In theory, nursing does not impress upon one as a field that is particularly concerned with philosophy or introspection. The scientific and technical aspects of a nurse’s job make it appear to be a decidedly systematic discipline, well removed from the philosophical underpinnings that characterize the social sciences. However, when one gets into the field, they discover that intimate interactions with clients and the loosely defined, but eclectic latitude of a nurse’s role call for a serious philosophy and constant reflection (Denehy, 2001). In my opinion, nursing roughly encompasses providing medical, emotional, and psychological care to one’s charges. To be effective in this role, the nurse must be willing to assume the perspective of the patient and empathize with their suffering without losing objectivity. My personal philosophy is largely inspired by the sum of my experience in the field so far. However, given that I get new experiences with every day of practice, I keep developing and expanding it based on the changes I observe or undergo. As a nurse, I aim to help my patients see past their medical conditions into the person they really are so they can avoid defining themselves based on illness. I want each patient to think of him/herself as a person with an illness, rather than the conventional “sick person”. I believe that a patient’s greatest source of healing comes from their willpower, therefore, in addition to tending to their physical needs, I also strive to reach out to their emotional ones and help them develop positive self-perception.
One of my role models in the field is Dorothea Orem, who is credited for developing the four metaparadigms of nursing, namely, person, environment, nursing and health. Before I interacted with her work, I belonged to the school of thought that perceives patients as a helpless subjects, entirely dependent on medics to improve their condition. However, her theory convinced me that a patient is an intelligent entity, quite capable of understanding and assisting in their healing process and the nurse should not disregard this. Orem describes health as a process that needs to be continuously maintained, as opposed to an absolute state as assumed by “healthy” people (Orem, 2003). From this, I came to understand that the term health applies differently to people depending on their current state. For example, a patient suffering from a terminal illness will never be healthy per se, however, there are days they are comfortable or feeling little or no pain. As a nurse, I should help patients embrace this notion so that they can understand their capacity for health, irrespective of the condition they are suffering from. Under the nursing paradigm, Orem discusses the practical role of the nurse in providing care to patients and helping them meet their therapeutic and care needs (Orem, 2003). My role as a nurse is to take over from where the patient’s limit to perform self-care starts. I then assist him, improve his ability for self-care and by so doing, I gradually restore his power over his own health. Finally, the environment can be described as the overall context in which the health care process is taking place (Fawcett & Lee, 2014). I had previously thought of it in physical terms but later realized it was much broader. It encompasses the patient’s mentality, their relationships with their family and caregivers and how these “outside” interactions impact on their motivation to get well.
From the paradigms, it is quite clear that Orem’s theory has had a profound impact on the formulation of my personal philosophy, which is grounded on helping the patients see themselves as independent entities from their ailments. From this viewpoint, one can take control and participate in the health and the healing process instead of passively waiting for nurses to care for them. In addition to applying it to my practice as a nurse, I believe this philosophy opens up a set or possibilities for future research. It can help nurses in studying the connection between attitude and healing so they can empirically establish if patients who are optimistic about their chances are more likely to recover than those that don’t. It also portends the opening of discourse on what makes patients more afraid, the ravages of the disease, or the fear of losing control over their lives?
Strengths and Weaknesses
The key strength of my philosophy is that, by separating a patient’s mentality from the illness, I can reach out to them and help them think about their condition objectively to reduce their fear and propensity for falling into self-pity and depression. In addition, it helps humanize patients, as nurses stop perceiving them simply as helpless victims in need of help, but rather as other humans who need to be assisted in assisting themselves. However, this philosophy is weakened by the fact that it cannot apply to all patients, especially those already in depression as they might use it as an escapist strategy. If one does not carefully evaluate the patient, they might end up giving them an excuse for denial, which would be retrogressive to the nursing process.
Denehy, J. (2001). Articulating your philosophy of nursing. The Journal of School Nursing, 17(1), 1-2.
Fawcett, J., & Lee, R. C. (2014). Advancing Nursing Knowledge A Response to Burns’ Letter to the Editor. Nursing science quarterly, 27(1), 88-90.
Orem, D. E. (2003). Self-care theory in nursing: Selected papers of Dorothea Orem. K. M. Renpenning, & S. G. Taylor (Eds.). Springer Publishing Company