and patient education. 3) The author discusses assumptions around caring for culturally diverse patients, the role of community in health, and relationships with other healthcare professionals. 4) The author's principles focus

1. Running head: CARING REQUIRED<br />Caring is Required: My Nursing Philosophy<br />Casey Burritt<br />UIN 00547741<br />ODU On Campus<br />Submitted in partial fulfillment of the requirements in the course<br />NURS 431: Transition to Professional Nursing Practice<br />in the School of Nursing<br />Old Dominion University<br />NORFOLK, VIRGINIA<br />Spring 2011<br />Caring is Required: My Nursing Philosophy<br />A philosophy about a particular topic dictates a person’s beliefs, principles or aims about this subject. By creating a philosophy of nursing, I am deciding what values and goals I want to begin my career with. As a sophomore and first-year nursing student, I wrote such a philosophy based on the small amount of knowledge I had gained and my personal beliefs. <br />My sophomore philosophy was rooted in the “golden rule.” I felt that to be a nurse, you had to be able to care about your parents and not just for them. I believed that I would always remember what it was like being on the other side of things so that I would be able to act as I would want in such a situation. I also believed greatly in what I call appropriate honesty meaning that I give the information I am licensed to in a way that is neither rude and brutally honest nor sugar-coated. <br />As a senior, I now feel that I am knowledgeable enough to begin working with patients of my own. According to Schoessler’s and Waldo’s Model of Transition, I am currently at a novice level and, upon graduating, moving towards an advanced beginning level (Schoessler & Waldo, 2006). <br />Definition<br />There are two organizations whose definitions of nursing I agree with. I am choosing to base my personal definition on those of both the American Nursing Association (ANA) and Sentara hospitals. The ANA’s explanation of nursing involves “protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations” (ANA, 2011). Sentara’s characterization of nursing encompasses using collaborative care, using evidence-based practice and patient education, and building relationships (Sentara Healthcare, 2011). <br />The most differentiating part about the ANA definition is the human response portion (ANA, 2011). Nurses visit the bedside more frequently than any other group of healthcare providers and because of this, we are in the best position to learn the most about our patients and share the information with the rest of the healthcare team. The knowledge we gain can be as simple as a patient’s wife explaining that her husband sleeps in the nude and that is why he cannot sleep well at night in the hospital or as important as past medical history involving the patient’s “normal levels” so that we can set appropriate goals. Building relationships is also key to this aspect of patient care (Sentara Healthcare, 2011). If I cannot make a patient or families feel comfortable with me, they will be much less likely to give me such helpful information. Building relationships may involve not only those with the patients and families but also with other healthcare providers. By building appropriate relationships, I will feel more comfortable approaching a physician or other specialist about questions or concerns that I may have about my patients which will lead to better care. <br />The ANA definition is specific about prevention and promoting health and wellness (ANA, 2011). This is achieved through the key element of the Sentara definition which is evidence-based practice (Sentara Healthcare, 2011). This research-driven way of doing things allows us to do things in the most up-to-date way, ensuring that our patients are truly being treated to the best of our abilities. Research not only dissects practices to come up with the most efficient, but also molds new practices and ways of treating and preventing illnesses. There is no way that I would be able to best serve and care for my patients if it were not for those who do behind-the-scenes research on how to do so. <br />Evidence-based practice also translates into other areas such as collaborative care and patient education. Research determines in a small group the best way to do something and we are the ones responsible for applying to large patient populations. Collaborative care allows people from every specialty to get together so as to determine holistically how a patient should be treated. From being on a unit where this was used in the form of multidisciplinary rounds, I feel that everyone including the physicians, nurses, assistants, pharmacy, respiratory and so forth all knew exactly what was going on with each patient. This allowed for more than one person examining the medications a patient was on to ensure there were not unnoticed interactions or contraindications. Also, by learning what a disease really does to the body and how to prevent it future side effects of such disease, we are able to teach our patients the best ways to manage any illness and prevent complications to the best of both their and our ability. <br />Purpose<br />I believe that the entire medical team is important in each in an individual way. The way of nurses is that we are the necessary link between patients and their physicians. As a nurse, I will be able to give more individualized care to my patients because I have the time and opportunity. I should be able to make the connections necessary to make the patient feel as if he or she can open up to me, allowing me that extra insight. <br />My childhood experiences are what have pushed me into this profession. I have had many stays in the hospitals for surgeries and I don’t remember much about the doctors, but I do remember the nurses who took the time to explain to me in my seven-year-old language what was going to happen to me and who brought me medicine to make my pain go away. I even remember them teaching my parents how to care for the newest round of stitches I had in my mouth and hip when I was eleven even though they had been caring for them since I was 3 months old. Also, my grandmother was a nurse for many years and I remember her telling me stories about how she “just did [her] job” and something she did that she took for granted meant the world to someone who was ill or his family. Her stories inspired me to lead a life similar to that with the goal of touching someone’s life every day that I work. <br />Assumptions<br />Nursing practice is often based on theories and part of those theories is the assumptions or concepts that we presume to be true (Johnson & Webber, 2005). These assumptions are critical in making theories work because they influence them, and if they go unrecognized, can skew the outcomes. Three areas that assumptions affect in nursing practice are the relationships between myself and my culturally-diverse clients, the community, and other healthcare professionals.<br />Culturally-Diverse Clients<br />Madeleine Leininger’s Culture Care Theory states its assumptions as including that healthcare is intended to supply care worldwide as well as being shaped by individuals’ and groups’ cultural values (Johnson & Webber, 2005). This theory brings to the forefront the idea of giving care to patients that is culturally competent and specific. <br />Culture is very important to many people and the same beliefs and preferences are not necessarily congruent between cultures. Many people may assume that they do not have culture because they do not have a rich ethnic background or strong religious view, but this is not the case. Personally, I do not have either of those, but as a child I frequented hospitals both for my purposes as well as those of my family. Because of these frequent visits, I understood more about the medical environment than most may. Since I do not have any overt religious views, I must take into account that others still may. Whether or not I agree with my patients’ beliefs, I must still respect them and make necessary allowances for them. All nurses must acknowledge their patients’ beliefs and, if necessary, negotiate with them ways to incorporate their beliefs into their medical care. <br />Community<br />The Health Promotion Model by Nola Pender involves the interaction between people and their environment as well as their ability to develop their health in “a positive dynamic state not merely the absence of disease” (Johnson & Webber, 2005, p. __). I interpret this theory to mean that a truly healthy life means excelling. For example, if a person loses his house and stays in a shelter, he likely has a new exposure to less healthy people and being in this place may be more damaging, causing him to spiral out of control with his career, personal life, and alcohol and drug use. <br />As a nurse, I have a duty to help those with little to no access to conventional healthcare in addition to those that have adequate access. Because this disadvantaged group is likely living in or near poverty, we must reach out with free services to help these individuals in the same way we would help someone walking into a hospital or doctor’s office. By doing something as easy as blood pressure screenings and teaching about reducing risk factors, I can immensely help someone who cannot afford a pharmacological fix. <br />Healthcare Professionals<br />James Burns developed the Transformational theory that involves creating change in social systems. This type of leadership improves the enthusiasm, confidence, and performance by being a role model and trying to connect each individual with the organization’s self and mission (Marquis & Huston, 2009). So what are your beliefs/assumptions about the relationship between nurses and other health care professionals? <br />Principles<br />I believe that the most important rule of thumb when practicing is that I treat my patients with every ounce of respect and caring that I would expect to be given if I were that patient. Doing so can be as simple as talking to a patient to alleviate the boredom in their hospital stay. During my second clinical rotation, I had a patient admitted after having a bowel resection related to diverticulitis. He initially told me that he was an incredibly active person and being stuck in bed “bored him to tears.” After I had all of my daily duties done, I came back and sat in his room. We talked for quite a while and before I left for the day, he told me that he was very thankful that I took the time to sit with him, even if just for the little time I was there. <br />The other principle that I hope to carry with me once I graduate is to always take the time to teach. All people have something to learn and while they are in the hospital or receiving medical care, there is something specific that they need to learn. There are many ways to impart knowledge to people across all ages. Adults may just require some demonstrations while children need games and fun ways to learn. During my pediatric clinical experience, there was one young girl who was admitted because she had her first seizure. They were still in the process of determining why it had occurred and if it would be likely to happen again. She had previously had “a seizure” explained to her as shaking and she could not quite figure out why that was such a bad thing. I decided to try to explain to her why it was harmful by playing an imagination game. We would walk around the room stopping at different spots and I would say “if you put your arms out & spun around right here, what would happen?” She was usually able to tell me that she would hit something and that it would hurt. However, when she got to the middle of the room away from the other objects, she couldn’t figure out what would hurt her until I suggested she lay on the floor and try to spin around, realizing that she couldn’t because the floor stopped her and hurt her arm. The next time the doctor came in to see her, she told him that she understands why seizure were so bad and could hurt her, even if she was on the ground and away from everything else. Teaching is certainly an important aspect of nursing, but not really a moral or ethical principle. <br />Conclusion<br />As a soon-to-be graduate nurse, I have developed a philosophy of nursing that revolves around evidence-based practice, working with all other members of the healthcare team, educating patients and building relationships between myself and my patients, coworkers, and other specialists. Caring is the most important aspect of nursing and I will use my experiences as a patient to deliver the best possible care to everyone. <br />The basis of my philosophy has remained the same since sophomore year, but it has changed when it comes to collaboration and research-based care. In my clinical experiences, I have realized how important is it to keep up-to-date with practices to ensure that the most efficient and appropriate methods of treatment are being used. Also, my intensive care unit rotation showed the importance of collaborative care in preventing excessive medications and unnecessary procedures. <br />This paper explains my intentions for my future nursing career. No matter which specialty I choose to go into or what age group I work with, this way of practicing can be applied. I have always been exceptionally comfortable with children and babies and hope that this is the direction I will be able to go in so that I can help children their families the way I and my family were when I was young. <br />References<br />American Nurses Association (ANA) (2011). What is nursing? Retrieved from http://www.nursingworld.org/EspeciallyForYou/StudentNurses/WhatisNursing.aspx. <br />Johnson, B.M. and Webber, P.B. (2005). An introduction to theory and reasoning in nursing. Philadelphia: Lippincott Williams & Wilkins<br />Marquis, M.L. and Huston, C.J. (2009). Leadership and management functions in nursing: Theory and application (6th ed.). Philadelphia: Lippincott Williams & Wilkins.<br />Schoessler, M. and Waldo, M. (2006). The first 18 months in practice: A developmental transition model for the newly graduated nurse. Journal for Nurses in Staff Development, 22 (2), 47-52. <br />Sentara Healthcare (2011). Sentara nursing philosophy. Retrieved from http://www.sentara.com/Employment/Nursing/Pages/nursing_philosophy.aspx. <br />Honor Code<br />I pledge to support the Honor System of ODU. I will refrain from any form of academic dishonesty or deception, such as cheating or plagiarism. I am aware that as a member of the academic community it is my responsibility to report all suspected violations of the Honor Code. I will report to a hearing if summoned.<br />Kristen Casey BurrittFebruary 4, 2011<br />Name Date<br />PHILOSOPHY OF NURSING GRADE SHEET <br />Grading CriteriaCommentsPointsAppropriate introduction is included. Introduction includes a summary of the philosophy of nursing written in Nursing 300 (5%) 5The student’s definition of nursing, whether borrowed or original, is described and explained. (15%)15The purpose of nursing from the student’s perspective is clearly described. (10%)-3 Purpose of nursing not clearly described/discussed7Assumptions about the relationships between the nurse and the client in a culturally diverse settingthe nurse in the communitythe nurse with other health care professionalsare discussed in relation to an appropriate theoretical model(s) (15%)15TWO principles or rules that guide professional practice are identified; and specific examples specific of how these rules have been utilized or demonstrated in a clinical practice experience are described and analyzed. (15%) -5 teaching is not really a moral or ethical principle 10Conclusion summarizes main points of paper, describes how personal philosophy has changed, goal for future (10%) 10Three (3) or more references are cited in the paper and included on the reference list (10%)10Correct grammar, spelling and punctuation (10%)-1 did not include pg # w/direct quote9Correct use of APA format, including adherence to page limit (10%)10<br />STUDENT’S NAME _____________________________________GRADE ____91____<br />Nice job!<br />