Initial Substantive Posts: Your initial post should be substantive (approximately 200-300 words in length for each discussion). In your substantive post you are encouraged to use references (you may use your textbook); show evidence of critical thinking as it applies to the concepts. At least One reference on each discussion.
1. Personal Philosophy in the Context of Nursing
Top of Form
How does your personal philosophy fit with the context of nursing? Does it fit? How do nursing, person, environment, and health fit into your philosophy?
2. Reflections on Troubling Clinical Experiences
Think about a clinical experience that was troubling to you. Reflect on what bothered you about the experience. What could you have done differently? What were the reasons behind your actions? Try to create and clarify meaning or a new understanding of the particular situation.
· Below is an example of a substantive discussion post (This content is not from this course):
Neutropenia is a decrease in circulating neutrophils in the nonmarginal pool, which constitutes 4-5% of total body neutrophil stores (Braden, 2016). Something that should be investigated is the underlying cause for the neutropenia. Knowing what would point myself as the nurse in the direction to educate the patient and would help the physician in treating the condition. The likelihood of having complication from neutropenia are very high as usually the reason for neutropenia is overwhelming infection.
Common presenting symptoms of neutropenia include the following: (Braden, 2016)
· Low-grade fever
· Sore mouth
· Gingival pain and swelling
· Skin abscesses
· Recurrent sinusitis and otitis
· Symptoms of pneumonia (eg, cough, dyspnea)
· Perirectal pain and irritation
Diagnosing neutropenis is realatively easy as the doctor would need to order a complete blood cell count, differencial white blood cell count, and a peripheral smear that is to be reviewed by a pathologist. Other causes of neutropenia, in the absence of overwhelming infection, may be (1) decreased neutrophil production or ineffective granulopoiesis, (2) reduced neutrophil survival, and (3) abnormal neutrophil distribution and sequestration. Hematologic disorders that cause ineffective or decreased production include hypoplastic or aplastic anemia, megaloblastic anemias, leukemia, or drug-/toxin-induced neutropenia (Huether, 2012). Educating patient on the way to care for ones self at home is very important. Making sure that the patient takes all of their antibiotics and committing to keeping their follow up appointment is very important to her recovery.
General measures to be taken in patients with neutropenia include the following: (Braden, 2016)
· Remove any offending drugs or agents in cases involving drug exposure: If the identity of the causative agent is not known, stop administration of all drugs until the etiology is established
· Use careful oral hygiene to prevent infections of the mucosa and teeth
· Avoid rectal temperature measurements and rectal examinations
· Administer stool softeners for constipation
· Use good skin care for wounds and abrasions: Skin infections should be managed by someone with experience in the treatment of infection in neutropenic patients
Braden, C. (2016, February 26). Neutropenia. Retrieved from MedScape: http://emedicine.medscape.com/article/204821-overview
Huether, S., & McCance, K. (2012). Understanding Pathophysiology (5th ed.). [https://bookshelf.vitalsource.com/#/books/978-0-323-07891-7/cfi/0!/4/2/4/4@0:65.4]. Retrieved from https://bookshelf.vitalsource.com/#/books
A personal nursing philosophy involves contemplations of ones beliefs, principles, and values with direct practice. My personal philosophy began with attempting to answer some questions, such as, “what does nursing mean to me,” and “what is guiding my practice.” In order to define my personal philosophy of nursing, I will address some of the key concepts of my theory, the four meta-paradigms of nursing, the nursing process, the application of my philosophy to my present nursing practice, research, administrations, and education, and finally, my philosophy’s strengths and limitations.
Key Concepts of my Nursing Philosophy
My nursing philosophy is characterized by holistic, empathetic and culturally sensitive care to all my patients and their relatives. It is essential to me to be a patient advocate, provider, teacher, manager, and leader because I think that we as nurses should deliver the highest quality nursing care in order to accomplish excellence in patient’s outcomes. To me nursing is about compassion and trying to understand human beings on all emotional, physical, and scientific levels. As a professional nurse, I feel a personal commitment toward life-long learning, through formal education and hands-on experience to better myself and my nursing knowledge.
My personal nursing philosophy characterizes the discipline of nursing using the four meta-paradigms concepts: person, environment, health, and nursing. First of all, I believe that the profession of nursing is all about people. Care involves the whole patient, and not just a single illness or health concern treated in isolation from the whole. Our holistic perspectives consider all facets of a patient’s life, and facilitate optimum quality of life to our patients. Secondly, while human beings are central to nursing, it is also necessary to look beyond the patient to the environment in which he/she lives. This is very important because people are members of a larger community with different features and characteristics that influence greatly our patients, so we cannot separate patients from their environment because they are interrelated. Third, I believe that health is a dynamic state that exists on a continuum from wellness to illness and shifts in response to environmental factors. Health is more about quality of life. I work in a hospital where I routinely encounter patients that have experienced trauma in their lives or suffer from multiple chronic and acute physical and mental health conditions. Lastly, I think that nursing involves being with individual patients or communities and being engaged in the moment. Each day we as nurses encounter different situations that require our ability to make meaning of a patient’s situation, such as, attaching significance to those things that can be felt, observed, heard, touched, smelled or imagined to our subjective interaction with patients. This process of being engaged in meaningful relationships requires we as nurses be actively involved.
The Nursing Process
The nursing process uses a holistic, patient-focused care and problem solving approach in relationship with patients and their families. Every person has different needs, and thus requires a different plan of action. Care must be planned according to each person or persons involved, which is why we use the nursing process. This system helps us better organize a plan that will accommodate the needs of our patients. While we often assume a nurse only works with an individual, we forget that as nurses our role is to help families and those in the community as well. We can provide direct care to our patients, and use indirect care for families and communities. The nursing process is an excellent way of catering to each patient’s specific needs. The first step in delivering nursing care is assessment. This is a systematic and dynamic way to collect and analyze data about the patient. Secondly, the nursing diagnosis is the nurse’s clinical judgment about the client’s response to actual or potential health conditions or needs. The diagnosis reflects not only that the patient is in pain, but that the pain has caused other problems such as anxiety, poor nutrition, and conflict within the family, or has the potential to cause complications-for example, respiratory infection is a potential hazard to an immobilized patient. The diagnosis is the basis for the nurse’s care plan. Third, based on the assessment and diagnosis, the nurse sets measurable and achievable short- and long-range goals for this patient that might include moving from bed to chair at least three times per day; maintaining adequate nutrition by eating smaller, more frequent meals; resolving conflict through counseling, or managing pain through adequate medication. Then, implementation takes place. Nursing care is implemented according to the care plan, so continuity of care for the patient during hospitalization and in preparation for discharge needs to be assured. Finally, evaluation concludes this process. Both the patient’s status and the effectiveness of the nursing care must be continuously evaluated, and the care plan modified as needed.
Application to Current Nursing Practice, Research, Administration and Education
My personal belief system has always been to be compassionate and caring. In the nursing profession you need to have an overwhelming amount of compassion and caring for your patients and their families. You are not only caring for the patient’s physical health, but also their emotional needs. For example, I work in a telemetry and med surgical floor where sometimes I take care of chronically ill patients, and there are a lot of complicated emotional issues that need to be recognized and addressed by the health care professional. I found that these patients, once you build a rapport and trust, are the more humble and neat patients to work with. We spend a lot of our time just talking to them about life and their interests and although we are still taking care of their medical needs, we are supporting them emotionally more often than not. In order to do this kind of nursing you must have a lot of empathy and compassion. In addition, we need to take a closer look at our society and the main health care issues we are seeing. It is important that we research about health problems such as health problems that our patients are presenting. The leading causes of death in this country are diseases or conditions that are lifestyle choices. We need to concentrate on wellness of the population, instead of being treatment orientated as a health care system. If, as nurses, we are successful in health promotion teaching, then we are doing our jobs to best of our abilities.
Strengths and Limitations
No individual is perfect in this world; however, God has blessed everyone with unique strengths that can be used effectively to avoid drawbacks of weaknesses, and live a successful life. I think I have a number of strengths that have allowed me to prove myself as one of the best in the nursing field. Self-confidence is an important strength that supported me in accepting challenges throughout my career and goals were achieved through a self-disciplined and emotional maturity, which is one of my other imperative strengths. On the other hand, it is very important that an individual should incorporate her weaknesses in such a way that it may turn into strengths. Similarly, I am very altruistic, which often seems like a weakness in this rational and materialistic world. However, all these strengths and weaknesses have made me a stable and realistic nurse, who can bring some change in this profession. I have been practicing nursing for one year, and cherished dealing with different patients. Now it is my utmost desire to continue my learning process. Since I know that I have passion for souls, to cater for them physically and in all areas of life, I can achieve this effectively as a registered nurse.
As nursing progresses into the 21st century there is some suggestion that survival and advancement of the discipline requires increase engagement of practicing nurses in utilizing and developing specifically nursing knowledge (Cody, 2006; Fawcett, 2006; Silva, 2006). Perhaps a beginning point may be developing a personal nursing philosophy that focuses on areas distinct to nursing as this enables reflection on understanding relationships between personal philosophical thought as related to current issues in the field (DeKeyser & Medoff-Cooper, 2009; Schlotfeldt, 2006). The goal of this paper was to discuss each component of my personal nursing philosophy in relation, how I arrived at my belief, how I encountered each in my practice and how each may facilitate my personal contribution to the current body of nursing knowledge. My personal philosophy of nursing incorporates components of the traditional nursing metaparadigm (Monti & Tingen, 2006) while also incorporating the concept of social justice proposed by Schim, Benkert, Bell, Walker and Danford (2006). I believe that nursing is a discipline that encompasses four integral attributes (1) the person, (2) society, (3) health and (4) nursing which I have discussed in relation to current literature on nursing, using examples from my own nursing experience, including explanation of how some have allowed me to contribute to the development of nursing knowledge.