Advanced Nursing Practice, Philosophies and Theories


Nursing is a diverse and multi-layered profession that involves multiple interactions with human subjects. To govern these interactions and improve the outcomes, it incorporates ethical standards, values, and principles that are often collectively referred to as nursing philosophy. Due to the increasing complexity and diversification of nurses’ responsibility, it eventually becomes inevitable that some of these principles conflict with the personal motivations and views of individual nursing practitioners. On the other hand, some of them may also be used for motivation and improvement.

Contribution to the Philosophy of Nursing

One of the most obvious values I regard as important for my nursing practice is compassion. I believe this is fairly common for nurses as I cannot imagine someone who is indifferent to the wellbeing of others pursuing a nursing career. Our ultimate goal as nursing practitioners is improving the outcomes of the patients, so feeling compassion is expected to increase our involvement in the service delivery process and pursuit of quality care. Another aspect of my worldview that shapes my professional practice is consistency and holism as a preferred approach. It is important since compassion is often pursued from a purely emotional standpoint and, as a result, becomes one-sided and lacks direction.

This can be acceptable at the personal level but is unacceptable in professional practice. By looking deeper into the results of my actions I am able to better understand their value for the patients and therefore my contribution to their well-being. In essence, the actions which may seem incompatible with compassion at a glance often contribute to patients’ health and is, therefore, an equally important act of compassion. Finally, I strongly believe in responsibility and embrace accountability for my actions as a part of my spiritual values. This defines at least some of my actions as a nurse regardless of the policies pertaining to the issue. In addition, I can say that it improves my understanding of accountability as a necessary component of successful practice rather than an additional burden resulting in stress.

Conflict with Obligation to Practice

However, personal beliefs and principles may also interfere with the integrity of nursing practice. Most ethical principles and values are pertinent to the field of nursing care based on generally accepted and recognized human values and morals and pursue the goal of doing as much good and as little harm as possible (Butts & Rich, 2013). However, under certain conditions and due to individual differences certain nurses will eventually find their understanding of good and harm incompatible with the implications suggested by the organization. For this reason, personal values and ethics can be defined as generally helpful for improving professional practice but introducing inconsistency and the risk of disruptive behavior in individual cases. Some of these irregularities are comparatively common since they are based on beliefs and values determined by universal cultural and social norms. In other cases, individual differences and unique experiences create fairly uncommon deviations from the norm and result in unpredictable behaviors. This situation is termed an ethical dilemma and presents a real barrier both to individual nurses and to organizations since it often leads to discrepancies in nursing practices. It should be emphasized that while professional ethics and philosophy should be prioritized, they are often disregarded by individual practitioners for a variety of personal reasons, which suggests the lack of understanding of their importance.

Possible Ethical Dilemmas

As a strong proponent of consistency and rationality, I expect to face several dilemmas during my professional practice. For instance, I consider resource allocation an important issue in a contemporary healthcare setting. Ineffective distribution of effort, time, and resources is one of the reasons for poor performance in the field (Huston, 2013). Unfortunately, some areas of healthcare still retain the necessity to allocate resources despite the questionable value of such a decision. For instance, the possibility of a patient in a vegetative state to remain on life support is understandable from the emotional perspective, but its actual value is unlikely. If I have to deal with family members of a patient under such a condition, I will likely argue in favor of stopping what I consider the useless and exceptionally irrational practice. In essence, this would be a dilemma between sympathizing with the needs of several emotion-driven individuals (whom I definitely can understand) and a hypothetical patient who will be stripped of the possibility to have the same resources and retain real feasible benefits (which I feel would be a far more appropriate solution).

Another issue that I anticipate is the dilemma of the degree of freedom a patient should remain in his or her decisions. I strongly believe that patient involvement improves outcomes, and will do my best to educate them and promote decision-making. Nevertheless, in the case where a patient is misled and chooses personal belief or traditional knowledge over the evidence-based practice, I will need to introduce a certain level of control, which goes counter to my understanding of the nursing practice and will undermine the trust and cooperation with the patient in question.

Thus, personal values and ethics can be used to assist and enhance the professional nursing practice but should be distinguished from nursing ethics whenever they conflict in order to avoid unnecessary tensions.


Butts, J. B., & Rich, K. L. (2013). Philosophies and theories for advanced nursing practice. Burlington, MA: Jones & Bartlett Publishers.

Huston, C. J. (2013). Professional issues in nursing: Challenges and opportunities. Philadelphia, PA: Lippincott Williams & Wilkins.