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[ANSWERED] 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

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.

Expert Answer and Explanation

Nursing Theory and Personal Nursing Philosophy

It is important for nurses to be aware of their mandate as providers, and be conversant with the processes and activities involved in the delivery of care. Nursing theories can help nurses in this case because these theories provide the frameworks which guide nursing practitioners on what they can do, and how they can meet patients’ needs. By using theoretical principles and concepts as the basis for making decision, nursing professionals can be able to communicate effectively with patients, develop new interventions through research, and provide better care. In a bid to assist patients, and address their needs, providers adopt personal nursing philosophy (Poghosyan, Liu, & Norful, 2017). The philosophy which a nurse adopts may or may not match a nursing theory, and it is important for a nurse to know how to align a theoretical framework with a specific clinical issue. It is imperative to provide a discussion of my personal philosophy as a nurse, and explore how this personal philosophy aligns with a selected nursing theory.

Nursing Philosophy based on the Literature Perspective

Nursing professionals hold belies, ethics and values which shape how they see and interact with their patients and colleagues, and how they practice. These ethics, values and beliefs constitute a nurse’s nursing philosophy which is important to the nurse because it can help shape their goals. A number of research studies explore this philosophy in terms of its benefits. According to Poghosyan et al. (2017), the philosophy stems from a nurse’s commitment to help ailing individuals and their families by providing compassionate care. It captures the nurse’s beliefs, and communicates their experiences as well as beliefs. By holding these beliefs and values, nurses are able to know their expectations, and know how to approach different patient situations. For nurses, embodying the nursing philosophy in terms of the way they act and behave can help shape the nurse-patient relationship. This is why it is important for the nursing practitioners to reflect on their values and beliefs.

Personal Nursing Philosophy

I am committed to helping empower patients, and this forms the basis for my personal nursing philosophy. As a nurse, I hold that the belief that a nurse has a responsibility of caring for patients, providing competent care, and promoting overall patient wellness. I base my practice decisions on these values, and I always strive to project and live by the highest professional ideals of respect, honesty and kindness. I am aware that as a nursing practitioner, I am likely to encounter patients with various needs, and those from diverse backgrounds. I always take these needs into account when working with diverse patients. This is why I am dedicated to providing culturally competent care by incorporating the aspects of the patient’s cultures, spirituality and belies into the care process Foss (Durant et al., 2015). Besides, my philosophy drives my interest to be more open in accepting patients, and not being biased or judgmental when working with patients.

Description of a Theoretical Framework that Fit my Personal Philosophy

The theory which seems to align with my personal nursing philosophy is the Roy Adaptation Model (RAM) of Nursing which Callista Roy conceptualized. This is an example of the grand nursing theory, and it emphasizes helping the patient to adapt to their environment. Based on the RAM framework, humans are bio-psychosocial beings that interact with their surroundings. The theory also recognize human abilities by maintaining that people have acquired as well as innate mechanism for adapting to their environment. This theory equally considers health as dimension of human’s life, and it maintains that an individual exhibits four models of adaptation. For example, one can adapt so that they can become inter-dependent or to meet their physiological needs. Role function and self-concept are the modes through which a person can adapt. This theoretical framework focuses on increasing one’s life expectancy, compliance and interdependence. It places a greater emphasis on a person’s strengths (Byrne, Baldwin, & Harvey, 2020).

The RAM framework presents major assumptions as well as a nursing process that can guide the nurse’s decisions. RAM assumes that it is possible to reduce a person into parts so that they can be cared for and studied. It also assumes that nursing is anchored in causality, and emphasizes respect for the patient’s values. According to the model, there are six nursing steps which start with the patient assessment. The goal of this assessment is to help explore the habits of the patient. Assessment is also used in the second step, and it helps the nurse to identify the individual’s stimuli. This is accompanied by patient diagnosis and goal-setting which are the third and the fourth steps respectively. The fifth step involves administering treatment to address the patient’s needs, while the sixth step is when the nurse evaluates the outcomes National (Consensus Project for Quality Palliative Care, 2018).

Comparison of Personal Nursing Philosophy and the Chosen Framework

Reflecting on the features of the RAM model, some of these elements seem to match with my personal nursing philosophy. According to my philosophy as a nurse, compassion, competency and cultural competency are the core elements of the nursing practice. Nursing, therefore, is about giving patient the best, and meeting their holistic needs. The RAM theory addresses all these elements because it advocates for the delivery of care with the patient as the center of focus. The assumptions which the theory puts forth place emphasis on the incorporation of the patient’s needs as well as beliefs in the care delivery process. This is one way in which my values about care resonate with the concepts of the theory. The philosophy which I live by as a nurse focuses on the delivery of the holistic care to promote healing. The theory seems to place weight on this area considering that it stresses the need to integrate the values the patient hold into their own care (Nikfarid et al., 2018).

Contrast of the personal Nursing Philosophy and the Chosen Framework

Despite the many similarities between my nursing philosophy and the theory, there is element of contrast between the two. The main difference is that the theory emphasizes the patient interdependence while I myself hold the belief that a nurse should care for the patient, and intervene to meet the patient’s needs. The other difference is that my philosophy does not take into account the environment as a dimension of health. RAM considers a person’s environment as being vital in their personal health. It also sees adaptation or healing as a process that occurs in stages. This contradicts my views regarding the process of healing and how it occurs. Based on my nursing philosophy, I hold the opinion that provider’s competency, compassion and kindness play crucial role when it comes to the patient’s recovery (Smith &  Gullett, 2020). From this comparison, it is evident that there is a notable difference between my views concerning nursing and the theoretical perspective presented by the RAM theory.

A Possible Situation in which the Framework may Conflict my Philosophy

 There is a clinical scenario in which the RAM model may conflict my philosophy. For instance, a situation may arise where a patient struggling with addiction, liver problems and depression may require nursing intervention. A clinician, guided by the RAM theory, will address this issue by empowering the patient to stop substance abuse, and know how they can deal with the stressors. Guided by this theory, still, the nurse would consider the patient’s environment such as family or other factors in the patient’s life which contribute to her problems.  Working under the domain of the nursing philosophy, I would approach this issue differently. I would focus on the patient rather than on the factors within the patient’s environment. My goal would be to help treat the depression, and assist the patient to recover from substance use.

Conclusion

The nursing theories serve various roles including communicating expectations, and directing nurses’ decisions. Nurses’ philosophies can either match or contradict nursing theories. This underscores the need for the nurse to use the theory in addition to their philosophy of nursing. The RAM framework maintains that patient adaptation culminates into healing. It also views environment as a factor that impacts not only the treatment outcomes, but the health of the patient. There are however instances in which the nursing philosophy differs from the nursing theory.

References

Byrne, A.L., Baldwin, A., & Harvey, C. (2020). Whose centre is it anyway? Defining person-centred care in nursing: An integrative review. PLoS ONE 15(3). Doi: https://doi.org/10.1371/journal.pone.0229923.

Foss Durant, A., McDermott, S., Kinney, G., & Triner, T. (2015). Caring Science: Transforming the Ethic of Caring-Healing Practice, Environment, and Culture within an Integrated Care Delivery System. The Permanente journal19(4), e136–e142. https://doi.org/10.7812/tpp/15-042.

National Consensus Project for Quality Palliative Care. (2018). Clinical practice guidelines for quality palliative care (4th ed.). Richmond, VA: author. Available from https://www.nationalcoalitionhpc.org/ncp/.

Nikfarid, L., Hekmat, N., Vedad, A., & Rajabi, A. (2018). The main nursing metaparadigm concepts in human caring theory and Persian mysticism: a comparative study. Journal of medical ethics and history of medicine11, 6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6150916/.

Poghosyan, L., Liu, J., & Norful, A. A. (2017). Nurse Practitioners as Primary Care Providers with Their Own Patient Panels and Organizational Structures: A Cross-Sectional Study. International Journal of Nursing Studies74, 1–7. Doi: https://doi.org/10.1016/j.ijnurstu.2017.05.004.

Smith, M. C., &  Gullett, D. L. (2020). Nursing theories and nursing practice. Philadelphia: F.A. Davis Company.

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