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Personal Philosophy & Reflection on Nursing Paper

Alex Depew

Bon Secours Memorial College of Nursing

NUR 4140

Dr. Marcella Williams

October 30, 2021

Honor Code: “I pledge”

Definition of Nursing

My definition of what it means to be a nurse has changed considerably over the course of this

program. Initially, I was enamored with the scientific aspects of what nurses do, and I remain in

love with those today. However, where my appreciation has grown and shifted is that I have a

significantly deeper passion for the interpersonal, human-focused components of the role.

Providing care based on evidence is critical to promoting the best outcomes for patients and we

have an ethical responsibility to remain on the cutting edge of understanding within the

discipline for as long as we are practicing as nurses. As important, though, is the attitude we

adopt and the way we make people feel while we deliver that care. This is where my philosophy

has developed the most since the start of training. At its heart, nursing seems to me to be the

balancing of those two components so that the entire person can be integrated into healing

modalities. I think often of the Maya Angelou quote “I've learned that people will forget what you

said, people will forget what you did, but people will never forget how you made them feel” and

how truly that applies in nursing. I am struck by how we tend to see people on some of the worst

days of their lives- when they are afraid, sad, lonely, in pain. It would be incredible to be able to

fix all that for every patient, but we all know enough to understand that we often don’t have that

power. The power we do have in nearly every interaction is to humanize the experience of these

difficult realities our patients face and help them feel just a little bit less harsh. In that way, we

may tangibly be the hands and feet of Christ, and what a terrific honor it is. That mindset is what

it seems to me sets apart the Catholic healthcare ministry from secular hospitals and one that is

exciting even to me as an atheist because it looks to provide dignity and comfort to every patient

in a particular way. It is a reminder that we are there truly to serve the sick- it is about more than

a paycheck, it is about more than “just a job”, it is about more than slapping a band-aid on the

problem and hurrying them out the door. We are called to be servant leaders, working to meet

the needs of patients and the community not for profit or personal gain but because we know

deep down in our hearts that it is what is just, right and proper.
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Personal Philosophy

A personal ethic I hold in high regard is treating people equitably. I work hard to be

aware of my own internalized biases and actively strive to learn more about what others

experience so that I am better able to prevent those biases from affecting how I treat the human

being in front of me. This has considerable spill-over into my professional code of ethics.

Certainly, there have been patients who I have had a moral dilemma caring for. In that space, it

has been critical for me to take a moment, step back from my immediate reactions, and

remember that whatever the chasm between me and this person may be, it is immaterial. They

are not asking me to understand their circumstances or condone their actions. They are asking

me to provide them with my highest level of care which is frankly something they have every

right to expect from me. For people to continue receiving important care it is critical that they

trust nurses, doctors and other professionals. One harmful interaction can have ripple effects

within the community when a patient tells the story of how they were treated poorly by a nurse

to a few of their friends. Confidence in the nursing profession erodes incrementally until

eventually people feel inhibited in seeking care, causing unnecessary suffering. 

I also have a strong commitment to advocating for the personal autonomy and agency of

others, both personally and professionally. Coercion should never be employed to force

someone’s hand, even in instances where I may strongly disagree with their decision. An

important role of nurses is as an educator for patients, and it has been my experience that when

provided with the relevant facts patients tend to make the choice that I would have made for

them, but in cases where they don’t I have no right to twist their arm. I am there as a nurse to

help people achieve what it is that they are asking of me, not tell patients what it is that they

must do. In fact, with very few exceptions, the entire healthcare system is in place to give

people the care they are requesting and I am a facilitator of that, not a dictator who directs their

actions.
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Values and Beliefs

A value is a culturally held idea that underpins a society and tends to be more subtle and

broad than a belief. Individuals carry beliefs, which are perceptions of what it is that is true.

While individual beliefs may vary, values are often more cohesive across a culture (Lumonisity) .

For example, while people in this country may have opposing beliefs about the ethical

implications of the death penalty, the societal value we place in the rule of law is much less

individualized and more collective. My values have remained consistent throughout this

program, but my beliefs have undergone a dramatic shift as I assimilate new information and

experiences into my thinking. For example, I still have faith in the societal value that human lives

are sacred. My beliefs about how to honor that sanctity, however, have moved from keeping a

patient alive at all costs to a more complicated way of considering whether the patient would

want to continue living, what their loved ones are ready for, the opportunity cost of providing

care for the patient, their chances of recovery and the probability of regaining a meaningful

quality of life. In the past, I would have had significant qualms about removing an NG tube that

was feeding a terminally ill patient even if it was their express wish, but I now have more

experiences to draw upon that have changed my belief about the morality of such an action.

This seems to me to be exactly the point of belief. When we have new information that adds

nuance to our thinking, our beliefs must change. 

Nurse-Patient Encounter

An interaction I had with a patient that tested my commitment to my personal nursing

ethics took place during my OB rotation. Without going into unnecessary detail, the patient had

chosen to carry to term and give birth to an infant that I would not have chosen to had I been the

one making the decision. Initially, this was confusing for me- how could this patient be so

foolish? Doesn’t she see she’s making a big mistake by bringing this child into the world? I felt

rather frozen for a time, trying to reconcile the reality of what was happening with what to me
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seemed to be the clearly moral decision in this instance. Obviously, these are not thoughts I

shared with the patient, and while I was striving to give her the best care I knew how I could

sense myself second-guessing her choice. In talking with the patient, there was this sudden

moment of catharsis in which I realized in a flash that what I was ethically obligated to do was

put aside my distaste for her choices and take care of someone who needed care in that space.

She was not asking for my opinion on the matter. She was asking for someone to be present

with her, help focus her energy, and give her care during an extremely traumatic moment in her

life. That interaction was pivotal for me in cementing the value my philosophy places on patient

autonomy and equitable treatment for all patients entrusted to my care.

Change Agent

My ability to operate as a change agent has developed in two primary ways through the

development of the NUR4140 practicum experience. Interestingly, the two areas of growth

seem to be diametrically opposed but in reality are more like two sides of the same coin: I have

a new sense for the possibility of effecting widespread changes even when the obstacles seem

considerable, and I have gained appreciation for the fact that a solution does not have to be

grandiose in order to be effective. The idea we came up with to reduce CAUTI numbers is,

prima facie, extremely simple and uncomplicated. However, the obstacle we face is that in order

for our solution to work it will have to be rolled out across the entire Bon Secours Mercy system

simultaneously; because of software compatibility issues, small-scale testing will not be

possible. Previously, such a solution would have seemed to me to be impractical to the point of

absurdity. Who is going to listen to an idea from a not-yet-even-licensed nurse? What

insurmountable bureaucratic hurdles would we face to implementing this plan? However, I

realized at some point along the way that all we can possibly do is try. Even if it seems like we

are facing slim odds of success, we have a higher chance to bring about a change if we present

our ideas than if we fold our arms and decide it could simply never happen. What would have

once seemed impossible now seems at very least worth a try.

Brenner’s Theory

Action Plan
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References

https://courses.lumenlearning.com/alamo-sociology/chapter/values-and-beliefs/