The Four Metaparadigms
Besides being a discipline studying the fundamental essence of knowledge and existential aspects of human life, philosophy can also be defined as an attitude of a person or a community that provides guidelines for behavior. Philosophy of nursing is aimed to state one’s personal ideas concerning the nature of the profession (including ethical beliefs) that direct one’s activities (McCormack & McCance, 2016).
Nursing can be defined as an act of providing and maintaining people’s health and capabilities, preventing illnesses, performing treatment, educating patients about proper self-care, and increasing the level of health care quality in general (by contributing to well-being of each person in particular) (Bahramnezhad, Shiri, Asgari, & Afshar, 2015).
Taking into account the assumptions provided, I can give the following interpretation of the domains of the nursing metaparadigm within the framework of my personal philosophy:
- Patient is a human being that possesses his/her specific background and should be examined comprehensively in dynamics (Alligood, 2013). I am going to analyze each person as a sum of constantly changing physiological, psychological, intellectual, and social characteristics (e.g. gender, age, habits, attitude to treatment, etc.) and pay equal attention to every constituent since you can never say for sure, which factor is decisive in each particular situation. The universal approach is not applicable in this case as each case is unique and has to be addressed only after all the components are identified and assessed correctly. There are situations, in which the patient’s perception of health and treatment would be more important than even having the results of all examinations (McCormack & McCance, 2016).
- Environment is understood as a context or settings of human experience that can vary in space, time, and nature (e.g. cultural norms and values, financial and social status of the patient, his/her political views, etc.) This factor is especially important when a nurse has to deal with representatives of minority groups as they should not feel discriminated on any basis. Culturally competent nursing implies correctly interpreting and using the context (Alligood, 2013).
- Health is a dynamic state comprised of wellness and diseases in their different proportions (McGibbon, Mulaudzi, Didham, Barton, & Sochan, 2014). I take into consideration that absolute health is unachievable and is always context-dependent and multifaceted (e.g. physical condition, mental stability, moral realms, self-perception, etc.). It is the ultimate goal of every health care professional to strive for the absolute health of the patient, which means ensuring as many factors as it is possible under the given conditions.
- Nursing for me is the art of providing comprehensive full-fledged care for those who cannot do it themselves (e.g. critical assessment, medical treatment, education of patients). Nursing is patient-centered activity that continues even when the nurse is not at work as it is his/her duty to help people under any circumstances.
The domains are interconnected: health is hard to restore without the interference of medicine, while nursing, in its turn, cannot be performed without people who need medical care. Environment plays a crucial role in forming the patient’s mentality including his/her attitude to treatment that is highly important for culturally competent nursing. I believe that the nursing of the future will be freed from stereotypes and will be culture-specific in both treatment and communication with patients and their families. As a nurse practitioner, I will encounter a lot of challenges, which include operation with technologies, ongoing education, acquiring intercultural communicative skills, learning foreign languages, etc.
My primary objective has always been to render medical aid to all people who need it, no matter what cultural background they belong to, what religion they have or what their financial and social status is. However, as far as professional development is concerned, I strive to obtain enough knowledge to become a nurse administrator that would allow me to give proper direction to young specialists and help them perform their duties, gradually bridging the gap between theoretical knowledge and practice.
Two Practice-Specific Concepts
If I want to develop professionally as a nurse practitioner, I will be required to develop not only be theoretical knowledge, but also problem-solving skills, and practical abilities that would help me to be able to deal with any conditions that surround me. First and foremost, it would be required to complete my studies to obtain the master’s degree in nursing.
My major role in relation to the patient is usually identified as clinical as I must ensure that all patients receive care that they need when they are hospitalized. Although I am not the major specialist in diagnostics, I still have an important role in prevention, supervision, and prescription of both pharmacologic and non-pharmacologic therapies to my patients, Moreover, I am responsible for monitoring patients’ conditions after they have already been discharged and have to continue their treatment at home in order to avoid readmission (Masters, 2015).
One of specific areas of my practice is patient education. I have to deliver all the required information to the patient and his/her family in order to ensure that they are aware of all the issues connected with disease prevention and promotion of the healty life style (Masters, 2015). Education is a combination of theoretical foundations and practical training clarifying my professional aims and duties as well as providing guidelines to the patient helping him/her to deal with his/her conditions without my constant supervision.
I will strive to obtain enough knowledge to educate patients that would allow me to give proper direction to those who cannot yet deal with their disease without assistance and help them bridge the gap between theoretical knowledge about their condition and its practical management. The scope of practice of a nurse practitioner in this areas ca be summed up as follows (Cherry & Jacob, 2016):
- clarifying assessment results to the patient;
- coordinating with patients and encouraging independence;
- discussing information concerning procedures and medications;
- teaching patients to manage their condition;
- discussing rehabilitation strategies and adaptation mechanisms;
- counseling the family on symptom management (especially, if they were unaware of the patient’s conditions and do not know how to deal with it);
- enhancing understanding of health care status for the patient in particular and all his family in general to make it clear for them what consequences their wrong behavior in health matters may bring about;
- clarifying challenges and barriers to patients for them to be realistic in their expectations;
- assessing patients’ knowledge and literacy levels;
- evaluating available teaching materials and tools;
- considering environmental, cultural, intellectual, etc. factors that may influence the way the patient perceives health and treatment;
- enhancing patients’ motivation to improve health.
Another practice-specific domain is the provision of the patient’s safety. Patient safety is an important aspect of my work that concerns not only technological security of medical operations but also provision of information to the staff and patients on topic concerning their personal safety. Moreover, I must be able to identify risk component, eliminate risk factors, do research on the topic of security, etc.
As a nurse practitioner, I should shape my working environment in such a way that all patients can be sure not only of their personal security but also of sanitation and cleanness of the settings, prevention of contagious diseases, and timely provision of relevant information of safety topics. Nurse practitioners must be able to develop effective methods to deal with all the componetns of patient safety with equal degree of efficiency (LoBiondo-Wood & Haber, 2014).
Being a high-quality specialist, I must show the best possible performance of my duties. It is essential when I have to handle emergency situations when I have to switch from one patient to another, and all must be sure that they have enough attention. I must stay concentrated in order to preserve the due safety level of my hospital. Yet, at the same time, it is necessary to remember that emergency cases are not the only ones, in which measures have to be taken.
I must be able to provide safe conditions daily, making visits to all my patients and informing them if they should pay attention to their condition and be more responsible for their behaviour affecting health. Besides, it is also crucial to help those who were injured and need physiotherapy during the rehabilitation process to ensure that their life and health are out of danger and full recovery is possible (Masters, 2015).
List of Propositions
Identifying your personal nursing philosophy means establishing links between opportunities that the profession can offer and your own values, competences, and expectations (McCormack & McCance, 2016).
My nursing philosophy is based on the following assumptions and propositions:
- the care that I provide must be patient-oriented, which means that all the peculiarities of the person must be taken into consideration regardless of my subjective perception of their significance;
- I must follow the patient through all treatment stages and provide a well-grounded follow-up plan that is going to be applied upon his/her discharge in order to avoid readmission;
- it is necessary that I should complement the role of the family physician for the family to perceive me as a crucial part of treatment and have deeper understanding of my role;
- I must ensure collaboration with other health care specialists not only to provide the best available service and environment to the patient but also to increase my professional competence;
- my task is a comprehensive one, which means that I have to provide examination, education, and disease management to my patients;
- it is crucial that I should think prospectively and identify risk groups for improving their outcomes even before any problem emerges and any real health assistance is needed;
- even if I do not have a policy-making power, I should do my best to facilitate access to health care services and take part in the policy-making process;
- it is my duty to encourage patients to take an active part in their own care, to learn everything about their present condition and the ways they can deal with it successfully;
- I must be able to explain to my patients their part of responsibility for their actions and make them acquainted with preventive measures that they should take to improve their condition and avoid readmission;
- I must provide enough information for patients to be able to acquire healthy habits that foster their gradual transition to a healthy life-style, which would mean prevention of a number of negative health consequences;
- I must continue learning throughout my whole nursing activity, not only from books and medical journals but also from other nurses’ experience as well as my own as cooperation is an important source of knowledge;
- my work should not run isolated as it is essential to provide support to fellow-nurses and other team members;
- the end of my shift never means the end of my work as nursing implies readiness to help people in need no matter where and when you encounter them.
Alligood, M. R. (2013). Nursing theory: Utilization & application. New York, NY: Elsevier Health Sciences.
Bahramnezhad, F., Shiri, M., Asgari, P., & Afshar, P. F. (2015). A review of the nursing paradigm. Open Journal of Nursing, 5(01), 17-22.
Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management. New York, NY: Elsevier Health Sciences.
LoBiondo-Wood, G., & Haber, J. (2014). Nursing research: Methods and critical appraisal for evidence-based practice. New York, NY: Elsevier Health Sciences.
Masters, K. (2015). Role development in professional nursing practice. Burlington, MA: Jones & Bartlett Publishers.
McCormack, B., & McCance, T. (2016). Person-centred practice in nursing and health care: Theory and practice. Hoboken, NJ: John Wiley & Sons.
McGibbon, E., Mulaudzi, F. M., Didham, P., Barton, S., & Sochan, A. (2014). Toward decolonizing nursing: the colonization of nursing and strategies for increasing the counter‐narrative. Nursing Inquiry, 21(3), 179-191.