My personal philosophy on nursing. Every nurse views the profession as something different based on their own personal philosophies, so I'm glad I can share this!
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Nursing has evolved over many years from the Florence Nightingale era. Since then there have
been several nursing pioneers who have contributed their own philosophy to the profession.
Nightingale, the most famed nurse, created a nursing philosophy during the Crimean War where
she saw a need to change the environment of where the wounded soldiers were. She addressed a
need, created a philosophy, and implemented her philosophy. At the core of her philosophy was
to create an environment that nurses could provide for safe and effective nursing care for
wounded soldiers. Her thoughts on nursing have become the foundation of nursing to many
nurses (Black, pg. 178). Throughout the years after Nightingale, we have had several other nurse
pioneers who have created philosophies of their own, based on an apparent need. Virginia
Henderson, another nurse pioneer, had a philosophy that nurses provide care to a patient who is
not able to provide that care for themselves, if they were otherwise able. Henderson addressed 14
basic needs of the patient, and these needs scaled from the need to breathe normally to being able
to learn and discover curiosity, leading to normal development (Black, pg. 180). The third nurse
pioneer and philosopher, Jean Watson had a philosophy that focused on the caring aspect of
nursing, and how the nurse provides that (Black, pg. 181). These three philosophers have
contributed to nurse education and the development of novice nurses to expert nurses. This paper
is going to address my personal philosophy on nursing and how it relates to the philosophies of
Nightingale, Henderson, and Watson.
When analyzing the nurse philosophies of Nightingale, Henderson, and Watson, I imagine
Maslow’s hierarchy of needs and where each nurses philosophy correlates. Nightingales
philosophy mainly addressed the physiological and safety needs of the patient. That the nurse
helps provide the two most important and foundational levels of Maslow’s. These are: food,
water, rest, warmth, security and safety (Jackson, 2016).
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When analyzing Henderson’s philosophy in relation to Maslow’s, her thoughts on nursing can
actually be applied to all levels of Maslow’s, excluding self-actualization perhaps. Henderson’s
philosophy has more depth than Nightingales and Watsons theories. In Henderson’s 14 Basic
Needs of the Patient, the needs that can be categorized under Maslow’s physiological needs are:
breathing normally, eating and drinking adequately, eliminating body wastes, maintaining
desired position, and sleep. Safety needs and Henderson’s theory in relation to Maslow’s are:
avoiding dangers and maintaining temperature and keeping the body clean and well groomed.
Finally, esteem needs and belongingness and love needs in Henderson’s philosophy are:
communicating with others to express emotion, worshiping ones faith, having a sense of
accomplishment through work, play and recreation, and learning and discovering to satisfy
individual curiosity (Black, pg. 180-181).
Watson’s philosophy is the last nursing pioneer whose philosophy will be analyzed. Watson’s
philosophy of nursing has very little to do with the first two levels of Maslow’s (physiological
and safety needs) and instead addresses the belongingness and love needs and esteem needs. Her
philosophy of nursing primarily focusses on the caring aspect of nursing. The idea of Watson’s
nursing care focuses on the relationship between the patient and nurse, and the importance of the
nurse to have the patient’s trust (Black, pg. 181).
When creating my own philosophy on nursing and looking at Nightingales, Henderson’s, and
Watson’s philosophies, I would say that my philosophy relates mostly to Henderson’s and
Watson’s.
My philosophy on nursing is that the nurse serves as an advocate for the patient in a time when
they are not able to advocate for themselves, whether it be due to lack of knowledge of their care
or the inability to communicate effectively due to illness or situation. When the patient is in the
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hospital setting, which I am most familiar with, the nurse builds a relationship with the patient
and becomes primary facilitator. The nurse helps coordinate the patients care with the
interdisciplinary team. During a 12 hour shift, I find myself in the patient’s room at least every
hour. By the time the shift is over, I have usually met the goal of gaining the patients trust in
having a transparent relationship. It is my duty not to judge, but instead take what information is
given to me and protecting that information and sharing only what is necessary with the other
nurses and interdisciplinary team. Building this relationship makes it so I can fully advocate for
the patient and explain what may be unfamiliar with their plan of care. The patient should be able
to ask the nurse questions about their care. When building trust, it is important to provide an
environment where the patient feels safe and respected by the nurse. As the nurse, it is important
to realize that the patient is in the hospital for a reason that brings them outside of their norm. It
is important for the nurse to recognize that the patient does not want to be in the hospital, but
needs to be in order to be better. The nurse should be responsible in making the patients
experience the best it can be by providing quality nursing care and advocating. This is my
philosophy on nursing and when I analyze Nightingales, Henderson’s, and Watson’s
philosophies on nursing, I would say that it mostly falls under Henderson’s ideas with some of
Watson’s views.
Advocating for the patient would fall under Henderson’s theory because I view patient advocacy
as something the nurse provides to the patient that the patient would do for themselves if they
were able. Building trust through advocating for the patient would be a Watson philosophy
because I would consider this as developing a helping-trusting-caring relationship (Black, pg.
181). My idea that nurses care for patients during a time that is not ideal for them would be a
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Henderson and Watson trait because the nurse is providing care that the patient would do for
themselves if they were able, and Watson because this is caring.
The role of the nurse varies based on what setting they are practicing. Most nurse’s interaction
with patients though is during times when the patient or individual is not well. Watson describes
illness as a lack of harmony in the mind, body or soul of the individual (Black, pg. 181). My
definition of illness is any condition that is outside the baseline of the individual. With that said,
some patients with chronic illness, their baseline is going to be their illness when not
exacerbated. Illness can be acute or chronic, stable or unstable, physical or psychosocial. It’s
important for the nurse to realize the patient’s baseline, and then provide care that is appropriate.
Health is a balance of physical, psychological, and emotion well-being, where all of Maslow’s
hierarchy of needs are met. Self-actualization may or may not need to be met for health, but is
the most ideal when describing health. The nurse plays a major role in health promotion and
helps a patient meet their needs of health through self-motivation as well as with collaborating
with all member of the healthcare team. The nurse plays an important role as a coordinator of
care in helping the patient progress from illness to health or at least the patient’s closest possible
form of health (Jackson, 2016).
When caring for patients, no matter what the setting, the nurse serves many roles and has many
responsibilities when providing competent care. Nurses should provide quality care, be ethical
with their decision making and patient information, be able to use their resources appropriately
with other nurses and use evidence based practice, provide competent patient education and
continue to research new things related to nurse practices, collaborate with not just the patient
but with other nurses, the interdisciplinary team, families and the patients. Nurses also act as
leaders as patient and family advocates.
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When providing quality patient care, caring and providing best evidence based practice go hand
in hand. It’s important to listen the patient to implement what is in their best interest. Focused
and accurate nursing assessment, best practice and appropriate nursing skill implementation,
effective communication, and evaluation of implementations all include quality nursing care and
will lead to good patient outcomes with quality is the focus of a nurses care.
The nurse is entrusted with having access to the patients’ health information and it is important
for the nurse to respect that information and keep it confidential and only sharing what is
appropriate to who is qualified to know. The nurse has a strong ethical standard when caring for
the patient because they serve as an advocate and have a duty to do what is in the best interest of
the patient (Hanks, 2012). Ethics is not black and white. What some may find ethical may not be
ethical to someone else. It is important for the nurse to have strong ethics because there are
situations where ethics are being questioned. An example of ethics is a scenario where the family
of an elderly patient is being reviewed for elder abuse and neglect. This patient is very confused
and came to the hospital with pressure ulcers all over her body and chemical burns from
incontinence. She lived with her family where she stayed on a mattress on the floor of the barn
and not taken care of. Her family called ems where she was brought her to the hospital for
mental status changes. When assessed in the ED it was clear that this patient had been neglected
for some time, this was evident by some ulcers wearing down to the tendon. This situation has
ethical concern because the role of the nurse is to provide the patient with the best care they can
while being cognizant of the family dynamic and the court case that will be filed. It is easy for
the nurse to be upset over this situation, but its important for the nurse to keep professional
despite having animosity toward the family.
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Resource utilization is important there will always be situations where the primary nurse does
not know what the best course of action should be. Nurses can seek out the input of other nurse,
the doctor, or other healthcare members like pharmacy or respiratory therapy. There are great
resources for nurses in the hospital setting as well as online resources. Rutland Regional Medical
Center has an online health library that is easy to access from the portal. I am fortuanate to have
resources readily available to me when I am at work, but this isn’t the case for nurses in all
setting. Nurses at some facilities are the only RN’s available during a shift. In these instances, it
is important for the nurse to realize they are the main resource and need to be confident in their
nursing care and know when to seek additional support when something is beyond their scope of
practice.
Nursing is not a stagnant profession and continuing education is something that all nurses are
responsible for. Nurse competencies and continuing education hours are examples of mandatory
education needs. However, some nurses take it upon themselves to earn higher degrees such as
their BSN or MSN, while other pursue certifications in their specialty. Education and research
correlate, and being familiar with new evidence based practices is important for nurses to
provide better patient care. Learning to be a better nurse through knowledge, credentials, and
research should be a responsibility all nurses take seriously to improve patient outcomes. It’s
important for the nurse to realize that medicine and medical practice are subject to change, and it
is the nurse’s responsibility to be able to adapt to an ever evolving healthcare system.
When creating a personal nursing philosophy, there are many nursing pioneers who have
contributed to nursing. Florence Nightingale created her philosophy when she saw a nursing
need to provide a safer and cleaner environment for wounded soldiers. Nightingale is well
known for her influence on nursing, even after over a century since her death. Virginia
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Henderson and her philosophy of the 14 basic needs of the patient is a very inclusive and
addresses Maslow’s hierarchy of needs and the physical needs as well as the emotional needs of
the patient. Jean Watson’s philosophy on nursing and the 10 Caritas Processes focuses mainly on
the care aspect of nursing. My own philosophy on patient advocating and providing meaningful
care relates to Henderson’s and Watson’s view. Nurses have many roles and responsibilities
when providing patient care, and it is a dynamic profession. Nurses provide quality care, are
ethical, utilize their resources, continue education and research, collaborate with all involved in
care, and serve as leaders to the patient and family.
