Nursing Philosophy The author of this report is asked to offer three main points of discussion within this report. These three sections all related to nursing theory and they will be compared and contrasted to the personal philosophy of the author of this paper. The three points of discussion are the four meta-paradigms of nursing theory, two practice-specific concepts and a list of propositions that the author of this paper would offer relative to nursing and the author's personal philosophy.

Four Meta-Paradigms

As intimated in the introduction, there are four meta-paradigms of nursing and they will each be described and analyzed in detail. The first of those four is person. A main point of this meta-paradigm is to use the word "subject" rather than "patient" to refer to the patient in the fullest and truest sense. The idea behind this is that the person is a fully singular and autonomous being and should be treated as such. The second meta-paradigm is health. As with many meta-related topics, health is a fairly wide-ranging subject and can take on many forms and sub-forms. Both clinicians and the subjects themselves would describe their health and well-being in very different terms, even for the same state of affairs or situation (Basford, 2003).

The third meta-paradigm of nursing is environment. The main crux of this meta-paradigm is that a litany of different factors and elements impact recovery in terms of how well it is perceived to be going or coming along. The home life, propensity to use drugs or alcohol, overall possibility of drug relapse and work pressures all have a bearing on when or how well a patient recovers or even if they want to recover in the first place. The nursing meta-paradigm is the final of the four. Slevin mentions that nursing should really be called caring instead as this is what is really going on. It is a meta-paradigm that is pervaded with ethical and emotional questions (Basford, 2003).

Two Practice-Specific Concepts

There are two practice-specific concepts that the author of this report finds very important. One of those two is a heavy focus on evidence-based practice. IT is important that nurses, doctors and other clinicians do not get wrapped up in assumptions or going off of anything other than best practices and what is truly ethical and right-minded to do. Too often, people get their nose too high in the air, get their personal ethics confused with what should be their professional ethics and/or are just operating in a sloppy or ham-handed fashion. This is not to say that doctors and nurses should throw everything plus the kitchen sink at a sick patient for fear of not solving the patient's malady, fear of lawsuit or just a fear of the patient getting incensed and coming back for another round of diagnosis (Whitlock, Orleans, Pender, & Allan, 2002).

Best practices are what they are for a reason. It is true that the normal way of doing things may not solve a patient's ills on the first past. Chest x-rays can give faulty indications. Different illnesses manifest very similar symptoms. However, these are clearly outliers and the normal course of treatment should be followed unless there is a clear reason to think that something else is or could be going on. For example, cold symptoms and a normal pulse are probably not a big deal but cold symptoms with a lower pulse than normal could be pneumonia or something else sinister and/or potentially life-threatening (Whitlock, Orleans, Pender, & Allan, 2002).

The other concept that will be discussed in this section was mentioned in part in the prior concept but deserves its own mention here is ethics. Specifically, the fact that there are multiple dimensions of ethics including personal, professional and government cannot be ignored. The first of those three dimensions is what a person's personal ethics are in terms of care, standards, feelings, emotions and so forth. Quite often, these are enforced and instilled by religion, family, environment and life experiences in general. Professional ethics can vary a bit from place to place, but these would be the ethics that drive the particular employer or organization that is administering...

Governmental ethics would be standards or even laws passed down by the federal or even the states in many instances (Butts & Rich, 2010).
In many to even most cases, these three paradigms will mesh quite well or in a way where conflicts can be avoided. However, the religious and political bents of some people will lead to some very questionable practices being engaged in. A lot of dangerous invective gets twirled around and the author of this report is troubled greatly every time it is seen or heard. A lot of it is just noise but when it comes to doctors and nurses refusing to do what they are morally or even legally required to do with little to no good reason, that is a problem. One can debate whether a nurse or doctor is compelled to offer birth control strictly for the purpose of preventing pregnancy, especially in areas where providers that ARE willing to dispense it are not hard to find. However, when it comes to birth control or other contraception that is used for some other medical purpose such as regulating menstrual cycles or other similar medically necessary or prudent treatments, there should be no question as to whether it can or should be offered and this is true even of Catholics and other religious groups that are opposed to the use and dispensation of contraception on moral grounds. That is but one example.

Another ethical quandary comes from the fact that there is vast need from the elderly, mentally ill and other people in need of assistance but there is not enough taxpayer or private money to fund all of those needs. People that truly need to be treated and committed while this treatment is undertaken (Amanda Bynes and Lindsay Lohan's receint travails come to mind), the help that is needed is not forced even when it should be. People without the financial resources of the aforementioned celebrities may very well want help but do not have the resources to pay for the needed rehabilitation and care. What this all means to nursing is whether or how much care should be given to people that will not or cannot pay and how much of the private nursing/doctor sector's funds should be allocated to that. There is certainly no singular answer that is present in this paradigm and the country remains extremely polarized and divided in this regard. Regardless, the three ethical dimensions above have to be reconciled in a way that does not sacrifice quality of care but also does not sink the financial metrics of a hospital and thus rendering it unable to continue functioning (Butts & Rich, 2010).

Five Propositions

The author of this report would offer a set of five propositions that explain how the author feels and thinks about certain things as juxtaposed and infused with the nursing concepts learned in this and prior classes and other learning environments. First, the author of this report would surmise and propose that people that are unwilling or unable to morally justify life-saving or life-improving treatment that does not relate to entirely discretionary and voluntary behavior should rethink their set of ethical beliefs or they might want to think about a different profession. Refusing to sell a diaphragm or a box of condoms is one thing but actively ignoring the medical needs of a person that have nothing directly to do with sex or other voluntary activities should not be politicized or treated in such an inhumane way. Similarly, doctor's offices that do not wish to provide abortions have that right. That is why organizations like Planned Parenthood and church-bound adoption agencies exist.

Second, the author of this report would propose that the constant rancor and divisiveness about the national healthcare situation is pointless and mind-numbing. Of course, the government should be a safety net to people that cannot, either temporarily or permanently, help themselves. However, it should not enable people that refuse to be self-sufficient when they can be as there is a finite amount of taxpayer money that is available for use and dissemination and anyone that can pay for their own healthcare should do so.

Third, the author would posit that state/federal health initiatives or law frameworks like the Affordable Care Act or others should not be rolled out and made available until they are ready for their reveal. The current rollout of ObamaCare is a debacle and the idea that people can be fined for not signing up when the website that they are to use for the same is basically unusable is a joke (Lovett, 2013). If the private sector has to be looped in to get the site operational, so be it. Doing things on the cheap or in a cut-rate manner is not a way to run a national health program and it only adds to the money losses that Medicare and Medicaid…