A Philosophic Perspective Of Nursing

A Philosophic Perspective
Of Nursing
By Laurie Clark, MSN, AGACNP-BC, APRN
_____________________________________
Nursing in a historical context has been around from the beginning of time. It has evolved from the cave man era when humans learned from animal behaviors of caring for their ill and mimicked this to care for their loved ones. We have medicine from 3000 BCE Egypt concocted from plants, minerals and animals to treat illness (Hood, 2014). There used to be witch craft and people were burned at the stake thinking they were demonized. We had a time in history when as a punishment one was sent to care for the ill and informatory. There was a time when there was home based nursing and then when the war began we had women nurses such as Florence Nightingale go into combat to care for our wounded. Ever evolving throughout the world has been different practices of medicine in the search for cures and treatment of ailments. Many are still practiced today like Chinese medicine, acupuncture, herbs and teas. We have holistic medicine that embodies natural substances from the earth to cure what ails them. We have culturally diverse care throughout history as seen in Chinese medicine. Nursing has evolved and will continue to in time. The constant throughout history are four key concepts: Person, health, environment, and nursing as the base of nursing practice. As a registered Emergency Room nurse with goals of becoming a nurse practitioner in the field of emergency medicine these concepts have personal ontological meanings that guide my practice. Throughout my educational experience certain theorists have great impact on influencing my nursing are such as Florence Nightingale as she paved the way for nurses today, Jean Watson with her Theory of Caring, Albert Bandura and his Theory of Self Efficacy, Maslow's Hierarchy of needs, and Peplau's Interpersonal relations models. Throughout this paper I will unfold my person views of nursing as influenced by the above mentioned theorists incorporating the four main conceptual bases for nursing practice.
The reason to have a personal philosophy in nursing is to have a solid base to practice nursing. One must be aware of what drives their beliefs of what nursing is. Much research and advancement has come in the way of nursing due to personal views and theories of how a nursing should be. My philosophy of nursing is through transparency, compassion, caring, and teaching creating greater outcomes. The patient and family are in the center of all that I do as an emergency room nurse.
The foundation of my philosophy on nursing is based on my belief that every human being deserves health care regardless of their ability to pay. I believe people should have the utmost compassionate care, access to needed tests, procedures and medications, have the right to be informed and educated in order to make decisions. I believe nurses have a moral and ethical responsibility to promote ethicacy in all they do.
Nursing care is patient centered, to be the center of their own health care not the other way around. As an emergency room nurse I dedicate myself to be there in the sickest, darkest days, whether to help with end of life care or any acute or chronic illnesses. My belief is patient/family centered care that as a nurse we are responsible for compassionate, ethical care. We promote health, wellness and education on preventative care and nurturing through compassion. My beliefs fall in line harmoniously with the definition of altruism, "caring for no obvious reward other than the belief that someone else will benefit or avoid harm. Altruism represents an amalgamation of intrinsic and extrinsic factors which either permit or coerce individuals to take responsibility for or care for another and to sacrifice things dearly held" (NCBI, 1996).
All patients have a right to competent, compassionate health care. Patients are the center of care and all that is done is for the purpose of health and wellness of the patient. The patient has the right to informed care and to be part of the decision process. The patient deserves to be educated in self efficacy to encourage individual growth and responsibility for one's own care.
The Worlds Health Organization definition of health states that," Health is a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity" (WHO, 2003). In today's world the focus is becoming more prevalent on preventive care and wellness. Health is determined not only by being free of disease and illness, but to be of optimal performance mentally, physically, spiritually, sexually and emotionally. As a nurse we are the sounding board of our patients and advocates to optimal health through the process of healing and education.
As defined by The American Nursing Association, "Nursing is the 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" (American Nursing Association, 2014). It is my belief that nursing is a science made up of evidenced based practices wherein embodied in a pyramid of philosophical based knowledge intertwined with cultural and spiritual beliefs that are ever evolving for the purpose of obtaining maximum health in order for man to achieve ones purpose in life.
The person's environment has an impact on one's health. Environment has many contextual meaning and they all factor into the patient's ability to be healthy. Climate is known to exacerbate allergies in chronic illness such as asthma. Living in a home full of violence or neighborhood impacts ones health as their focus is in on flight /fight modes unable to concentrate on any other realm of health. It is conceivable to use the environment for health. Eating food grown from the earth and eating natural sources of food while being in-tune to one's digestive system and how it reacts to the food put in one's body. Is it providing a source of energy, or does it make one feel sick and sluggish? Keeping notice of these things will increase optimal health. Spending time taking care of the most important environment, your home, which is your body that one cannot escape. It needs to be nurtured to be sustainable to the elements. These holistic practices are something I would like to see more of in practice rather than the practice of medicine, giving a pill for every ailment. The way medicine is evolving, the rampant allowances of antibiotics are setting up for superbugs that have no cure. We are starting to see with outbreaks of Ebola, and other disease.
There is not one model that fits in with my person views of nursing thus allowing the sum parts of theory by different theorist's hone ingeniously to my practice guided by the base of health, nursing, environment, and person as my foundation.
Abraham Maslow's hierarchy of needs shows environmental impacts on human motivation. It is a pyramid of 5 levels starting at the base is physiological needs. In a person's environment must air, food, water and shelter are basic needs. Imagine if any one of those need were missing there would be a serious upset to a person's environment. After a person has their physiological needs met the next realm is safety then love and belonging, esteem and self-actualization. A person can go back and forth in between each realm and it is theorized that many people never reach self-actualization (Maslow, 2015). I bring Maslow in as a theory to environmental impact on a person's health because they are all part of one's environment or directly related to on environment. As a nurse it is important for us to screen the patient to find out what elements they are in. Knowing the environment and effects of such enables to the nurse to be more proficient at caring for our patient and families as well as their needs.
The model of self-efficacy by Bandura attributes conceptual beliefs that a person's perception of oneself influences outcomes in one's behavior, environment and personal and cognitive factors (Nursing Planet, Self-efficacy, 2012). It is the outlook in one's life that instills the capacity to thrive or fail to thrive. It is deemed that one's perception of their abilities has a direct impact control their health by their lifestyle choices, the way they think, eat and manage life. The thought is structuring self-efficacy with "goals, outcomes, expectations, and perceived environmental impediments and facilitators in the regulation of human motivation, behavior, and wellbeing"(Bandura, Albert http://heb.sagepub.com). Each person has their own beliefs and concept of responsibility to each owns health which drives efficacy to positive or negative outcomes. Teaching patients' to be accountable for their health through efficacy will enable contentment through achievement.
Peplau's interpersonal Relations believe family as a whole is the center of care. The nurse looks at the family unit as a whole instead of the individual patient. The nurse gains trust from each family member in order to devise a relationship with each family member. In order for this to occur each participant shares their thoughts and concerns and as unit the family as, an entity, plan goals and outcomes that is the best for the family not just the individual patient. The idea of family in the center instead of the patient is to encourage growth and learning whiling gaining a deeper interpersonal relationship with one another (Hood, 2014, p.417). It is regarded that when one member of the family is sick it affects the entire family. By facilitating interpersonal relationships the family comes together as a unit to address an illness of a person it has a much greater impact on healing and growing into a deeper relationship as a family unit.
Jean Watson concept of caring is an intricate part of nursing. To care for a patient and family is one not to be taken lightly. It is not done for the money, it is the ability to reach beyond the depths of physical illness and spiritually connect to another through body mind and spirit. Watson state caring is the moral compass of nursing (Hood, 2014). One must have efficacy, determination, compassion, diligence, the ability to problem solve through integrity and a strong moral compass. It is with a soft soul and heart to deliver the quality care as you would want given to you or your family member in there time of need.
It is the value of human life and the belief that nurses help promotes wellness and healing through the science of nursing.
In conclusion my philosophy of nursing is quite simple. It comes to the basic, treat others how you would like to be treated. Every human being deserves the best health care. My personal values in beliefs stem from my belief in God. It is through him that I am guided to be a humble citizen and servant of the lord. To serve my brothers and sisters in Christ as he would want it to be done. It is through my spiritual strength that carries me through the tough cases of traumatic passing's of life in failure of valent efforts to save them. I have and will again question why, but it is not for me to understand but to be there as a nurse giving myself in the best way I humanly can to make a difference in the lives that I meet. It is in the field of nursing in times of great stress, no one, neither patient nor family expected to wake up that day anticipating a visit to the hospital. It is with the compassionate mindful set nurse to embrace the situation and give what is expected and deserved of every human being. I have a moral and ethical obligation to my patients and families. It is my values and beliefs that create a high moral which drives the ethical decision-making process that must be incorporated in the care of humanity.

When taking responsibility for our own health by living a healthy lifestyle lends to defy illness by being on the health side of the health and illness spectrum. Defines "person" and identifies beliefs about the rights and responsibilities of person with regard to health processes. It is the responsibility of everyone to take accountability for one's health. Knowledge is power. The reason this theory holds dear to me, and my nursing practice is, "Most of the models of health behavior are concerned only with predicting health habits but they do not tell you how to change health behavior. Social cognitive theory offers both predictors and principles on how to inform, enable, guide, and motivate people to adapt habits that promote health and reduce those that impair it" http://heb.sagepub.com). These theories embody central nursing concepts consisting of person, health, nursing, and environment.



Hood, L. (2014). The Professional Nurse. In Leddy & Pepper's conceptual bases of professional nursing (8th ed., p. -). Philadelphia: Lippincott Williams & Wilkins.
http://www.who.int/about/definition/en/print.html
http://en.wikipedia.org/wiki/American_Nurses_Association
http://www.ncbi.nlm.nih.gov/pubmed/8970856
http://en.wikipedia.org/wiki/Maslow's_hierarchy_of_needs
http://nursingplanet.com/theory/self_efficacy_theory.html
http://heb.sagepub.com.cyrano.ucmo.edu:2048/content/31/2/143.full.pdf+html
Health Education & Behavior, Vol. 31 (2): 143-164 (April 2004)
Downloaded from heb.sagepub.com at University of Central Missouri on February 24, 2015