Patient Centered Care in the Art of Nursing

Developing a Personal Philosophy of Nursing

Introduction

This paper focuses on the fundamental concepts within the field of nursing, particularly through the lens of the nursing metaparadigm which includes nursing, person, environment, and health. It begins by examining and elaborating on these key concepts, drawing upon definitions from renowned nursing theorists and literature. It then goes into how these concepts are mirrored in the philosophy, mission, and vision of a specific healthcare organization, Hackensack Meridian Health, highlighting the alignment between organizational values and nursing principles. The paper then transitions into a more personal interpretation of these concepts, with my own individualized definitions for nursing, person, environment, and health. Building upon this foundation, the paper culminates with my articulation of a personal philosophy of nursing. This philosophy integrates the previously defined concepts and is guided by values such as patient-centered care, ethical practice, and a commitment to continuous learning. It is informed and supported by established nursing theories and models. In short, my personal philosophy sees nursing as both a science and an art in the approach to patient care.

Four Concepts of the Nursing Metaparadigm

Nursing, as defined by Alligood in "Nursing Theorists and Their Work," encompasses the protection, promotion, and optimization of health and abilities, the prevention of illness and injury, the alleviation of suffering, and advocacy in the care of individuals, families, communities, and populations (Alligood, 2018). This comprehensive definition highlights the diverse roles of nursing, which include health promotion, disease prevention, and patient advocacy, underlying its commitment to holistic patient care.

The concept of person in nursing is central to patient care and is intricately defined by Rogers in "Nursing: Science of Unitary, Irreducible, Human Beings: Updated Edition." Rogers (1992) views the person as a “unitary being,” emphasizing a holistic approach that integrates physical, mental, emotional, and spiritual aspects (Rogers, 1992, p. 25). This perspective underscores the integrity and individuality of each patient, necessitating personalized and comprehensive care.

Nightingale's theory, as outlined in her seminal work "Notes on Nursing: What It Is, and What It Is Not," presents the environment as a critical factor in health and recovery. According to Nightingale (1860), environmental factors, which include physical, psychological, and social conditions, significantly influence the health and well-being of individuals (Nightingale, 1860). Her theory has been foundational in nursing, highlighting how nursing care can actively modify the environment to promote healing and recovery.

The World Health Organization's definition of health, as stated in the "Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference," goes beyond the mere absence of disease or infirmity. Health is described as a state of complete physical, mental, and social well-being (WHO, 1948). This definition brings to light the holistic nature of health, recognizing the importance of not only physical well-being but also the mental and social aspects of health.

Compare and Contrast with Employer/School Philosophy

Mission: "Transform health care and be recognized as the leader of positive change."

The mission statement is the organization's core purpose and function. For Hackensack Meridian Health, the focus is on transforming health care. This implies a participation in the healthcare industry, and it also suggests actively seeking to change it for the better. Being recognized as a leader in positive change also suggests an ambition to set standards in the healthcare sector.

Vision: "Innovation is in our DNA, compelling us to create a world where: the highest quality care is human-centered, accessible and affordable; we deliver outcomes that matter most; and excellence is the standard."

The vision provides a forward-looking statement about what the organization aspires to achieve in the future. It is more aspirational and long-term than the mission. Hackensack Meridian Health’s vision emphasizes innovation and sets high standards for quality, accessibility, affordability, and excellence in healthcare. It points to a future where healthcare is not just a service but a well-integrated, human-centered experience.

Beliefs:

1. Creative: "I will do my part to make things better."

2. Courageous: "I will do the right thing."

3. Compassionate: "I am the human experience."

4. Collaborative: "I embrace teamwork."

5. Connected: "I am part of something bigger."

These beliefs act as guiding principles or values that inform how the organization and its members should conduct themselves. They focus on and emphasize creativity, courage, compassion, collaboration, and a sense of connection—things that go beyond the standard protocols of a workplace. In short, Hackensack Meridian Health calls upon nurses to exercise the art of nursing at the same time as it expects them to implement the science of nursing. It thus reflects a holistic approach to healthcare that goes beyond mere medical treatment.

In relation to the book "A Personal Nursing Philosophy in Practice" by Allison Marchuk (2014) and the book "Nursing Theories and Nursing Practice" by Smith and Parker, these components align with several key concepts in nursing practice:

CSLO 2: Describing the development of nursing as an art and science.

Hackensack Meridian Health's emphasis on creativity and innovation aligns with the development of nursing as both an art (creative, compassionate) and a science (innovation, delivering outcomes).

CSLO 3: Explaining the components of nursing knowledge.

The beliefs reflect an understanding of nursing that goes beyond technical knowledge to include ethical and interpersonal aspects.

CSLO 4: Discussing selected conceptual models used in holistic professional nursing practice.

The holistic approach reflected in the vision and beliefs of Hackensack Meridian Health aligns with holistic nursing models that consider the full spectrum of human experience in healthcare.

Thus, Hackensack Meridian Health’s mission to transform healthcare and be recognized as a leader of positive change resonates strongly with the broader definition of nursing. The organization’s commitment to innovation and quality care aligns with the nursing metaparadigm’s emphasis on optimizing health and advocating for patients. This reflects a shared dedication to advancing the field of healthcare and prioritizing patient well-being, central tenets in the practice of nursing.

In terms of the concept of the person, Hackensack Meridian Health’s belief in compassionate care and viewing the person as a unified whole mirrors the nursing metaparadigm’s view of the person. This perspective recognizes the individual not just as a patient with physical needs but as a holistic being with mental, emotional, and spiritual dimensions. Such an approach aligns with the nursing profession's commitment to treating individuals with comprehensive, personalized care, respecting their integrity and individuality.

Regarding the environment, Hackensack Meridian Health's emphasis on teamwork and being part of something larger indicates a deep understanding of the environment as encompassing more than just the physical aspects. This perspective acknowledges the social and relational factors that significantly impact health, in line with Nightingale’s environmental theory in nursing. It highlights the importance of creating supportive and collaborative settings that can positively influence patient care and outcomes.

Finally, the organization's vision of delivering outcomes that matter most and setting excellence as the standard echoes the World Health Organization’s holistic definition of health. This vision moves beyond the traditional focus on the absence of disease to embrace a broader understanding of health, including physical, mental, and social well-being. It demonstrates a commitment to a comprehensive view of health, paralleling the nursing metaparadigm's inclusive approach to health and wellness.

Overall, Hackensack Meridian Health's philosophy, mission, and vision showcase a harmonious blend with the nursing metaparadigm's core concepts. Both emphasize a holistic, patient-centered approach in healthcare, underlining the importance of individualized care, supportive environments, and a broad understanding of health that transcends physical well-being.

Creating a Personal Set of Definitions

My definition of nursing is an integrative practice that unites scientific knowledge with empathy and compassion. It is a profession committed to promoting holistic well-being, preventing illness, and providing care and support to individuals in a variety of settings. This view of nursing recognizes the two aspects of the field: the scientific, which includes the technical and evidence-based practices critical to effective medical care, and the empathetic, which involves understanding and responding to the emotional and psychological needs of patients. It shows the importance of treating patients not just as cases or conditions, but as whole individuals whose overall well-being is the primary concern.

In defining a person, I view each individual as a holistic entity, that includes their physical health and their mental, emotional, social, and spiritual dimensions. This perspective sees that each aspect of a person's life contributes to their overall health and well-being. It challenges the nurse to look past the immediate medical needs and consider the overall context of the patient's life, like their emotional state, social relationships, cultural background, and spiritual beliefs. This comprehensive approach is so that care is patient-centered and tailored to the unique needs of each patient.

The environment, in my view, is a composite of the various external and internal influences that impact an individual's health. This includes physical factors like living conditions and climate, social factors such as family dynamics and community support, cultural influences including beliefs and traditions, and psychological aspects like stress levels and mental health status. Understanding the environment's role in health means recognizing that health and illness do not occur in a vacuum but are influenced by a complex interplay of various factors. This understanding is needed for providing effective healthcare that addresses not just the symptoms but the root causes of health issues.

Last, I define health as a state of complete physical, mental, and social well-being. This definition can change, however, as the patient defines it. It acknowledges that true health is different from one person to the next. In general it refers to a state of overall well-being where the aspects of a person's life are in balance. This is a holistic view of health that I find to be dynamic, because people are constantly changing and being influenced by different ideas and factors. It shows that the goal of nursing care to support patients in achieving and maintaining an optimal state of health in all areas of their lives.

My Personal Philosophy of Nursing

My personal philosophy of nursing is rooted in the belief that nursing is not just a profession: it is a calling that blends scientific knowledge, ethical practice, and compassionate care. It is an integrative discipline that demands a commitment to patient-centered care. This is needed so that the needs, values, and preferences of the individual are respected. This philosophy is tied to the recognition that each patient is a unique individual with their own set of experiences, challenges, and strengths. In my practice, upholding the dignity and uniqueness of each person is not just an ideal but a daily commitment.

The core of my nursing philosophy is the understanding that health is a holistic concept. It is not just a focus on curing disease or addressing whatever physical ailment might exist. It looks at the mental, emotional, social, and even spiritual dimensions of a person's life. This holistic view compels me to consider all these aspects in my care delivery. I believe that the environment, both physical and social, plays a critical role in an individual’s health. Therefore, my approach to nursing involves not only addressing the immediate health concerns but also understanding and mitigating the environmental factors that could impact the patient's well-being.