Introduction
The profession of nursing encompasses various domains, going beyond the limits of pure medical knowledge. In particular, nursing requires having a solid personal philosophy, inner beliefs, and ethical values that guide a nurse in day-to-day practice. In my opinion, one can draw a parallel between the personal philosophy of nursing and the concept of personal knowing introduced by Barbara Carper in 1978 (Thorne, 2020). Carper (1978) described personal knowing as the knowledge necessary for starting authentic interpersonal relationships with a patient (as cited in Thorne, 2020, p. 4). Therefore, one can perceive the personal philosophy of nursing as a bridge that connects nurses’ medical expertise with an interpersonal aspect of care.
In this regard, nursing philosophy is essential for creating a holistic professional approach that incorporates medicine and psychology to achieve the best possible patient outcomes. This paper attempts to demonstrate an example of personal nursing philosophy built on three key elements — nursing theory, values, and professional ethics. I illustrate how these elements of nursing philosophy find a practical application and affect such major concepts of care as person, environment, and health. Overall, I argue that a modern-day nurse has ceased to play a merely functional role, as nursing has become an inherently complex and philosophical profession.
Theoretical Foundation of My Personal Philosophy: The Self-Care Deficit Theory
My nursing philosophy is based on a grand-level self-care deficit nursing theory (SCDNT). Developed by Dorothea Orem, this theory states that nursing is an all-around beneficial activity if individuals have health-derived or health-related limitations for engaging in self-care or care of dependent others (Friberg, 2019). As a grand theory, SCDNT consists of three essential parts — nursing systems theory, self-care theory, and self-care deficit theory. A nursing system allows nurses to provide care according to the patient’s limitations and needs (Gligor & Domnariu, 2020). The self-care theory introduces a concept of self-care, or activities initiated by an individual to maintain health and well-being (Friberg, 2019). Lastly, the self-care deficit represents a gap between the individual’s capacity for self-care and the actual care needs (Gligor & Domnariu, 2020). In this regard, a nurse’s goal lies in creating a nursing system that enhances patients’ self-care capacity and lets them overcome the self-care deficit.
I strive to apply the self-care deficit theory to every major concept of the metaparadigm. For instance, I draw the personal motivation for work from the dependent care agent concept. As a nurse, I fulfill the role of a care agent; my patients depend on me since I am responsible for bridging the self-care deficit gap in their needs (Friberg, 2019). In this regard, I perceive individuals in the healthcare setting as an inalienable part of the nursing system.
Regarding the person concept, I utilize SCDNT to improve the patient’s self-care capacity. According to Friberg (2019), Orem’s theory defines illness as an individual’s inability to maintain self-care. Depending on the patient’s case, I attempt to create an optimal nursing system for the patient’s self-care capacity enhancement. For instance, I establish a supportive-educative nursing system if the patient needs educational and informational support (Gligor & Domnariu, 2020). As a result, the patient gradually acquires the necessary knowledge and skills to overcome self-care deficit.
Regarding the concept of health, I apply SCDNT to promote beneficial behaviors in patients. According to Yip (2021), SCDNT offers a framework that allows a nurse to evaluate specific cases and select appropriate ways of contributing to patients’ health and well-being. I incorporate this knowledge in my nursing philosophy — I treat my patients as individuals capable of self-care rather than passive care subjects. In particular, I instruct my patients on how they can manage their symptoms at home. As a result, the patients’ ability to maintain health through self-care increases, which allows them to manage or overcome illness.
Finally, I use the SCDNT to create a patient-empowering environment of care. I believe that educating patients on specific symptom management behaviors is beneficial for their self-care capacity. The clarity of the SCDNT framework is particularly useful for chronic disease management (Yip, 2021). Furthermore, when patients have the power to manage their condition, they become more inclined to follow through with the newly-learned behaviors. An atmosphere of mutual trust increases my satisfaction with the role of dependent care agent. Ultimately, I feel delighted seeing how patients adhere to my instructions and achieve favorable outcomes.
Overall, SCDNT serves as a vital theoretical foundation of my nursing philosophy. On the one hand, I find confidence and motivation in the role of dependent care agent. On the other hand, I bolster the patients’ self-care capacity by choosing a suitable nursing system. As a result, I build a structure of a nursing philosophy that helps patients overcome self-care deficit by increasing their participation in the care process.
Values of Love, Caring, and Health in Nursing Philosophy
The values of love and caring are integral to my nursing philosophy. These concepts might seem similar at first look, but they differ quite significantly. In a broad sense, one can define love as a human attribute that creates feelings of empathy, solidarity, and unity (Adib-Hajbaghery & BolandianBafghi, 2020). Meanwhile, caring is not a feeling, but an applicable nursing phenomenon, a scientific knowledge related to doing what is best for the patient (Karlsson & Pennbrant, 2020). As such, love acts as a prerequisite for caring since a nurse has to create a spiritual connection with a patient in order to achieve optimal outcomes.
I perceive love in my interactions with patients as a moral responsibility rather than a sensation. In its traditional understanding, love is related to an affection one feels toward their dearest people. In nursing, I do not know my patients until I meet them. Even after getting acquainted, my patients and I remain separated by professional ethics and social status. However, love in the nursing context allows one to act morally and connect a nurse with their patient (Adib-Hajbaghery & BolandianBafghi, 2020). As such, the sense of moral responsibility brings me closer to the patients, making me significantly more attentive to their needs.
Ultimately, love for my patients creates a personal moral obligation to be caring. In turn, a caring attitude stimulates kindness and respect for the patient’s dignity. Together, these values serve as an integral part of my nursing philosophy. I love my patients, so I gladly take responsibility for their well-being. I care for my patients, so I apply my theoretical knowledge of nursing to help them achieve the best possible outcomes and promote healthy behaviors. In addition, my caring covers the value of health, as I strive to enhance my patients’ self-care capacity to help them address the self-care deficit. Finally, my caring is manifested in awareness about the economic security of my patients. I always consider their socioeconomic situation and strive to deliver the most cost-effective care possible.
American Nurses Association’s Code of Ethics Provisions: A Beneficial Impact for Practice
American Nurses Association is a champion of nursing ethics in the United States. The critical standards of ethical nursing are listed in the American Nurses Association (ANA, 2015) Code of Ethics. The Code consists of nine Provisions covering a wide spectrum of domains that constitute ethical nursing — from compassion and respect to integrating social justice into the profession (ANA, 2015). I dutifully strive to follow Provisions related to personal ethical conduct. However, I feel that additional attention to Provision 7 (Contributions through Research and Scholarly Inquiry) and Provision 9 (Collective Articulation of Nursing Values) would benefit my practice. I believe more thorough incorporation of these Provisions would make me a better advocate of nursing values through the virtue of academic accomplishments and participation in the collective efforts of the nursing community.
The impact of these improvements can be explained in the example of the medical-surgical practice. A nurse who contributes to research and scholarly inquiry directly participates in the development of safe and ethical professional standards (ANA, 2015). Furthermore, involvement in research and scholarly activities would allow a nurse to reach the national and global nursing communities to promote and reinforce healthy practices (ANA, 2015). As such, a nurse who incorporates Provisions 7 and 9 into their medical-surgical practice expands their benevolent influence beyond the limits of personal ethical conduct.
Conclusion
Modern-day nursing requires having a personal philosophy since this profession has expanded beyond the limits of medical knowledge. My nursing philosophy consists of three parts —SCNDT as a theoretical foundation, values of love, caring, and health, and ANA’s standards of ethical practice. SCNDT allows me to achieve consistent progress in all four major concepts of the metaparadigm — person, health, environment, and the nursing profession. Love and caring establish the necessary emotional basis for ensuring favorable patient outcomes through moral responsibility for their health. Finally, I adhere to personal provisions of ethical nursing but wish to contribute more to the research and collective value articulation. This change would let me spread the beneficial influence on larger scales, making me a better advocate of ethical nursing.
References
Adib-Hajbaghery, M., & BolandianBafghi, S. (2020). Love in nursing: A concept analysis. Journal of Caring Sciences, 9(2), 113-119.
American Nurses Association. (2015). Code of Ethics for nurses with interpretive statements.
Friberg, E. Conceptual foundations: The bridge to professional nursing practice (7th ed.). Elsevier
Gligor, L., & Domnariu, C. D. (2020). Patient care approach using nursing theories-comparative analysis of Orem’s self-care deficit theory and Henderson’s model. Acta Medica Transilvanica, 25(2), 11-14.
Karlsson, M., & Pennbrant, S. (2020). Ideas of caring in nursing practice. Nursing Philosophy, 21(4), e12325.
Thorne, S. (2020). Rethinking Carper’s personal knowing for 21st century nursing. Nursing Philosophy, 21(4), e12307.
Yip, J. Y. C. (2021). Theory-based advanced nursing practice: A practice update on the application of Orem’s self-care deficit nursing theory. SAGE Open Nursing, 7, 1-7.