Personal philosophy and core values

nursing has changed from a wholly altruistic effort of caring for others to a profession burdened by a failing health care system. As a sixteen-year veteran of the profession, I have noticed that nurses still retain their optimistic spirit as a whole. Unfortunately, as care costs rise and staffing problems persist we have a harder and harder time maintaining the joyful attitude we once had toward our careers. I have witnessed both the best and the worst possible scenarios in a system that has become more burdened by the day by the burgeoning baby boomer senior population. My experiences fuel me to feel poised to make positive changes to the health care industry, its administration, and nursing methods in general. I have seen what doctors and hospital staff have to do to work around a system that is increasingly built more on profit than on healing. The pharmaceutical and medical products industries as well as the insurance conglomerates influence the type and quality of care given to patients. Moreover, nurses have become more task-oriented than care-oriented, treating patients like products on an assembly line instead of as human beings.

Still, nurses like me who have been in the profession long enough to watch it change are poised to make positive changes that will impact the future of health care. Our values cannot be compromised. We veteran nurses can become involved in hospital administration or in public policy in order to kick-start the much-needed changes in the American health care system. The changes I envision are rooted in my personal nursing philosophy that includes the following three points. First, nursing is a patient-centered caring profession. Second, nurses are obligated to help patients achieve a higher quality of life, which is more important than life extension. Third, nurses can capitalize on the increasingly multicultural environment we find ourselves in by incorporating different values, beliefs, and traditions into our personal practice. Doing so requires listening intently to all patients, learning how to overcome language barriers, and resisting the temptation to impose our own belief systems on others.

Too often I have seen doctors and nurses ignore patient needs because of the intense pressure to rush patients through the system. A system with finite funds must find some means to limit treatment to essential services and streamline costs without sacrificing quality of care. This may be our number one challenge as we face rising costs in health care and a booming population that is living longer. The needs of seniors are becoming more important as older generations are challenging the health care system to respond to not only an increasing number of patients but also to a wider range of health care issues. Nurses are still learning how to deal with mental health as well as physical health issues on a daily basis. New research and new treatment interventions must be mastered rapidly if we are to provide the best quality of care.

Therefore, one of the most important actions nurses can take to minimize the problems associated with rising health care costs and an overtaxed health care system is to improve our education. The nursing education system should be expanded so that we are continually challenged, expected to master emerging technologies and techniques immediately in order to provide the best possible patient care. To meet the changing needs of patients, nurses need to continually refine their practice via accepted avenues of established medical traditions. Yet doing so means burdening the system even more by pressure to offer nurses the means to achieve their professional goals.

The government needs to step in to relieve the burdens placed on health care and educational institutions if it hopes to offer its citizens the promise of a world-class medical system. If the trend toward medical procedures traveling continues, more and more patients will be heading toward developing nations like India that are offering world-class medical services at a fraction of the cost of what those procedures are in the United States. Clearly, our system is failing patients but the system is also failing to change the problems we nurses see every day. One of the ways our system is failing patients is by offering procedures that gloss over the root causes of problems only to offer the cheapest, most immediate form of treatment that is covered by the patient's insurance plan. For example, I have inserted PEG feeding tubes and presided over tracheotomy procedures in cases in which the patients long-term care needs were not addressed. Our ethics are being challenged as we nurses compromise our values and integrity in order to keep our jobs. Even when we ascend through the hospital administration ranks to positions of leadership, we nurses cannot hope to influence the decision-making at the level of local, state, and federal governments. We have started to feel powerless, and I feel it is my duty as a nurse and caregiver to empower myself and others in my profession.

Until our system becomes less profit-oriented and more care-oriented we must work within its parameters to the best of our ability without compromising our core values or our professional ethics. Some of us are starting to refuse performing procedures or administering medications we do not agree with. I fully support the rights of nurses to act on their conscience rather than to accept what we feel are unnecessary or even harmful practices. If our primary goal is to heal patients, then we need to address patient needs before everything else.

To maintain a heart like Florence Nightingale we must assure patients that their needs trump those of the insurance and drug companies. We need to offer more opportunities for patients to improve their quality of life rather than simply extend their lives via expensive and often unnecessary medical procedures or pharmaceutical interventions. Hospitals need to invest more funding into providing higher quality meals for patients: meals that are prepared with fresh ingredients and not as heavily processed as the ones we offer now. I have been dismayed at the lack of response of hospital administration to the demand for more healthful eating choices in hospital cafeterias, where healthful eating is more important than it is in any other institution.

Patient-oriented care also includes avid attention paid to the quality of care at every level of service. From waiting room to bedside service and outpatient care, patients in our system must feel comfortable enough to express their needs and communicate their desires. Moreover, nursing staff need to be more sensitive to the needs of patients from diverse backgrounds. Language and cultural barriers should never become barriers to health care. We can still offer the best quality of care to patients whose cultural backgrounds and languages are different from our own.

Until resource allocation is a reality, we nurses must learn how to navigate through the system as it is now. Although I have become cynical, I still feel motivated to care for others because I have hope. Maintaining hope is the most important thing nurses can do to mitigate the negative trends currently in our health care system. Hope is transmitted to our coworkers every day through our faces: our smiles and our kind words that pierce through the stress lingering in the hospital hallways. Whenever we pull together with teamwork and mutual respect, we do ourselves the biggest possible favor: we do not allow a failing system to fail our patients. We pick up the slack and do whatever we can to ensure that patients receive the best quality of care.