Nursing Philosophy through the Eyes of a Novice Nurse
Katie Blume
Auburn University School of Nursing
Abstract
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This paper explores values that I have incorporated into my nursing philosophy.
Balancing my thoughts and personal reflections with support from peer reviewed journal articles,
my philosophy regards nursing as caring for others when they cannot care for themselves. This
means actively forming relationships and bonds with people at their most vulnerable. Utilizing
key concepts from Nightingale’s theory allowed me to conceptualize a nursing theory of values
that represent this. Consideration towards both the patient and the patient’s immediate family is
essential to my philosophy. Drawing from personal experiences my personal nursing philosophy
emphasizes advocating for patients, centering care around patients, creating a positive
environment, communicating with other healthcare professionals, and fostering a healthy work
culture with my fellow nurses.
Keywords: nursing philosophy, workplace, Florence Nightingale, patient centered care,
patient advocacy
Nursing Philosophy through the Eyes of a Novice Nurse
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Introduction
The definition of nursing cannot be limited to providing care for the sick and infirm. This
definition views nursing in its simplest form and does not encompass the true scope of nursing.
Florence Nightingale, a famous nurse from the Crimean war, defines nursing as “an art: and if it
is to be made an art, it requires an exclusive devotion as hard a preparation, as any painter's or
sculptor's work; for what is the having to do with dead canvas or dead marble, compared with
having to do with the living body, the temple of God's spirit? It is one of the Fine Arts: the finest
of Fine Arts” (Selanders, 2012). Nightingale’s depiction of nursing as an art form resonates
much more loudly with me than such a simplistic definition of just caring for the sick. Before I
began my nursing curriculum at Auburn, I did not know who Florence Nightingale was or her
impact on nursing. From my personal experiences and knowledge gained from Auburn
University School of Nursing, I have been able to shape a nursing philosophy mirroring hers that
I hope to continue to build on. My personal nursing philosophy will help guide me through this
difficult but rewarding profession. The purpose of this paper is to explore Nightingale’s nursing
theory coupled with my own life experiences allowing me to shape a personal nursing
philosophy that emphasizes advocating for patients, centering care around patients, creating a
positive environment, communicating with other healthcare professionals, and fostering a
healthy work culture with my fellow nurses.
Patient Advocacy
Nightingale and I share several similarities that contribute to our philosophies of nursing.
At seventeen years of age, Nightingale believed she was called into service by God “to do
something toward lifting the load of suffering from the helpless and miserable” (Selanders,
2012). Similarly, at 16 years of age I found myself devastated by personal tragedy. I was
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diagnosed with Premature Ovarian Failure (POF). Put simply, my dream of being a mother was
ruined. I desperately needed someone to “lift my load of suffering.” Effective use of advocacy
enhances the care-giving environment. Advocacy has been defined as an active process of
supporting a cause or position, and my diagnosis allowed me to witness this process firsthand.
Because this is a difficult diagnosis and a tender age, having a nurse be an advocate eased some
of the pain and helped me see nurses in a new light. This nurse changed my perception of
nursing and exemplified patient advocacy by truly caring for my feelings and supporting me
when I was vulnerable. Ironically, this nurse was pregnant, and she made me feel loved and not
alone. It was at this moment that I saw the potential a nurse can have on someone’s life. This
simple exchange of words between a nurse and me before I saw the doctor became a pivotal
point in my life. I decided I wanted to help others in their time of need. I never wanted others to
experience the helplessness that I was consumed by.
Nursing continues to evolve yet Nightingale’s use of advocacy in the 19th century still
applies even in the 21st century. However, advocacy has not always been a clear expectation in
nursing. Advocacy is now identified both as a component of ethical nursing practice and as a
philosophical principal underpinning of the nursing profession, helping to assure the rights and
safety of the patient (Selanders, 2012). Nurses are seen as advocates both when working to
achieve desired patient outcomes and when patients are unable or unwilling to advocate for
themselves. These serve as reasons for why I wish to incorporate advocacy into my philosophy. I
wanted to be like Florence Nightingale and “lift the load of suffering from the helpless and
miserable” (Selanders, 2012).
Patient Centered Care
In my personal struggle with Premature Ovarian Failure I had my mother beside me at all
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doctors appointments. This made all of my care not only directed towards me but my mother as
well. This is why my philosophy encompasses “patient centered care.” To me this means the
patient is not only the person who is sick, but also their family members who support them
during their time of need. Patient centered care requires treatments and recommendations to be
customized in response to patients’ preferences and beliefs. As seen in Crossing the Quality
Chasm, patient centered care is an essential component of quality care. Research reveals that
patient centered care leads to enhanced patient satisfaction, better outcomes, improved health
status, and reduced utilization of care (Finkelman, 2012). Additionally, people often trust in the
nurse because that who is organizes their plan of care and continues to be the most visible
member of healthcare. Because I saw first hand effects of centering care on the patient, I want to
incorporate patient centered care to be a part of my philosophy.
The Environment
The environment is believed to have an immense effect on humans. An individual sleeps,
breathes, eats, and learns in a particular setting. Therefore it only makes sense that nursing must
place importance on the patient’s environment if they expect results. Nightingale believed that
nursing had a far more effective role to play in the maintenance and promotion of health than just
medicine. Nightingale sought to “provide a safe and caring environment that promotes patient
health and well being” (McCurry, Revell, & Roy, 2010). She believed that nursing is an act of
utilizing the environment of the patient to assist him in his recovery. It involves the nurse's
initiative to configure environmental settings appropriate for the gradual restoration of the
patient's health. It is important to recognize that external factors associated with the patient's
surroundings affect biologic and physiologic processes as well as development (Porter, 2001).
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The environment should be determined by external factors like the age of the patient, condition
of the patient, available care in the past, and emotional status of the client. A stressful
environment will not allow the patient the ability to rest and overcome their ailments.
Environment is an important component to my nursing philosophy because a comfortable
environment makes others feel more relaxed and accepting of care. For example, in my situation
discussions on adoption and other options to start a family were not necessarily appropriate while
I was in high school. In fact, as a teenager, I was too focused on the current situation of how this
made me different from my appears. However, now that I am 22, this conversation is age
appropriate and I am more receptive to considering plans towards the future. Regarding the
patient’s environment is one more way to personalize care towards a patient. Incorporating
environment into my nursing philosophy allows me to individualize care, which also helps
promote my previous goal of patient centered care.
Nurses and Other Health Professionals
Nurses work both directly and indirectly with different health professionals in the
workplace. Physicians, therapists, pharmacist, and techs all must speak the same language to be
able to communicate and complete the task at hand. If the different levels of healthcare cannot
communicate, it places the patients at risk and compromises their trust. Therefore, it is
imperative that the nurses and other healthcare workers share a strong, trusting bond. Because of
this and my own personal experiences of the detrimental effects of poor communication amongst
staff, my nursing philosophy holds a strong belief that relationships must be cultivated between
the different levels of healthcare. For example, I found that different results were not being
communicated between the doctors and the nurses while I was dealing with my POF. This
resulted in me becoming frustrated and angry at my doctor’s appointments because I would
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relive all of my negative tests results. My care for the day was compromised due to how upset I
was from the mix-up as well as the diagnosis, which in turn would upset my mother, thus
rendering the appointment counterproductive. For this and other reasons, I want to work where
there is a healthy flow of communication between all the departments that are providing care for
an individual. This will provide the individual with the best care possible and ultimately a more
pleasant experience. In my philosophy, I believe the nurses are the glue in the relationship
between the patient and the other healthcare personnel. My personal philosophy leads me
striving to cultivate communication no matter where I work.
Work Culture
Just as the relationship between different healthcare professionals is a key tenet of my
philosophy, I believe that healthy relationship amongst the nurses is critical in creating a positive
workplace environment. From my experience in clinical, the people you are working with can
influence your experiences. I value the work culture as an important attribute to my nursing
philosophy. If there is cohesion between the nurses on the unit, then things will go more
smoothly and patient care will be better. When care goes more smoothly, stress is likely to be
reduced leading to a happier healthier environment for both the nurses and patients. If the staff
shares similar beliefs, positive outcomes can be facilitated. I believe characteristics like
autonomy, time management, flexibility, knowledge, eagerness to help and other characteristics
must be embodied in the employees in order for a proper work culture to develop. For example,
during clinical I was asked to give a patient an enema. While this is not usually regarded as a
pleasant task, because of the work culture, a typically “less desirable activity” was fun and
educational. One nurse was eager to teach me, knowledgeable, and willing to help through out
my time at this hospital and helped me give my first enema. Although I do not want to work at
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this specific hospital, I would feel blessed to work with someone like this particular nurse
because he always went above and beyond what was required of him.
Conclusion
In conclusion, the purpose of this paper was to examine my view of the nursing practice
and reflect upon my own beliefs about nursing in order to develop my own personal philosophy.
My personal philosophy will help guide me to be a better nurse and to understand what is
important to not only myself, but my patient as well. Nightingale’s nursing theory helped me
identify what I valued to be important. My personal nursing philosophy emphasizes advocating
for patients, centering care around the patient, creating a positive environment, communicating
with other healthcare professionals, and fostering a healthy work culture with my fellow nurses.
In order for a philosophy to be “correct,” I think that the professional must be open to change
and their philosophy must adapt to what others view as important as well. In class we discussed
the quote “Communication is not intent, it is perception, and perception equals reality.” This
quote reminds me to always consider what the patient hears or think is important, because the
healthcare provider must somewhat adjust their philosophy to address what the patient views as
necessary while maintaining their philosophy. No two philosophies will ever be completely
alike, but hopefully the nurses that I work with in the future will hold similar values, which will
enable us be able to provide the best possible care to our patients.
References
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Finkelman, A. (2012). Leadership and Management for Nurses (2nd ed.). Pearson: Washington,
D.C.
McCurry, M., Revell, S., & Roy, S. (2010). Knowledge for the good of the individual and
society: linking philosophy, disciplinary goals, theory, and practice. Nursing
Philosophy, 11(1), 42-52. doi:10.1111/j.1466-769X.2009.00423.x
Porter, S. (2001). Nightingale's realist philosophy of science. Nursing Philosophy, 2(1),
14-25. doi:10.1046/j.1466-769X.2001.00029.x
Selanders, L. C., & Crane, P. C. (2012). The Voice of Florence Nightingale on Advocacy. Online
Journal Of Issues In Nursing, 17(1), 1. doi:10.3912/OJIN.Vol17No01Man01