PhilosophyOfNursing

Philosophy of Nursing Sheena PayneMetro State University of Denver Philosophy of Nursing Since starting my nursing career, a little over three years ago, I have been working at Devereux Cleo Wallace, one of the largest and most advanced behavioral healthcare organizations in the country, specializing in providing individualized care for children and adolescents that have significant mental health and behavioral needs. I also briefly worked at a detox facility, which closed due to licensing issues. Working as a child psychiatric nurse is both extremely rewarding and challenging. Helping kids improve their lives is tremendously gratifying. Child psychiatric nurses play an important role by providing not only medical care but holistic care to kids with significant trauma. On the other hand, working with kids with severe behavioral disorders who can be extremely difficult and possibly violent can be physically and emotionally taxing. My nursing experience, thus far, has taught me a lot about myself, my capabilities, and limitations, both as a person and a nurse. Nursing is a profession that strives to improve, minimize, and prevent poor health through the application of a specialized body of knowledge and individualized evidence-based care, using a holistic approach. When it comes to nursing, my philosophy emphasizes on holistic, patient-centered, evidence-based, and compassionate care. Holistic care, which focuses on caring for the whole person, not just their physical illness, is the foundation of my nursing philosophy. Perhaps as a nursing student, prior to working as a nurse, I did not fully grasp the concept of holism. Now, as a practicing nurse that works with children that have been through significant trauma, I understand that holism is beyond the mere actions performed or words expressed to a patient. Rather, it is an intentional method that strives to care for all parts of a patient. It involves caring for a patient by taking into account their uniqueness. In the article titled “Holistic nursing care: theories and perspectives,” the authors describe health as the harmony between mind, body and spirit, and advise that nurses must go beyond caring for current presenting illness and focus on the unique needs of each patient as whole (Papathanasiou, Sklavou & Kourkouta, 2013). The article further elaborates that nursing care that is routine-based and one-dimensional, one that solely focuses on a patient’s physical needs ignores the patient’s psychological, spiritual, emotional, and social needs. The article urges nurses to not treat a disease as a “mechanical malfunction of an instrument” but rather “as the result of a disturbance in the balance of an organism as a whole and its environment” (Papathanasiou, Sklavou & Kourkouta, 2013). As a psych nurse, I see the importance of a holistic approach in my daily practice. For example, a child with somatic symptom disorder (SSD) may experience extreme anxiety about a physical pain he or she is feeling when, in fact, there is no physical cause that can be found. Children with a history of physical or sexual abuse are more likely to have this disorder (Henningsen, 2018). By applying holistic care method, the focus is not on the fact that the child does not have an immediate or “real” physical need, but rather the unique needs of the child, his or her experience, trauma, coping skills, spiritual needs, and more; it is beyond executing doctors’ orders and completing tasks and procedures. The second focus of my nursing philosophy is evidence-based care, which goes hand-in-hand with holistic care, as there is an overwhelming amount of evidence on the importance of holistic care. Thus, holistic care is evidence-based care. I believe evidence-based practice should be the back-bone and key principle of nursing and medicine in general. Why do we do what we do the way we do it? For me, that is essentially what evidence-based practice answers. When our actions are backed by solid research and evidence, we are able to follow standards for high quality and safety. In the article titled, “the impact of evidence-based practice in nursing,” the author points out that nursing policies, when written based on research evidence, have proven to highly improve patient outcomes (Stevens, 2013). For instance, there was a belief by some that providing oxygen to patients with chronic obstructive pulmonary disease (COPD) can create hypercarbia, acidosis, or even death. However, through research and evidence, the protocol is now to provide oxygen to COPD patients as it can help prevent hypoxia and organ failure. I think it’s imperative that nurses are well-informed when it comes to the research and evidence behind the routine tasks they perform daily. For example, using a smaller-gauge catheter during packed red blood cell transfusions is a protocol that is rooted in evidence which suggests that a smaller-gauge catheter increases patient comfort. A key recommendation of the article was to use evidence-based practice in all aspects of nursing, based on the belief that research produces the most reliable knowledge (Stevens, 2013). Another important aspect of nursing is compassion. I am a firm believer that nursing is more than a job, it is indeed a calling. I decided to pursue nursing because I recognized that my desire to help people far outweighed the numerous challenges the profession presents. As nurses, we have the responsibility to provide compassionate, safe, holistic, and patient-centered care. We must be able to view our patients more than a room number or the illness they are dealing with. In a job as stressful as nursing, we may sometimes feel like we are “losing” our compassion. The demanding nature of the job can get us so focused on tasks that we sometimes forget what is truly important to patients. External stressors are not the only things that can deprive us of compassion. Sometimes, it is our own attitudes and judgments. It is easy to have compassion and care for patients that are grateful, kind, and cooperative. I might have an easier time having compassion for the cooperative patient with the sweet family than the alcoholic, angry, disheveled man that curses at me every time I enter his room. It might not always be easy to look beyond the attitudes and appearances of patients. I believe judgment is one of the biggest threats to compassion. Most of us pursue a career in nursing because we are genuinely interested in helping people. But whom do we think of when we picture people? Does that include the chronic complainers, drug seekers, sex offenders, those with severe psychiatric illness? As nurses, we must be able to deliver compassionate care indiscriminately and not allow our personal bias and preconceived notions influence the care we provide. My philosophy of holistic and evidence-based care impacts the healthcare environment and the way care is delivered. Focusing on treatment of the whole person, as opposed to just the disease, recognizes that an array of mind-body-spirit connections influence patients’ ability to heal from diseases, thus promoting long-term wellness as well as short-term relief. For example, when taking a patient’s health history, a holistic nurse might inquire about the patient’s religious or spiritual practices, recognizing that one’s spiritual practices might also impact other areas of his or her life, such as health practices and beliefs. In an article titled “what is evidence-based practice?” the author demonstrates how the philosophy of holistic care shifts our focus from just the disease to the whole person, thus changing the way we care for patients (Thyer, 2004). The article emphasizes that the philosophy of evidence-based care impacts the clinical decision-making process and the delivery of care, relying on evidence as opposed to tradition (Thyer, 2004). Lastly, the philosophy of compassionate care is extremely important in a profession that is becoming highly mechanized. Nurses work in an environment where human suffering is evidently present. As the fundamental part of nursing care, nurses have a duty of care to deliver care with compassion, free of judgment and bias. Care that lacks compassion leads to patients feeling degraded and insignificant. Evidence-based practice is key when it comes to ensuring patient safety. It eliminates practices that are not effective or might even be dangerous (Leape, Berwick, & Bates, 2002).For example, aspirating a syringe during an intramuscular injection used to be the standard practice. This is no longer the case since there is now evidence that it can cause trauma to patients. There was also a time when milking chest tubes and using Aspirin to control fever in the pediatric population were standard practices. At the time, these practices seemed logical, however, evidence-based practice has confirmed otherwise. There are endless examples of medical and nursing practices that are no longer used since the integration of research and evidence into our daily practices as health care professionals. Through evidence-based practice, we can continue to improve the policies and protocols that guide our actions, thereby improving patient outcomes (Leape, Berwick, & Bates, 2002).I believe my philosophy of nursing has a positive impact on the use of leadership and management principles. In an article written by Robert Hess, he suggests that evidence-based practice can improve nurse satisfaction (Hess, 2017). Guidelines and protocols founded on evidence-based practice not only improves patient outcomes but also gives nurses confidence and satisfaction. Furthermore, the application of holistic care is not only applied to patients but also to employees as well. When evidence-based leadership is applied, it leads to an overall better outcome. ConclusionUltimately, the way we define nursing and our personal philosophies affect the choices we make daily. The values, traits, and skills that mean the most to me in my profession of nursing is providing care that is holistic, evidence-based, and compassionate. Treating the person as whole, not just the disease, taking into account the connection of mind-body-spirit, is extremely important. In addition, I define high-quality care as care that is rooted in evidence, which ensures the safety of patients and improves patient outcomes. ReferencesHenningsen P. (2018). Management of somatic symptom disorder. Dialogues in Clinical Neuroscience, 20(1), 23-31. Retrieved from https://www.dialogues-cns.org/dialoguesclinneurosci-20-23/Hess, R. (2017). How evidence-based practice can improve nurse satisfaction. Nurse Leader Insider. Retrieved from http://www.hcpro.com/NRS-328960-868/How-evidencebased-practice-can-improve-nurse-satisfaction.htmlLeape, L.L., Berwick, D.M., Bates D.W. (2002). What practice will most improve safety? Evidence-based medicine meets patient safety. JAMA, 288(4), 501-507. Retrieved from https://www.researchgate.net/publication/11248777_What_practices_will_most_improve_safety_Evidence-based_medicine_meets_patient_safetyPapathanasiou, I., Sklavou, M., Kourkouta, L. (2013). Holistic nursing care: theories and perspectives. American Journal of Nursing Science, 2(1), 1-5. Retrieved from https://www.researchgate.net/publication/235759117_Holistic_Nursing_Care_Theories_and_Perspectives Stevens, K. (2013). The impact of evidence-based practice in nursing. The Journal of Issues in Nursing, 18, 5-13. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-18-2013/No2-May-2013/Impact-of-Evidence-Based-Practice.htmlThyer, B. A. (2004). What is evidence-based practice? Brief treatment and crisis intervention, Oxford Academic, 15(3), 167-176. Retrieved from https://btci.stanford.clockss.org/cgi/reprint/4/2/167.pdf