Tuesday, April 14, 2009

My Philosophy of Nursing

I suppose the best way to begin journaling my experiences as a registered nurse on my way towards becoming an Advanced Practice registered nurse (APRN) is to outline my philosophy of nursing. I will post more details about myself and my practice at a later date. I need to sleep sometime.

Nightingale, in "Florence Nightingale to her Nurses", describes nursing as, "under Doctor's orders, to cure or to prevent sickness and maiming, surgical and medical". The ANA (American Nurses Association) took things a bit farther in their most recent definition (and gave Mr. Doctor the boot long ago), "Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations."

My particular definition is based on the ANA's current definition, various states' nurse practice acts, and Betty Neuman's systems model.

Nursing has undergone many changes in the last sixty years. With the advent of mechanical ventilators and other complex, invasive, life-sustaining devices, the necessary educational preparation of nurses has increased. Increasing health care costs, an increasingly elderly population, and a rise in the prevalence of chronic diseases has changed the way care is delivered in the United States. Nurses are being called upon to do more complex work in a wider variety of settings than ever before. All of these changes beg an important question: what is nursing? What do a nurse practitioner seeing patients in a clinic, a community health nurse educating families on home safety, and an ICU nurse treating a critically ill trauma patient have in common? They are all working under legal, professional, and institutional regulations as a part of the broader nursing profession.

Nursing is an autonomous practice profession, which is based on scientific nursing research and works to help clients achieve their maximum, holistic levels of wellness. As a profession, nursing manages its own affairs and is responsible for its practice (Murphy 2004). The interventions carried out by nurses are based on nursing science, which has been explored by nurse researchers. Advanced practice nurses, as leaders in the field, are qualified to design and execute research on topics within nursing’s scope of practice. Nurses can, depending on their practice setting, view individuals, families, or communities as their clients. Nurses apply the nursing process to these clients to help them achieve their maximum level of wellness in the physiological, psychological, sociocultural, developmental, and spiritual domains (Tomey & Alligood, 2002).

Nurses, despite their differing practice setting, share a common mandate to use their specific skills and expertise to help their clients to be the healthiest they can be, according to the client’s beliefs and values. Nursing is not a branch of medicine, nor is it some blend of medicine and the social sciences. Nursing is a profession in its own right that holds its own contract with society to help the various clients of nursing’s services to maintain or regain their desired levels of wellness.

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