This paper articulates a personal nursing philosophy centered on two foundational pillars: patient-centered care and evidence-based practice. The author argues that keeping patients as the primary focus of all clinical decisions represents the profession's cardinal goal. Drawing on Florence Nightingale's environmental theory, the ecocentric perspective in nursing, and Comte's positivism, the paper demonstrates how theoretical frameworks validate the use of empirically proven interventions. The author also reflects on practical experiences — including incorporating shared decision-making and self-care management — that reinforced these philosophical commitments. The paper concludes by tracing a direct relationship between knowledge development, positivist epistemology, and patient-centered nursing practice.
Perhaps the most fundamental tenet of my nursing philosophy is the administration of care in an intrinsically empathetic manner that benefits the patient. I unequivocally believe in patient-centered care, and I hold that nurses who maintain this component of their practice as their primary goal are able to produce the greatest efficacy in serving patients. Moreover, with all of the concerns of the contemporary healthcare market — including financial and technological pressures, practitioner shortages, and innovations in precision medicine — it is easy to forget that the most vital component of the health care industry is the patients themselves. Quite simply, patients have the most to gain and lose from the health care system. Therefore, I firmly believe that keeping patients at the center of the care delivered by me and others within my profession is the best way we can serve that population, fulfilling the cardinal goal of our profession.
It is equally important to acknowledge the impact that evidence-based practices have had on my nursing philosophy. There are several ways in which a solid core of evidence-based practice, rooted in a firm foundation of knowledge validated by positivist theories, is all but necessary to truly effect patient-centered care. By utilizing knowledge gleaned from empirical evidence — which in the most cogent examples pertains to that available from sensory perception — one can clarify which measures are effective for providing patient-centered care. In fact, the evidence-based approach is one of the only verifiable means of improving one's practice in a manner timely enough to assist patients.
Developing entirely new approaches to supplement those advocated in nursing education is too time-consuming. Furthermore, it is extremely impractical to use patients depending on nursing assistance as subjects to test treatments and procedures that may or may not actually benefit them. To this end, the most professional means of introducing innovative techniques to benefit the patient population is to incorporate measures already proven to demonstrate efficacy — such as those found within peer-reviewed journals reporting the results of clinical trials.
The sustained valuation of evidence-based approaches as a means of consistently implementing patient-centered care also provides additional utility that is an integral part of my nursing philosophy. The continual interaction between the individual practitioner and the nursing profession as a whole — largely facilitated by awareness of relevant studies in one's areas of interest and by contributing one's own research to that growing body of knowledge — is a viable means of engaging the practitioner with the broader nursing community. I believe that such community interaction is the nucleus for expanding the body of knowledge pertinent to nursing and, indeed, to any health care profession. Therefore, I make a point to frequently review a variety of peer-reviewed sources to stay current with evidence-based ways to improve my practice, while simultaneously engaging in research to further the knowledge base of nursing in general.
Of the many philosophical underpinnings that have influenced my nursing philosophy, the most salient is the ecocentric perspective of nursing, which has been advocated by numerous thought leaders within the profession. The basis of the ecocentric perspective is to create a synthesis of harmony between humankind — in the form of the patient — and the surrounding environment, which includes society, the world, and the broader universe (Andrist et al., 2006, p. 101).
Other thinkers have also recognized the inherent value of a hospitable environment to patient health. One of the first to articulate this critical connection is Florence Nightingale. Although her environmental theory was largely predicated on basic tenets of sanitation, she alluded to the merit of the overarching impact the surrounding environment has on patients and their ability to restore or maintain wellness (Zborowsky, 2014, p. 19). What is most impactful about Nightingale's conception, in relation to my own philosophy, is her foundational realization that the patient should be the central focus of nursing care — a goal the practitioner should strive toward by creating an ideal balance between the patient and his or her environment.
"Comte's positivism grounds evidence-based nursing knowledge"
"Clinical practice reinforces patient-centered philosophy"
"Positivism, evidence, and patient care form a unified framework"
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