Running head: PHILOSOPHY OF NURSING

My Philosophy of Nursing: A Caring Profession

Sharanjit Saini
Athabasca University

PHILOSOPHY OF NURSING

My Philosophy of Nursing: A Caring Profession

In the mid-nineteenth century, Florence Nightingale started building the foundation of
modern nursing (Mattern, 2014), paving the path for a profession that has become the central
element of todays health care system. She proposed that nursing was not just about lay women
caring for sick family members, and gradually her work and writings began to change the image
of nurses from that of a mother (Mattern, 2014, para 1) to a trained professional who cares for
the sick in the wider community. In this paper, I will state my ideas about nursing in seven parts:
1) what nursing is, 2) its goals, 3) how it is an art and a science, 4) key values embedded in my
philosophy of nursing, 5) how this philosophy affects my nursing practice, 6) a discussion of the
code of ethics, and 7) a discussion of Boykin and Schoenhofers Nursing as Caring Theory.
Definition of Nursing
Nursing as compassionate caring is a profession and as seeking scientific knowledge, its
a discipline. It is a unique combination of activities that bridge the gap between services
provided by a physician, a psychologist, and a social worker. Doctors diagnose and prescribe, but
nurses carry out the treatments that heal. While echoes of the disease-focused medical model still
pervade modern medicine (Stamler & Yiu, 2012), nursing has expanded its scope to include
many other aspects that affect health. It has an all-encompassing role in the health care system as
they approach patient problems from various perspectives to find creative solutions. Nurses see
the patient not just as the carrier of a disease but rather as a person with an emotional, social,
intellectual, and spiritual life, all of which are intertwined with the patients disease experience.
Picturing an efficient health care system without nurses is difficult. How ideal is a
prescription for an anti-allergy drug if the patient receives no teaching on what caused the
disease or how its effects could be mitigated in future? Nurses do not simply follow the medical

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approach, instead they encourage activities that can truly improve health: patient teaching, health
promotion, disease prevention, eliminating inequalities, and considering social determinants of
health. Nurses do not use the paternalistic 'you must take this pill' approach; rather, they engage
with patients in a partnership where effective teaching and counseling can occur. This counseling
or health teaching opens doors to authentic interactions with patients, where nurses provide
emotional and social care like a psychologist and a social worker would.
Open and honest discussions with a patient allow nurses to tap into their mental world
and clearly understand the root causes of problems. Nurses' non-judgmental attitude creates an
equal status for the patient where he/she can offer, reject or agree with solutions that will work
best in his/her life. Patients bring their stories and vulnerabilities, while the nurse brings expert
knowledge and compassion to the therapeutic relationship. Through this equal partnership with
the patient, with the goal of improving well being, nurses bridge the gap between the band-aid a
pill for each problem approach to efficient interventions. Thus, through providing care that
addresses physical, mental, social, intellectual, and spiritual aspects of health, nurses perform a
very special role that has elements of medicine, psychology, and social work.
Primary Goal of Nursing
The primary purpose of nursing is to provide compassionate, holistic and ethical care to
any persons who seek medical care. Compassion includes being non-judgmental towards other
human beings, doing everything to see the situation from the perspective of another person, and
engaging in an authentic manner. Nurses provide holistic care which considers various aspects of
health: social determinants of health, assessment in context of the environment, and patient
empowerment. By doing so, nurses address not just the disease or its medical treatment but also
the equally paramount social context that includes family support, other relationships, and living

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conditions, and so on and so forth. Finally, nurses provide ethical care by keeping up with the
latest information technology, engaging in continuous knowledge seeking, and using critical
thinking to find upstream solutions to adversities arising from health determinants. Thus they
engage in personal moral development and incorporate evidence-based research into practice to
remain accountable and ethical in the care they provide.
The profession and discipline of nursing continue to expand. Nurses are no longer
subservient to physicians. Instead, they now practice autonomously using their theoretical
knowledge, practical training, and critical thinking skills. Nurses in the role of nurse practitioners
(NP) and extended class registered nurses (RN) now prescribe medications and provide primary
care autonomously (Mattern, 2014). RNs working in communities provide health teaching, skills
development, and health promotion; strategies that focus on prevention rather than cure. This
holistic approach to care helps nursing fulfill its primary goal of ensuring that all sick persons
receive the necessary care.
Art and Science of Nursing
Nursing uniquely combines the art of compassionate caring with the science of
pathophysiological knowledge of human body. I think that nursing needs elements of both art
and science, as it would be incomplete if either were missing. Donahue (1985) sums up the
debate well: nursing is an ongoing process that needs a scientific knowledge basis, sensitive
persona, and inventive thinking (as cited in Brunt, 2006).
Nursing is like art because it requires creativity, sensitivity, and devotion. Creativity is the
art of using critical thinking to find novel solutions to unique patient problems: good nurses can
sense needs of their patients and respond with creative interventions. Devotion is necessary to
withstand the physically and emotionally tiring nursing work: nursing can involve negative

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feelings like physical exertion or mental burnout, but devotion to the profession helps to
overcome these harmful consequences.
The scientific side of nursing is crucial to ensure safe and ethical patient care: just like
scientists, nurses must keep themselves up-to-date and be knowledgeable of the most effective
evidence-based research. Education, including knowledge of ethical principles and codes of
conduct, helps nurses govern themselves in a safe manner. Nurses draw on personal, empirical
and ethical knowledge to bring the artistry of nursing to life (Boykin and Schoenhofer, 2001, p.
14). They bring the expert knowledge to care-giving situations; this knowledge is transformed
into an artistic moment through their awareness and sensitivity to the uniqueness of each patient
(p. 14). Brunt (2006) calls nursing a fine art (p. 1), something defined as an activity that
requires skill and care to create something beautiful (Merriam-Websters online dictionary, n.d.).
The skill of nursing is the scientific knowledge while the art of nursing is to care. The full nature
of nursing lies in the harmony between these two elements.
Key Values Embedded in My Philosophy of Nursing
According to Dehehy (2001), articulating a philosophy statement requires one to identify,
clarify and prioritize their values. The processes of self-awareness and values clarification can
help with this (Burkhardt et al., 2014). Self-awareness is an ongoing process that requires ones
commitment to knowing the truth about their values (2014), while value clarification requires
one to identify and articulate them (2014). My current philosophy of nursing includes two key
values: doing no harm to others and protecting patients rights.
My first nursing value is to ensure that no unnecessary harm occurs to any patient
through my nursing practice. This value coincides with the ethical principle of non-maleficence
described by Gillon (1994) as the concept of producing net benefit over harm (para 9). To do

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no harm, I seek knowledge by coordinating with coworkers, keeping up-to-date with the best
practices guidelines through continuing education and workplace in-services. In my opinion,
nurses have the ethical responsibility to provide safe care, so they must seek out accurate and
current information to strive for providing the best nursing care possible. Gillon (1994) discussed
that the principle of beneficence (to do good) as inevitably related to non-maleficence, as there is
always a risk of doing harm whenever nurses try to help a patient. This connects to my second
value, that of protecting patients rights, which coincides with the prima facie obligation of
protecting patient autonomy (1994). Advocating for patient autonomy is important because as a
moral agent, every human has the right to self-rule (para 5). If a physician or nurse attempts to
decide what is best for a patient, the fundamental helping relationship breaks down. Each human
is unique and has a story about which the nurse may know nothing. Therefore, ultimately only
the patient can decide what is best for them. As an expert professional, nurses have the duty to
provide information to patients and to advocate for their right to make decisions about their
health.
Nursing Philosophy and Nursing Practice
Values are to behavior as roots are to a tree: how we act in a given situation stems
inevitably from what our core values determine to be the best course of action. In my nursing
practice, my value of compassion helped me while caring for a family with a palliative elderly
woman. The patient was loved deeply by her children and grandchildren, and family members
remained at her bedside around the clock, as they wanted to be there for her when she took her
last breaths. Initially, I felt uncomfortable and conscious of my every move when providing care
to my patient in presence of her family, as the sense of responsibility to preserve her dignity
while being watched by her loved ones was paramount. I was afraid of saying or doing the wrong

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thing. After the first few contacts, however, I began to rely on my compassion to guide my
behavior (verbal and non-verbal) around this family. Compassion made it easier to imagine what
it would be like to be in my patients or her family members shoes. As I interacted more with the
family and explained every step of the nursing care I was performing, all of us came to
understand more of the perspectives of the other. Although I didnt always know what the right
thing to say was, the family still greatly appreciated the care. Later, I realized that sometimes it is
not the words, but our body language that can speak volumes. In vulnerable situations like
palliative care, a gentle touch or silence can be better than any words or actions at all. Our values
continuously develop and change over time with influences from our environment, education,
and other experiences (Burkhardt et al.,2014). I look forward to transitions and improvements
that will occur in my nursing practice as I transition into the RN role. I will continue to rely on
my core values, nursing ethics, and ongoing learning to guide my nursing practice in the future.
Nursing Practice Standards
It is crucial for the profession of nursing to consider multiple viewpoints when making
moral decisions (Burkhardt et al., 2014). Gillon (1986) argued that the nursing profession should
be concerned with ethics because nursing aims to improve patient well-being, and nurses may be
subjected to moral distress in their practice, especially as the field of nursing is increasingly
becoming autonomous. The Code of Ethics for Registered Nurses (Canadian Nurses Association
[CNA], 2008) is based on many different schools of thought, including relational ethics, an
ethic of care, principle-based ethics, feminist ethics, virtue ethics and values (p. 30). The code
outlines seven primary nursing values (hereafter called codes) (CNA, 2008, p. 8) that nurses
must apply in all interactions with all patients. The following is a discussion of how these codes
align with my philosophy of nursing.

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The first code relates to my idea of compassion: it requires nurses to use professional
body language, build honest relationships, minimize harm and violence, create safe
interventions, and use research to guide their practice. The code also requires nurses to protect
patients autonomy by promoting informed consent and reducing power differentials. Implying
that health care is like customer service, and only those services that the patient agrees are
beneficial to him or her should be provided. The code requiring nurses to respect people as
individuals with intrinsic value means the most to me. Nurses do this by respecting boundaries of
professional relationships, protecting privacy and confidentiality, advocating for patient rights,
aiming to relieve suffering, and providing dignified care. The code also addresses what I think is
the primary purpose of nursing: ensuring health care for all. Nurses must uphold justice by
balancing human rights and fairness for both the individual patients and the broader community.
Gillon (1994) states that justice requires equitable allocation of resources, so nurses need to
create solutions that will produce the most good for the greatest number of people. CNA (2008)
states that justice also includes everyday values like avoiding discrimination, deceit, and
promoting openness. The code also requires accountability; nurses must keep themselves fit for
practice, train novice nurses, and engage with coworkers in ethical manner. CNA (2008) extends
the idea of accountability to requiring a declaration of conflicts of conscience and interest. The
value of accountability states that experienced nurses should train newly graduated nurses. All in
all, the four prima facie principles of medical ethics discussed by Gillon (1986) - autonomy,
beneficence, non-maleficence, and justice - are captured by the Code of Ethics.
Theory of Nursing As Caring
The nursing theory that most resonates with my philosophy of nursing is Anne Boykin
and Savina Schoenhofers Theory of Nursing as Caring. Boykin and Schoenhofer (2001) present

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several ideas that resonate with my personal views of nursing. Major themes of this theory
include: all humans are caring people, humans are complete, and caring is a lived experience.
The basic premise in the theory is that all humans are caring and grow throughout their lives in
their capacity of caring. Nurses as carers who enter the patients world with the understanding
that patients are also carers (p.14). This openness and reciprocity of relationships highlights that
humans evolve as they grow and change through their experiences all the time. I completely
agree with the view that nurses must enter the patients worlds as all authentic interactions need
people to openly accept themselves and the others as unique people (p.14). Nursing situations are
shared lived experiences in which person-hood of both the carer and the cared for are enhanced
(p. 13). Another idea of Boykin and Schoenhofer (2001) that I completely agree with is that
nursing is not about correcting an inadequacy or lack in a patient, because humans are already
whole, complete and caring (p. 12). I also believe that humans are ends in themselves and not
means to some end. A sense of interconnectedness between the nurse and the patient enhances
humanness and the ability to experience the beauty of the caring moment (p. 14).
Conclusion
The goal of this paper was to articulate my current philosophy of nursing by stating my
views about what nursing is, my professional values, and my understanding of nursing theory
and ethics. I look forward to further developing and clarifying my nursing values as I transition
into the RN role, as I believe that self-improvement and self-reflection are of paramount
importance to my growth as a health care professional and a fellow human being to my patients.

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References

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