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Saturday, January 7, 2012

Philosophy of Nursing

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I believe that personal philosophy is based on knowledge. In 171 Kneeler described five kinds of knowledge (cited in Blais, Hayes, Kozier and Erb, 00 , p. ); revealed- disclosed by god, intuitive- based in self-discovery, rational - logic derived, empirical - based on observation or experiment, and authoritative- vouched for by authorities. At times, knowledge is gained through epiphany, and our own life experience (revealed and intuitive). At other times we learn from the experiences and experiments of others (authoritative and empirical). Sometimes we know things are so because they just make sense (rational). Learning is a life long process. As our knowledge increases our personal philosophy grows, the two becoming tightly woven about one another and becoming ultimately inseparable.


My personal philosophy defines who I am as a human being. It shapes my life and drives my daily experience as I interact with myself, my family, strangers, my environment, and my world. The keystone of my personal philosophy is listed by Watson, as one of the critical values in Nursing; “a belief in the dignity and worth of each person” (as cited in Blais, Hayes, Kozier and Erb, 00, p. 15). A second fundamental piece of my personal philosophy is the Native American proverb ‘before you can know someone you must walk two moons in their moccasins’. I remember vividly the first time I was introduced the Maslow’s Hierarchy of Needs (Anonymous, Maslow’s Hierarchy of Needs and More, 001). At last! A short cut to walking two moons, a way to understand someone by looking at their circumstances. Maslow’s theory prioritizes human needs from most basic physiologic needs such as oxygen, food, water and constant body temperature, necessary to maintain life, to the ultimate human potential, self-actualization.


How then does a personal philosophy integrate with the elements of nursing practice, environment, health, illness, and nursing? What follows is an exploration of how my personal views integrate with the philosophies of other nurses in terms of environment, health, illness and nursing,





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Environment


A definition of environment will vary from one person to another. Blais. Hayes, Kozier and Erb (00) define environment as “the internal & external surroundings that effect the client, including people in the physical environment, such as families friends, and significant others”(pg. 1). Rogers describes environment as “all that is outside a given human field” (as cited in Blais et al., 00, p. 4). I would go even further than Rogers and add ‘throughout their existence”. In other words, our environment is everything we interact with throughout our lives. If we consider Rogers’s broad definition of environment, an individual’s environment extends through their interaction with other s. When I interact with another, their environment becomes part of mine because it defines their reality and their reality interacts with mine. Further, past experiences with our environment pattern present and future interactions. Following this chain of thought, we truly see environment as infinite. On more a practical level, the key concept for me,, our environment determines where we are on Maslow’s Hierarchy. Where we are on Maslow’s Hierarchy affects our interaction with our environment and that includes the nurse-patient relationship.


Health


Health has been described as the absence of disease. Nightingale (cited in Blais, Hayes, Kozier and Erb, 00) defined health as a state of “being well and using every power the individual possesses to the fullest extent.”(pg 7) The World Health Organization (cited in Blais et al., 00) defines health “as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.”(p.7) My definition of health would include a little Maslow in the mix; health is a state of physical, mental and social well being which allows the individual to work towards self-actualization.


Illness


Illness is defined by Blais, Hayes, Kozier and Erb ( 00) as ”a highly personal state in which the person feels ill. Illness is highly subjective and only the individual person can say he or she is ill.” (p. 8) Once again, I would toss a little Maslow in and define illness as any internal condition that infers with the individual’s ability to achieve self-actualization. Any internal condition that interferes with an individual’s ability to meet their need for oxygen prevents attainment of self-actualization and causes a state of illness. Any condition that interferes with an individual’s ability to meet their need for nutrition prevents attainment of self-actualization and causes a state of illness. Any internal condition that interferes with the individual’s ability to be secure, belong, or maintain self respect prevents attainment of self actualization and causes a state of illness.


Nursing


The definition of nursing depends on the theorist. Henderson, in 155, (cited in Blais, Hayes, Kozier and Erb, 00) defines the function of the nurse “to assist the individual, sick or well, in the performance of those activities contributing to the health or recovery that he would perform unaided if he had the necessary strength, will or knowledge, and to do this in such a way as to help him gain independence as rapidly as possible.”(p. ) Jacobs (001) defines Nursing as ”respect of human dignity”. She further states; “Nursing’s central phenomenon …is to ennoble the lives of the people who nurses relate to in community”(pg?). Still adding a little Maslow into the mix, I define Nursing as ennobling the lives of our clients by assisting them in the activities they would perform themselves in their journey towards self actualization, in such a way as to help them gain independence as rapidly as possible.


It is very difficult to face the demands of caring for people from day to day with out the solid foundation of a personal philosophy. Ethical issues are a frequent component of nursing in the twenty first century. A sound personal and nursing philosophy is required to deal compassionately and comfortably with issues such as abortion, allocation of resources, termination of health care efforts, use of restraints, caring for prisoners, etc. For me, investigation and development of a personal philosophy is a prerequisite for a joyful life and a fulfilling career in nursing.





References


Anonymous. (001, October 15). [Maslows Hierarchy of Needs] Retrieved April , 00, from Maslows Hierarchy of Needs and More http//www.connect.net/georgen/maslow.htm


Blais, K., RN, Ed.D, Hayes, J. S., RN, Ph.D, Kozier, B., RN, MN, & Erb, G. R. B. (00). Professional Nursing Practice, 4th ed.. Upper Saddle River, New Jersey 07458 Prentice Hall.


Edwards, S. D., (001). Benner and Wrubel on caring in nursing. Journal of Advanced Nursing, (), 167-171.


Jacobs, B. B. (001). Respect for human dignity A central phenomenon to philosophically unite nursing theory and practice through consilience of knowledge. Advances in Nursing Science, 4(1), 17-5.





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