This paper presents a personal nursing philosophy developed through nearly 15 years of gerontological nursing practice. Grounded in the four nursing metaparadigms — person, practitioner, health, and environment — the philosophy integrates family-centered care, developmental care, and social justice to guide holistic practice. The author emphasizes that optimal patient outcomes are not always restored health; for aging and terminally ill patients, a dignified death may be the highest standard of care. Drawing on Reed's (2012) definition of nursing philosophy and incorporating spirituality alongside scientific knowledge, the paper articulates core propositions including ethical practice, perpetual learning, trans-cultural competence, and meaningful patient relationships.
I have dreamt of being a nurse all my life. My mother and older cousins tell stories of how I loved to line up my dolls and stuffed animals, place bandages over them to nurse their "injuries," and stick branches in their armpits to check their temperature. I believe these stories, because to this day, those same impulses keep my life going — I derive deep satisfaction from being able to help people when they are in no position to help themselves. I took an elective nursing course in high school, where I was required to report to the local facility at least once every week to assist in administering basic care to patients. That experience marked the beginning of my nursing career, and since then I have logged nearly 15 years in multiple areas of care, including work as a critical care nurse, medical assistant, nurse practitioner, lab technician, and X-ray technician. I became a board-certified gerontological nurse in 1992, and currently hold two bachelor's degrees — a BSN in Nursing and a BS in Psychology — as well as a Master of Science in Nursing from a Gerontological Nursing Program.
For years, I observed how healthcare professionals overlooked the spirituality of patients and the possible role it played in their health. I felt a strong need to serve my patients more fully by offering all-rounded care that addresses both their physical and spiritual needs. For this reason, I pursued a second master's degree in Pastoral and Spiritual Care. This, combined with my experience and academic background in nursing, provided a solid foundation for the kind of patient care I consider holistic and effective. To me, wholeness and healing are matters of the spirit just as they are of the mind and the body, and it is this conviction that has guided my practice over the years and continues to drive my passion in the day-to-day operation of my own facility, where I now serve as a full-time gerontologist and manager.
Reed (2012) defines a nursing philosophy as "a statement of foundational and universal assumptions, beliefs, and principles about the nature of knowledge and truth and about the nature of the entities presented in the metaparadigm" (p. 41). My personal nursing philosophy is grounded in the four metaparadigms of nursing — the person, the practitioner, health, and the environment — and incorporates the concepts of social justice, developmental care, and family-centered care. It is based on my own beliefs, values, reflections, and personal nursing practice, and captures nursing both as an art and as a science, expressing my personal understanding of what nursing is and what it ought to entail.
Most nurses structure their theories and personal philosophies to emphasize the delivery of quality care aimed at improving patients' overall health status. From my experience as a gerontological nurse, however, I have come to believe that the best outcome for a patient may not always be an improved health status. At times, a dignified death is the best health outcome a practitioner can offer. This is the position I take in my nursing philosophy, and for this reason I base my practice on conveying nursing science with compassion, so that my patients may have a dignified end-of-life experience that aligns consistently with their values and priorities (Volker & Limerick, 2007). The sections that follow show how this position shapes my personal practice, how it aligns with nursing theory and concepts, and how it contributes to existing nursing knowledge.
The four nursing metaparadigms — the patient, the practitioner, health, and the environment — are the central concepts of nursing practice and form the basis for the development of both nursing knowledge and nursing philosophy. The four interrelate and interact with one another and must be considered concurrently when developing a nursing philosophy (Reed, 2012). They are also integral to nursing knowledge, which Reed and Lawrence (2008) regard as "useful and significant to nurses and patients in understanding and facilitating human health processes" (p. 432). This explains why all four are fundamental to my nursing philosophy and my personal understanding of nursing.
"Holistic view of patient, wellness, and social context"
"Nurse's role, family-centered and developmental care"
"Five guiding principles underlying the nursing philosophy"
Practicing nurses have a responsibility to develop a nursing philosophy that frames the values and beliefs guiding their professional practice. A personal philosophy articulates the individual practitioner's understanding of nursing and what it entails. My personal nursing philosophy is grounded in the four metaparadigms of nursing — the person, the practitioner, health, and the environment. It embraces the concepts of family-centered and developmental care and focuses on maximizing the health outcomes of the population, not just those of the individual. Central to my philosophy is the conviction that compassionate, holistic, and spiritually informed care — including the facilitation of a dignified death — represents the highest standard of nursing practice in gerontological care.
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