In the account of developing this personal nursing philosophy paper, my personal professional resume was critical in evaluating my deep intuitions about the nursing profession. Educationally, I possess a Bachelor’s degree in nursing that I acquired in 2011 and I have been a Registered Nurse (RN) from 2005-2009, with a certificate of a Licensed Practical Nurse (LPN) acquired in 2005. In addition, I possess an Associates’s Degree in Liberal Arts, which I earned in 2001. Currently, I provide specialized care to medically complex patients at LTAC Hospital. Being a Registered Nurse since 2005, I am experienced in performing Trach care, PEG/NG Tube care, PICC care, as well as Colostomy care. I possess immense experience in titrating critical I.V drips, administering medications, and monitoring vital signs and blood glucose levels. As an RN, I have crucial expertise in monitoring telemetry rhythms, inserting Foley catheters, and fecal bags, performing I.V insertions, and cares for ventilator dependent patients, as well as performing venipunctrure for laboratory blood draws.
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On a part-time basis, I have been working in Medical Assurant Inc. and I am apt with the task of a site review consultant. The main duties of expertise were undertaking medical chart reviews, performing medical record reviews/abstractions, and completing remote reviews. I scanned relevant components of medical records electronically and uploaded review assignments of scanned medical records coupled with communicating effectively to care providers. I also worked at Tri-County Nurse plus LLC and undertook numerous duties within the Contingent in Rehabilitation/ LTAC/ LTC facilities. During this time, I administered medication and performed RN roles in various metropolitan area homes. I also assessed patient conditions during admissions as per Medicare guidelines and ensured daily charting on patient assessments. I also worked with HCR-Manor Georgian East Nursing Home, where I undertook several patient-care activities and finally at Advent Home Medical, Nurse Match Staffing and Home Care and New Light Nursing Home. In these hospitals, I managed to acquire ventilator experience LTV 1150 & 950 and cared for spinal cord and traumatic brain injury patients among others.
The Four Metaparadigms in nursing
Nursing is a broad profession, but it is defined in only four main metaparadigms that bound its professional practice within the healthcare boundaries (Brencick & Webster, 2000). Metaparadigm is one of the major terminologies established in nursing practice that mean the most globally renowned perspective or viewpoint of a certain discipline and it principally acts as a summarizing framework or unit, within which restricted structures can barely develop (Master, 2011). In other words, metaparadigm can remain defined “as the global concepts that identify the phenomenon of central interest to a discipline, the global preposition that describe the concepts, and the global prepositions that state the relations between or among the concepts” (Fawcett & Madeya, 2012, p.4). Each concept or discipline in the four metaparadigms of nursing identifies phenomena of its attention that it intends to deal with and normally in a unique manner. The main metaparadigms or concepts, which are globally recognized in the nursing practice include, “a person or patient, environment, health, and nursing” (Fawcett & Madeya, 2012, p.4).
Person, also known as a patient, as a nursing Metaparadigm refers to the recipient of healthcare or care that can be either in the form of physical treatment and care, spiritual care and support, psychological support, or even socio-cultural components of support (Masters, 2011). Person, as a Metaparadigm, can also mean individuals, families, or even communities that are crucial participants seeking healthcare support. Environment is another Metaparadigm that means all external and internal atmospheric conditions, influences, or even circumstances that affect human beings. In addition, environment may signify physical surroundings including regional, national, or worldwide boundaries as well as social, cultural, political, or even economic conditions associated with human health. Health is the third Metaparadigm that refers to human conditions that depict the degree of wellness or illness inherent in persons or processes of living and dying (Masters, 2011). Nursing is the final Metaparadigm which means actions taken by nurses towards managing and improving healthcare in human beings.
- Person – Person and environment are important metaparadigms in the nursing practice. Person within the medical context includes patients who seek medication or healthcare support from practitioners (Brencick & Webster, 2000). A person, being the patient who requires medical attention is quite important and individual factors are paramount considerations in delivery of healthcare services. The nursing practice is holistic and personal factors in healthcare have a great impact on the successfulness of the medication outcomes. Masters (2011) identifies numerous human or patient-related factors that include “personal biological factors such as pubertal status, age, menopausal status, sex or gender, body mass index, aerobic capacity, body balance, strength, and agility” (p.86). Psychology or emotional conditions of human beings are critical factors that may significantly determine the outcome of medication. Personal psychological factors include self-motivation, depression, trauma, and even self-esteem. Personal socio-cultural factors “that determine medication outcome include ethnicity, racial background, socio-economic status, acculturation, and even educational level” (Masters, 2011, p.111). Some personal factors are susceptible while others are not.
- Environment – Environment, as postulated in the definitions, is the surrounding or atmosphere inclusive of all physical, interpersonal, and even economical circumstances in which human beings live and nurses can manipulate to enhance comfort (Masters, 2011). Florence Nightingale pioneered a philosophical theory that revolutionized healthcare delivery with core concepts engaged in the theory involving the patient and the environment. According to Nightingale, nurses and other healthcare workers should seek ways of manipulating the environment to enhance positive medical outcomes or perfect patient recovery (Masters, 2011). As stated in the code of ethics and standards, nurses should avoid environmental dangers and inuring others while in the course of duty. The human system must maintain integrity towards environmental stimuli and the goal of nursing is foster successful adaptation. Critical environmental factors that significantly influence positive medical outcomes as per perceptions developed from the nightingale theory include proper ventilation, temperature, noise ambience, food taken, light, cleanliness or hygiene, and hospital management among other critical environmental factors.
- Health- Health in the context of nursing practice refers to the degree of wellness or illness of a person or even person’s ability to perform independently. In a bid to develop a deeper and succinct meaning, Masters (2011) defines human health as “a state characterized by soundness or wholeness of developed human structures and of bodily and mental functioning” (p.58). The healthcare profession holds that individual’s physical and mental state of wellness significantly influences successful treatment outcomes and from nursing propositions, human beings have capabilities to take care of themselves independently. According to Masters (2011), health is a critical nursing metaparadigm and health-deviation self-care requisites are related to variations in structure and functioning of human beings. Based on the nursing profession, self-care that depicts individual’s state of wellness is paramount and major requisites include the patient’s ability in seeking appropriate medical support, patient’s ability to be aware of effects of an underlying illness, and patient’s ability to undertake medically prescribed treatments effectively coupled with accepting and learning to live with health conditions.
- Nursing- Nursing is another significant metaparadigm that means activities or actions taken predominantly for providing the required medical assistance for achievement of positive treatment outcomes in patients (Brencick & Webster, 2000). Nurses are the persons responsible for manipulating the environment and providing care in the form of physical, psychological, or even spiritual assistance to patients to enhance positive outcomes. The practice of providing optimal care to patients is quite imperative and the actions or interventions undertaken by the nurses during their professional duties can influence achievement of positive medical outcomes in patients greatly. According to Masters (2011), nurses should practice their professional duties while considering important domains and competencies to enable achievement of positive treatment outcomes in patients. Nurses must defend principles governing their professional practices, perform their duties with dignity and high integrity, observe all integral philosophies concerning the nursing profession, and perform their duties in respect to the stipulated codes of ethics and standards and in accordance of national laws.
Two Practice-Specific Concepts
Nursing is a universal profession that consist numerous concepts that are essential towards understanding the theoretical perspective guiding the profession of the nursing practice (Kim & Kollak, 2006). The nursing profession contains theoretical works categorized as theories, philosophies, or even conceptual models depending on the intensity of pensiveness. According to Masters (2011), the nursing theory contains concepts with its conceptual model being distinctive from a theoretical basis through its intensity in abstraction and specificity. Concepts of culture and nurses’ behaviors are two practice-specific concepts that are integral in determining medication success of patients. Culture and individual’s professional behavior are significant factors that can contribute heavily or determine medication effectiveness. According to Masters (2011), “trans-cultural nursing is a substantive area of study and practice focused on comparative cultural care (caring) values, beliefs, and practices of individuals or groups of similar or different cultures with the goal of providing culture-specific nursing” (p.68). Culture care in this sense thus implies assistive and facilitative concerns that seek to help persons from a specific culture.
In promoting good health, a critical aspect that may determine the successful outcome in nursing as a profession is personal behavior that affects the patient’s physical and psychological wellbeing. Nurses’ behaviors are specific variables including attitude towards patients, interaction with patients and several individual traits that influence medication. Masters (2011) followed Nola Pender’s health promotion model before identifying behavior specific cognitions in nursing as perceived benefits of actions, activity related affect as well as perceived barriers to action and perceived self- effectiveness. Perceived self-effectiveness refers to the judgment of individual’s aptitude to handle professional duties diligently and competently to enhance positive outcomes on given assignments. “Perceived benefits of actions are individual’s anticipations towards positive outcomes resulting from health behavior and regarding recognized barriers to action, it means anticipated, imagined, or even real blocks of behavior” (Kim & Kollak, 2006, p.103). Finally, activity-related effects, as per Pender’s health promotion model, are subjective negative or positive feelings that emerge during, before, or even after certain emotional factors. All these behavioral factors in nurses influence medication.
List of Propositions
Propositions or assumptions are individual’s intuitions or beliefs on how something is or how something should be. In the context of professional nursing, theorists have emerged with numerous propositions on how the nursing profession should behave in the continuum of care (Kim & Kollak, 2006). Likewise, healthcare individuals are human beings like professionals in other fields and they possess significant assumptions or propositions or even ideas that may significantly change the continuum of care required. The ANA code of ethics and standards hold that nursing as a profession involves protection of individuals, promotion of healthcare, prevention of harm and illness, alleviation of suffering ,and helping patent’s by providing maximum and unbiased care (Brencick & Webster, 2000). It concentrates deeply on how nurses must assist individuals, sick or in good health, in performing activities contributing to health and its recuperation. Based on my personal proposition, advanced nursing education and knowledge (expertise), self-motivation, time management, advocacy, respect, compassion, and respecting the quality of life are integral aspects in nursing that must receive considerable attention.
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In a bid to remain competent throughout an individual’s career, incessant nursing education must prevail throughout a person’s professional life as dynamics in medicine keep changing each successive year depending on several issues (Fawcett & Madeya, 2012). Knowledge that combines with skills and experience is the core success factor in the nursing career. As nursing practice continues to prove challenging over the years, nurses must remain motivated at work and manage time effectively to avoid being subjective to negligence of duty of care. It is important for nurses to advocate for good health and care of individuals, families, groups, or communities. Respecting the patient’s dignity in spite of their physical, emotional, cultural, or economic status can significantly help in achieving optimal care in nursing practice (Kim & Kollak, 2006). Being compassionate towards people would greatly help nurses to provide unbiased care as respecting the quality of life is important in health care.
Brencick, M., & Webster G. (2000). Philosophy of Nursing: A New Vision for Health Care. New York, NY: SUNY Press.
Fawcett, J., & Madeya, D. (2012). Contemporary Nursing Knowledge: Analysis and Evaluation of Nursing Models and Theories. Philadelphia, PA: F.A. Davis Publishers.
Kim, S., & Kollak, I. (2006). Nursing Theories: Conceptual and Philosophical Foundations. New York, NY: Springer Publishing Company.
Masters, K. (2010). Framework for professional nursing practice. Sudbury, MA: Jones & Bartlett Learning, LLC.