Nursing is a set of standards of practice that are presented and acted on in the healthcare world. Nursing encompasses a realm of characteristics such as: caring, empathetic, advocacy, value, and respect, integrity, honesty. Autonomy is a big part of nursing even though you are a bigger part of a multidisciplinary healthcare team. To protect, promote, optimize, prevent and alleviate are the basis of nursing not only for one patient, but for the family, community, and the rest of the population at large. Some other key points to define nursing are: promoting a safe environment, conducting research, helping change health policy, and education.
What is your personal philosophy related to how you practice nursing?
The three branches of philosophy that I use most in my practice are ontology, epistemology, and ethics. Ontology plays a big part in my practice as I take care of many end-of-life patients. Feelings are brought up of what has been the means of existence for one's life and what has that meant to the patient and the family. A lot of time is spent with the patient, families, and my-self sitting at the bedside in the patient's room speaking of one's existence here on earth and their future existence with a higher being. The amazing and unexplainable events that occur with an end-of-life patient are one that I will hold with me in my professional and personal life. The will that one patient (mother of two) has to live until her daughter's graduation and then she passes, the week after as well as the will that one soldier (man, son, brother, nephew) had to live until Christmas and then pas the day after are just two of many of the many amazing events that occur in my practice. The will, love, and determination of the families and patients with whom I have worked have been branded in my soul for eternity.
Epistemology is used every day in my practice because my basis is on nursing knowledge and what methods are being used to develop that knowledge. The basic types of knowledge that I use most in my daily practice are empirics, intuitive, metaphysical, and moral knowledge (). Empirical data/knowledge is used from verifiable testing (). Theses verifiable tests help me know that when a patient's labs are a certain number or their heart rate is out of the normal range that I need to intervene and contact the physician. As a nurse I am the first line to helping that patient. The relationships I have with the physicians are ones of respect and value and that is reciprocal. The doctors trust me and my clinical judgement. Intuitive knowledge is one that I am using more and more. As a new nurse I really did not know about nursing intuition, because right out of school I had all the by-the-book knowledge in my head and nothing else. As the years have gone on I understand and feel the intuition when there is something just not right with a patient. I use metaphysical knowledge daily in my practice. In the care of many end-of-life patients the question of a higher power is always a foot. Not being very spiritual before I became a nurse has changed emensely over the years based off of the experiences I have had and have made me a better persona and nurse. Moral knowledge is one of what is right or wrong (). The values patients and families are sometimes not in line with mine, but I have to overlook that and do what is best for the patient. Many cultural issues can arise such as an Orthodox Jewish patient will not have a blood transfusion. Just recently was in charge and new of a patient on the unit who had a procedure and with her hemoglobin and hematocrit already being low, the team took off two units of her own blood and replaced that blood into her body. I am not sure how this really worked because it was the same amount of blood, not additional blood. This patient would have received a normal transfusion from donor blood if cultural differences were not present. It is tough to say if this patient was bleeding out and needed a blood transfusion, would I do transfuse? I would want to, but would not be able to conduct the transfusion. I do not like that answer, but it is the correct one. I will not always agree with or like the intervention or lack there-of and the outcome that come along with it.
Ethics are something that I deal with everyday not only in nursing, but in my personal life as well. I have an obligation as a nurse to do what is right for my patients. My patient population is so diverse that there are many different values, and cultural norms that may affect the treatment the patient can receive. I have already mentioned the blood transfusion issue with an Orthodox Jewish patient, but there are many other instances such a patient's wishes may or may not be occurring because of the family's wishes. I have had many patients that I have had to stop the feedings I was giving and really stop all unnecessary care, except for comfort, such as