You have spent six weeks exploring theories of nursing. These represent the “how” of what we do as nurses. This week we enter a higher level of thought and explore the “why” of what we do. Present a personal nursing philosophy. Apply what you have read throughout the course and explore the literature on nursing philosophy. While Fawcett was not a nursing theorist, she is a nursing philosopher and her Metaparadigm of Nursing approaches philosophy over theory. Once you have discussed your philosophy, identify a theoretical framework (not the middle-range theories but the underlying assumptions in that framework) that fits your philosophy. Compare and contrast your philosophy and the chosen framework. Describe a possible situation in which the framework may conflict or not fit your philosophy. While it is an important skill to be able to match a theory with a situation, it is also critical to understand when a theory or framework does not fit a situation.
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Personal Theory Framework for Advanced Practice Nurse
The purpose of this essay is to provide a detailed analysis of my philosophy of nursing to inform my nursing career. It will integrate Florence Nightingale’s environmental theory and Jacqueline Fawcett’s four meta-paradigm concepts of (a) health, (b) person, (c) environment, and (d) nursing to create a solid understanding of the critical similarities and differences in the selected theoretical framework and my nursing philosophy. As a registered nurse with 17 years of experience, my primary goal is to gain the requisite knowledge, skills and competencies, values, and experiences that would enable me to offer holistic, safe, top-quality, and patient-centered care and support. The paper provides a solid discussion of my personal philosophy of nursing by referring to my own experiences as an Advanced Practice Nurse and to the knowledge, competencies, and skills I have acquired throughout my nursing career.
My Personal Nursing Philosophy
First, my choice of nursing as a noble career path was inspired by my unrelenting ambition to become a productive, helpful, and meaningful community member with the ability to assist people with healing and recovery. My philosophy as an Advanced Practice Nurse (APN) is that nurses have a significant responsibility of providing evidence-based care and patient-centered care. I hold that this kind of patient-oriented care should respond to the distinct needs and conditions of each individual regardless of their socio-economic background, race/ethnicity, religion, and gender (Ayse et al., 2019). Ideally, I firmly believe that patients must be recognized and treated as individuals who deserve individualized attention and care as the fundamental basis for improving their health condition and wellbeing. As an Advanced Practice Nurse (APN), I have focused on acquiring relevant knowledge and skills in nursing. I have no doubt that these competencies would enhance my overall ability to offer exceptional nursing and clinical services in a calm and supportive environment characterized by (a) empathy, (b) communication, (c) collaboration, (d) learning, and (e) diversity.
Personal Meanings within Nursing’s Metaparadigm
The four-domain metaparadigm articulated by Fawcett can organize nursing knowledge, competencies, values, and beliefs associated with the nursing practice. These concepts include (a) person, (b) health, (c) nursing, and (d) environment. Fawcett (1984) indicated that applying these metaparadigm concepts in developing and implementing treatment plans can prove instrumental in enabling improvements in the provider-patient therapeutic relationships and, subsequently, ensuring high quality and safe patient care.
The first concept is the person. Fawcett (1984) indicated that a person is a human being. Ideally, the person’s centrality in nursing care is based on the understanding that individuals live with others in the society in a unitary, rational and relational manner. As a Family Nurse Practitioner, I consider patients as people first, which has been instrumental in enabling me to forge two-way and collaborative relationships during my encounters with individuals. Moreover, I also consider patients to be partners in the treatment process based on how they possess vital knowledge regarding their medical condition and the capacity to pursue decisions and actions that can impact their care (Sullivan, 2016). As a family nurse practitioner, I often strive to establish and maintain meaningful encounters and relationships with patients to create a working environment where shared negotiation, two-way communication, and collective responsibility are genuinely practiced.
The second metaparadigm concept is health. Miriam (2018) noted that health is a multi-faceted term that reflects the state of being secure and comfortable in the physical, spiritual, mental, and social domains of life. As a nurse, I hold the perspective that good health extends beyond the absence of illness or disease, and hence my commitment to improving patients’ health is based on providing holistic, tailored, and evidence-based care and support. Moreover, I have often focused on gaining a better understanding of each patient’s distinct needs, realities, and conditions as the basis for tailoring treatment plans and interventions to suit their health concerns (Sullivan, 2016).
The third concept is the environment. According to Nightingale’s environmental theory, providing a safe, supportive, calm, and clean physical environment is integral in nursing practice. I have always ensured that the patients I interact with are able to access the relevant support systems and to maintain their sense of self, freedom, and independence. Throughout my nursing career, I intend to create positive conditions where patients can receive holistic care and achieve positive improvements in their health and wellbeing. Moreover, focusing on the patient’s state of mind may become a practical means to understand some of the intervening environmental factors that influence their health condition and recovery.
The other concept of the metaparadigm is nursing. According to Nightingale’s theory, nursing has one primary objective, “to put the patient in the best condition for nature to act upon him/her” (Riegel et al., 2021, p.3). This conceptualization applies to my nursing philosophy based on how it captures the art of nursing as a people-oriented endeavor that is focused on assisting the patient in restoring his/her health and wellbeing. Moreover, I believe that effective nursing practice is focused on enhancing patients’ lives with empathy and compassion. The core nursing values that inform my practice include (a) respect, (b) honesty, (c) altruism, (d) human dignity, (e) autonomy, (f) integrity, and (g) social justice. Riegel et al. (2021) pointed out that these core values are shared and practiced within the medical community and reflect the spiritual and human approach to the nursing practice. Therefore, my nursing philosophy embraces these core values, and I intend to embed them in my day-to-day operations to ensure caring, holistic, and patient-centered care and support to patients.
My philosophy of nursing correlates with the philosophies of Fawcett and Florence Nightingale. Ideally, the core teachings advanced in the philosophies of these two individuals focussed on providing an integrative and holistic viewpoint regarding nursing as a people-centered profession. Moreover, the main ideas advanced in Nightingale’s framework sought to embrace the different components of nursing as the fundamental basis for looking into some of the key factors and themes that can be considered to ensure the delivery of patient-centered and evidence-based nursing care (Riegel et al., 2021).
Regarding a situation where the framework fits my philosophy, I consider patient-centered care to be at the forefront in enhancing the experience of care of people using nursing services. I believe that the importance of considering the patient as an individual lies in the fact that the practitioner and the health care provider must focus on adopting individuals and comprehensive care plans that capture the patient’s mental, physical, and sociocultural needs. Therefore, the person component as exemplified in the framework is well placed in my nursing philosophy based on how it calls for a good deal of respect, two-way communication, and collaboration between and among the different partners across the care continuum. A better understanding of the patient’s cultural background, preferences, and beliefs is required to inform culturally-competent nursing service.
Moreover, I have also understood that the quality of care offered to patients should be the same irrespective of the (a) geographic location, (b) cultural factors, (c) gender, and (d) socio-economic conditions. As a provider, the practicing family nurse practitioner must be well-positioned to identify differences in norms, demographics, desires, and practices associated with providing care in diverse environments. Therefore, Fawcett has successfully established upon Nightingale’s original concept of seeing the patient as a living and whole individual with the capacity to interact with his/her environment. Ideally, the concept of patient, therefore, fits my philosophy based on how it captures the centrality of identifying and responding to each patient’s distinct realities and conditions as the fundamental basis for providing patient-oriented care and support.
Pender’s Health Promotion Model (HPM) is the selected middle-range theory that resonates with my nursing philosophy. As an advanced practice nurse, the theory provides the basis for developing empathetic and compassionate relationships with people to provide appropriate medical, emotional, and physical support to patients. Precisely, the theory offers a guide for examining the complex bio-psychosocial processes, relationships, and factors that assume a role in motivating individuals and groups to pursue a health-promoting lifestyle or behaviour (Pool et al., 2018).
Overall, my nursing philosophy is still developing as I gain more knowledge, experience, competencies, and skills in the ever-changing nursing field. I believe that providing patient-centered care and support is integral to meeting each patient’s distinct needs and demands. Integrating nursing theories and frameworks in my philosophy is undoubtedly a meaningful starting point to enhance my sense of personal confidence as a family nurse practitioner and passion for nursing practice, knowledge, and values.
Ayse, D., Oznur, K., Ruveyde, A., & Kamile, K. (2019). Nursing Students’ Perceptions of
Nursing Metaparadigm: A Phenomenological Study. Journal of Nursing Research, 27(5), 1-8. doi: www.10.1097/jnr.0000000000000311
Fawcett, J. (1984).The Metaparadigm of Nursing: Present Status and Future Refinements. The Journal of Nursing Scholarship, 16(3):84-9. doi: www.10.1111/j.1547-5069.1984.tb01393.x.
Miriam, B. (2018). Re-conceptualizing the nursing metaparadigm: Articulating the philosophical ontology of the nursing discipline that orients inquiry and practice. Nursing Inquiry, 25(3), 1-9. https://doi.org/10.1111/nin.12243
Riegel, F., Crossetti, O., Martini, J.G., & Nes, G. (2021). Florence Nightingale’s theory and her contributions to holistic critical thinking in nursing. Rev Bras Enferm, 74(2), 1-5 doi: www.10.1590/0034-7167-2020-0139.
Sullivan, M. D. (2016). Patient-centered care or patient-centered health? Oxford Medicine Online. doi: www.10.1093/med/9780195386585.003.0002
Pool, N., Koithan, M., & Ringdahl, D. (2018). Nursing as an integrative healthcare profession. Integrative Nursing, 350-362. https://doi.org/10.1093/med/9780190851040.003.0023