Nursing is inseparable from caring. Compassion, cultural diversity, autonomy and integrity are the foundational ingredients of professional nursing. This paper provides reflections on the nursing profession and professional expectations in nursing. The mission, vision, goals and core nursing values are discussed. The concepts of Watson’s theory of caring are included. The paper includes the philosophy of the UW School of Nursing and AACN standards of practice. The goal of the paper is to discuss the value of nursing philosophy for nursing practice and define professional development priorities.
Nursing Theory Paper and Guide to Nursing Practice
Nursing leadership has always been one of the most popular objects of professional analysis. The current state of literature suggests that effective leadership predetermines positive outcomes for patients, health care organizations and health practitioners (Cummings et al., 2008). All nurses are leaders by nature, since leadership and nursing have several essential commonalities. First, like leadership, nursing is a process (Cummings et al., 2008). Second, leadership and nursing both entail influence (Cummings et al., 2008). Third, like leadership, nursing always takes place in a context and works to achieve a common vision and goal (Cummings et al., 2008). Nursing education lays the groundwork for developing outstanding nursing and leadership capacities, and it is with the help of professional education that the current and future nurses can reconsider their values and identify their self-growth and development priorities.
Since the very first day of my education, I have been persistently trying to define my professional goals, visions, missions and core values. Now, I can say with confidence that my main professional goal is to provide responsible, compassionate and professional care in ways that meet the health, cultural and individual needs of patients. I am convinced that nursing is holistic by nature, and professional nursing cannot be limited to satisfying patients’ health needs. As nurses, we are expected to treat patients as whole entities, and their individual and cultural needs should also be considered. As nurses, we are also expected to be leaders in the provision of quality, compassionate care, and leadership is always about quality relationships with people. The latter create the foundation for achieving effective positive changes and outcomes (Cummings et al., 2008). As a result, my goal as well as my mission is to be the leader in the development and provision of responsible, compassionate and individualized holistic care in ways that meet patients’ health, cultural, and spiritual needs.
As a professional nurse and a future nursing leader, I envision myself as the provider of knowledge, vision, and caring. The latter is at the heart of all my professional endeavors. Although the concept of caring lacks a single universal definition, my core values are closely linked to caring. Jean Watson’s theory of caring reflects my approaches to and beliefs about nursing. My core values include: caring about patients, caring about colleagues, caring about the community, in which I live, and caring about my profession. I perceive caring as a transpersonal process that transcends physicality, space, and time and is closely associated with healing (Watson, 2006). I view caring as a single moment, but this moment does not put an end to caring – on the contrary, caring is effective and professional only when it informs future experiences and predicts future professional actions of nurses (Watson, 2006). When I care for the patient, I actually seek to meet patients’ needs and the needs of their families. When I say that I care for my colleagues, I do everything possible to contribute to the development of a collaborative working environment, where respect, cooperation, communication and positive interactions prevail. Caring for the community is the same as serving the community members who seek professional nursing care and support. Finally, I am committed to professional excellence in nursing and work hard to create and sustain the integrity of research and practice as well as continuous learning and self-development among colleagues.
In many instances, my philosophy of nursing echoes that of the UW School of Nursing. The latter describes nursing as an integral mixture of education and practice, which is informed by research and theory (UW School of Nursing, 2011). Like the UW School of Nursing, I believe that nursing is deeply rooted in the values of integrity, creativity, diversity and professional excellence (UW School of Nursing, 2011). The strongest side of my nursing philosophy is in that I rely on the holistic vision of nursing care, but the weakest side is that there is no clear definition of caring. The current state of literature provides an insight into numerous theories of caring, which reflect the existing disparities in nurses’ perceptions of the essence of caring. For example, while Jean Watson (2006) describes caring as a transpersonal process, Kristen Swanson (1993) relies on the concept of informed caring, whose goal is the well-being of others. Swanson (1993) asserts that nursing is informed by empirical knowledge of the nursing science, other sciences as well as the personal, ethical and aesthetic knowledge, borrowed from other fields of human performance, individual and professional experiences, clinical and social values. In this sense, Swanson (1993) reaffirms the vision of nursing as the unity of theoretical and practical knowledge. In light of the growing number of caring theories, it comes as no surprise that practicing nurses hold different perceptions of caring and prioritize different dimensions of nursing, from altruism to personal involvement (Lea, Watson & Deary, 1998). This is why I think that defining and exploring the nature of caring should become one of my top research priorities.
My philosophy has already proved to be of value in clinical nursing environments. I was able to develop relevant practical connections between the core premises of my nursing philosophy and the main standards of Baccalaureate Education for Professional Nursing Practice. I view myself as a leader and provider of individualized care in ways that meet the needs of patients. In other words, I support nursing care that is individualized and culturally sensitive. This is how I try to defend the values of autonomy, personal integrity and dignity in patients (AACN, 2008). Autonomy means that patients have the right for self-determination, whereas human dignity is essential about the sense of respect for the inherent uniqueness and worth of individuals (AACN, 2008). My philosophy of nursing promotes the view of nursing care as a process that is highly individualized, and this is how nurses should confirm their concern for patients’ dignity and respect their personal needs, values, beliefs, goals and expectations. By being responsible before patients, other professionals and colleagues and the rest of the community, I also assume the fullest responsibility for my behaviors in clinical environments (AACN, 2008). As a future nursing leader, I promote the vision of the nurse as a role model for other nurses; leadership provides an inner capacity to model professional values and articulate my vision and mission to others (AACN, 2008). Eventually, as a nurse and future nursing leader, I constantly engage in self-reflection, with the goal of identifying changes in my beliefs and values and their implications for my professional practice.
The rationale for these standards and philosophic statements is clear. First, patients who, due to problems with their health, seek professional nursing assistance also expect that health professionals and nurses will respect their individuality and recognize their health vulnerabilities. This is why human dignity, integrity and autonomy should guide all nursing decisions. Second, it is clear that nurses operate in challenging and diverse professional contexts (Cummings et al., 2008). Therefore, it is at least incorrect to consider nurses as separate entities, and they are personally responsible for the contribution they make to the creation of sustained collaborative atmosphere in clinics. Finally, without constant self-reflection, we can never identify changes in our values and beliefs and understand what factors influence them. Again, since nurses operate in a context and nursing is a continuous process (Cummings et al., 2008), nurses are constantly exposed to multiple internal and external influences. I regularly review my practices and interactions with patients, to identify the major strengths and weaknesses of my nursing philosophy. Unfortunately, I have not been able to devise a single and universal definition of caring, and I gradually come to realize that the meaning of caring constantly changes, depending on the context and circumstances, in which caring is provided.
Nursing education provides the basic knowledge of nursing professional scope of practice, standards of practice, specialty certification and code of ethics, but this is just the beginning of nurses’ continuous development and growth. According to the American Nurses Association (2010), through improvements in quality and safety of nursing care, nurses gradually achieve the highest point of professional evolution – self-determination. This is also my biggest priority and the eventual goal of my professional growth. I feel that being a professional nurse is impossible without being able to define one’s place in the clinical context, the boundaries of nursing care as well as the effects of nursing on patients, other professionals and the rest of the community. Self-assessment and self-determination are the two areas I am passionate about, because through self-assessment I can evaluate my professional and personal capacity to provide quality nursing care to diverse patients. Moreover, I think that nurses’ self-assessment can be conceptualized as an important dimension of nursing quality (Tzeng, 2004). In other words, nurses who can interpret their job competencies, values and beliefs from more than one perspective have greater chances to develop perfect caring abilities than nurses who avoid self-assessment and self-research. As of today, I need to understand how self-assessments should be carried out and what role other nurses should play in this process. This is how I can ensure that the results of these self-assessments reflect the realities of the nursing profession and my position in the field. Simultaneously, I am confident that individual assessment of competencies and decisions will contribute to my professional satisfaction and improve job performance (Tzeng, 2004). I have some hope that my participation in professional nursing education will help me to develop a better view on my self-assessment capacities, job competencies and skills.
Nursing and caring go hand in hand. At the heart of professional nursing is the need to care for patients in ways that meet their diverse needs. Unfortunately, there is no single definition of caring. Different nurses hold different perceptions of caring. Nursing education has the potential to enhance the integrity of research and practice and lead to the development of a better view on nursing leadership and practice, through self-reflection and regular self-assessment of job competencies and skills.