My decision to become a nurse was guided by my love for people, which is fueled by compassion and empathy. I believe that my purpose in this life is to serve humanity and nursing offered me that chance.
My first certificate was in Medical Coding and Billing in 2008 from the Florida National University before I became a certified EKG technician from the same University in the same year. In 2015, I graduated with a Bachelors Degree in Nursing from the same university
Between August 2008 and February 2010, I worked as an assistant manager at the Therapeutic Associates of South Florida where I coordinated the patients’ appointments with physical and occupational therapists among other management duties. From April 2010 to February 2012, I worked as an Intake Coordinator at Casper Home Health, Florida, where I verified medical orders for home health among other responsibilities. Between December 2012 and October 2014, I worked as a Registered Nurse at the Behavioral Health Service at St Luke’s Center before working as a Utilization Review Nurse at the Leon Medical Centers Health Plans from October 2014 to April 2015. Currently, I am working at the Magellan Complete Care as a Utilization Review Nurse where I ensure that patient care is provided according to the medical necessity of patients coupled with checking if the provided medical care meets the insurance company standards by InterQual program among other responsibilities.
My most memorable experience as a nurse came when I was working at the Living Care Home in Miami, Florida. One elderly patient approached me and said, “Nurses are a gift to humanity, whatever you do here cannot have a price tag.” This compliment moved me to tears and every day I wake up, I get this deep sense of satisfaction knowing that my actions will touch one soul in need and lift humanity to a different level.
The four meta paradigms
The four meta paradigms of nursing include the patient, the nursing practice, health, and the environment. Fawcett (2005) defines metaparadigm as “the global concepts that identify the phenomenon of central interest to a discipline, the global propositions that state the relations between or among the concepts” (p. 4). The four meta paradigms of nursing touch on the different areas of focus when providing patient-centered care. The relationship amongst these four meta paradigms determines the quality of patient care and the success of the nursing profession in any given set up.
This metaparadigm defines the person receiving care. Human beings are complex perhaps due to the uniqueness associated with every individual. Patients have unique life experiences that determine how they view different aspects including the provision of care. Nightingale (2007) observed that the patient is a complex being having psychological, social, biological, and spiritual dimensions and needs that have to be addressed in the process of providing care. Therefore, in the provision of care, patients are not just clients bringing money to the healthcare institutions. On the contrary, they are individuals with varied needs that can only be addressed successfully through the creation of meaningful patient-nurse relationships. In this light, patients become partners in the provision of care, and thus, they have to be involved in the decision-making process. The nurse-patient relationship seeks to address the psychological, social, and spiritual patient needs, which contribute significantly to the health of a functional human being.
In the course of dispensing my duties as a nurse, I seek to establish nurse-patient relationships based on core values like trust, altruism, and respect for human dignity. I endeavor to make patients feel part of the process and system of the provision of care. I refrain from referring to patients as clients because I believe that nursing goes beyond the financial aspect. After realizing that they are partners in the provision of care, patients respond positively, and they open up to receive holistic care, which makes them better individuals. This way, nurses become part of the patients’ families, and hospitals become an extension of their homes.
The environment covers both internal and external factors that contribute to the wellness of an individual. According to Nightingale (2007), patients should be placed in the best environment for nature to act upon him or them. This assertion is based on the view that while doctors treat, nature heals. The internal environment entails personal values and morals coupled with societal beliefs and expectations. On the other side, the external environment covers the different aspects surrounding a patient including socioeconomic, political, and physical components. During the provision of care, these factors should be considered for quality care and positive outcomes. The environment is “an energy field in mutual process with the human energy field and is conceptualized as the arena in which the nursing client encounters aesthetic beauty, caring relationships, threats to wellness and the lived experiences of health” (Thorne et al., 1998, p. 1268). In this light, the environment plays a critical role in the healing process of a patient. Therefore, the hospital setup should create an ambiance that takes care of the patient’s needs for quality care.
In my nursing practice, I always ensure that both the internal and external patient environments are aligned to improve the quality of care. In the internal environment, I usually ensure that patients are at peace with themselves. Some patients may be in denial of their condition, which impairs the recovery efforts. Acceptance is the first step towards recovery, and thus, I normally encourage patients to accept their condition first. I inform patients that their conditions can be treated successfully, and this realization gives them confidence in the care provision system. On the external environment, I ensure that the hospital set up evokes equanimity in the patients’ minds.
The health paradigm focuses on the physical, psychological, and socio-cultural factors that contribute to one’s well-being. In this context, health is not simply the lack of disease, but a conceptualization of lived experiences in one’s life. In this context, Basford and Slevin (2003) posit that health is “negotiated and contextual rather than being imposed and universal” (p. 195). Based on this argument, it suffices to conclude that different health determinants shape the patients’ recovery process. Therefore, the health aspect covers the lived experiences that shape one’s realities and possibilities. Some illnesses result from bad lived experiences, and they can be addressed via caring relationships between the patient and the nurse. In other words, the health paradigm brings together all aspects involved in life. A patient can be cured of a certain pathological disease, but if his or her mind is unsound, such an individual cannot be said to be healthy. For a person to be termed as healthy, s/he has to be socially, psychologically, physiologically, spiritually, and economically well. Largely, the health aspect compliments the environment paradigm.
In my nursing practice, I look beyond the provision of treatment-related services in the definition of health. In most cases, the causes of the problem may not be diagnosed through the established clinical procedures. Unfortunately, when the causes of a problem are not addressed, health practitioners will keep on dealing with recurring symptoms and the cycle becomes futile. Therefore, as a nurse practitioner, I endeavor to engage patients at a personal level to determine if the causes of their illnesses have been addressed comprehensively. At times, I reach out to the family members, friends, and the community to ensure that any underlying causes are unearthed and addressed.
The nursing practice is wide and different individuals have come up with varying definitions of the same. Thorne et al. (1998) give a comprehensive definition of nursing as a practice that involves “facilitating, supporting, and assisting individuals, families, communities, and societies to enhance, maintain, and recover health, and reduce and ameliorate the effects of illness” (p. 1265). Nursing as a practice entails the collective actions that nurses execute every day in the process of providing care. Nightingale theorized that most patient conditions are not a result of the disease in question, but the involved relationships that a patient experiences and the environment where one is placed during care (Bishop & Scudder, 2009). Therefore, the role of a nurse is to ensure that the patient is in an environment that facilitates both clinical and natural healing processes. Nursing can also be viewed as an art where creative knowledge is used to provide therapeutic interventions, which constitute human care. The need theory by Florence Nightingale emphasizes the development of the nursing practice through experience and education (Bishop & Scudder, 2009). While nurses learn a lot from practicing and interacting with patients, there is a need to have scientific knowledge concerning the nursing practice.
In my nursing practice, I appreciate the role of gaining skills through education and experience. Nurses have to be lifelong learners through advancing their nursing education to the highest level where possible. Every day, I seek to learn something new from my nursing environment. The patients’ experiences and feedback offer a rich source of learning opportunity for nurses. The nursing practice also covers advocacy efforts to share with patients on the different steps they can take in their daily lives to experience improved health outcomes. As mentioned before, patients are not just recipients of care, but partners in the process to ensure that they achieve all-rounded health experiences.
Two Practice-Specific Concepts
A concept is described as “abstraction, mental formulations, mental images, and words that represent mental images” (Fawcett, Watson, Neuman, Walker, & Fitzpatrick, 2009, p. 407). Health and health promotion are the two concepts explored in this section.
The concept of health in my practice is wide, and it covers the different elements that contribute to the holistic wellbeing of an individual. As a nurse, I believe that a healthy individual should be psychologically, socially, economically, spiritually, and physiologically well. One has to experience safety from worries caused by the lack of economic empowerment. I have seen many patients deteriorate and sink into hopelessness after being diagnosed with a certain sickness. I have met individuals who walk in hospitals for normal check-ups, but they end up being hospitalized for months. The fear that is occasioned by the diagnosis cripples the individual to a point of showing symptoms that did not exist before. As a nurse, I believe that the concept of health and wellbeing should start with preparing the patients mentally to accept their conditions and believe that the sicknesses can be healed. This confidence stirs the human will to soldier on irrespective of the prevailing situation. The economical well-being gives the patient the assurance that s/he can pay for whatever services needed to achieve positive health outcomes. Therefore, availing of affordable insurance covers is a sign of health in a given society.
This nursing concept underlines the different stakeholders in the provision of quality care. The major stakeholders include patients, health practitioners, the community, and policymakers. Patients have to understand that they play a key role in the achievement of quality care. Therefore, nurses need to educate patients on the different healthy lifestyles that one can practice to ensure wellbeing. Besides, nurses have to be equipped with advocacy skills to ensure that the policymakers understand the need for having policies that promote human care. For instance, nurses understand the need for having insurance covers for all especially the minority groups and economically disadvantaged individuals. Nurses can reach out to the patients and know their fears associated with the lack of economic empowerment. Therefore, nurses promote human care by empowering individuals to lead healthy lifestyles and lobbying for the creation of sound policies on the same.
List of Propositions
- Patients are not just receivers of care, but partners in promoting quality care
- Economic disempowerment will kill a man faster than a disease
- The quality of care is directly proportional to the quality of policies in place
- Health is not the absence of diseases
- Nurses are the pivot that determines the quality of care according to patients
Basford, L., & Slevin, O. (2003). Theory and practice of nursing: an integrated approach to caring practice. Cheltenham, UK: Nelson Thornes.
Bishop, A. H., & Scudder, J. R. (2009). Nursing as a practice rather than an art or a science. In P. Reed & N. Shearer (Eds.), Perspectives on nursing theory (pp. 638-643). Philadelphia, PA: Wolters Kluwer.
Fawcett, J. (2005). Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories (2nd ed.). Philadelphia, PA: F. A. Davis.
Fawcett, J., Watson, J., Neuman, B., Walker, P., & Fitzpatrick, J. (2009). On nursing theories and evidence. In P. Reed & N. Shearer (Eds.), Perspectives on nursing theory (pp. 407-414). Philadelphia, PA: Wolters Kluwer.
Nightingale, F. (2007). Notes on nursing: what it is, and what it is not. Radford, VA: Wielder Publications.
Thorne, S., Canam, C., Dahinten, S., Hall, W., Henderson, A., & Kirkham, S. (1998). Nursing’s metaparadigm concepts: disimpacting the debates. Journal of Advanced Nursing, 27(6), 1257-1268.