As I stated in my written Reflection that encompasses my experiences of the last three years, I initially turned to CUNY for a nursing degree as an avenue to earn a living, no more, no less.  However, somewhere along the way I fell in love with the entire process of becoming and being a Nurse; college, reading, writing, studying, the exams, the patients, the interaction with doctors and fellow nurses, the hospital setting… everything!  During this journey of discovery, I have developed a deep sense of satisfaction and pride in my accomplishments and at the thought of practicing this honored profession.  Even though I am still a student, the nursing profession has already begun to surpass my expectations of personal reward, transcendent of and far beyond the consideration of monitary remuneration.  Already, Nursing is imparting to me a sense of harmony in my daily living, a much needed aura of balance and a pervasive sense of joy.  The first two years of my formal nursing education has expanded my growing repository of knowledge to include a wide variety of practical skills, sharpened my ability to employ critical thinking, broadened my horizons, opened my eyes to a myriad of professional practice possibilities and ingrained in me a deeper understanding of what it means to be a Registered Nurse.

     Now, entering the senior semester in the nursing program, we as students were called upon to engage in an exercise of introspection, make an honest evaluation of our thoughts, define our aspirations and make a determination about how we would put into practice the knowledge we have gained regarding the profession of Nursing and commit these ideas to paper as we develop our very own Nursing Philosophy Statement.  Admittedly, a daunting task considering that I do not have years of actual practice under my belt.  However, after some serious soul searching, taking into consideration the educational process, the teachings imparted at lecture, the patient contact, the hospital setting, observing licensed Registered Nurses at work, the brief exposure to nursing philosophers and theorists in several books and learning about their teachings, the prospect of working in the real world outside the cloistered atmosphere of academia, I have postulated an immature, unpolished treatise of how I intent to practice nursing; Cultural Sensitivity will be my anchoring cornerstone.

     Before I begin I must comment that in retrospect my original Nursing Philosophy Statement, first formulated after our initial semester of Fundamentals of Nursing, while in its infancy was technically correct in its content but lacking in substance.  However, admitting that the writing was naive and incomplete in both proficiency and execution, it was fundamentally on target.  So, without abandoning the core concepts of which I originally wrote, time, distance, and education combined with clinical experience have enabled me to step back, reevaluate and expound upon the direction for my practice of nursing.  Defined within the context of nursing practice as I understand it, a Nursing Philosophy is a set of mores adopted by a professional practitioner of the art of nursing to guide, rule and ethically direct all decisions and actions perpetrated on patient. 

     My nursing philosophy will be the foundation that constructs my platform for future employment.  Viewing the practice of nursing as a science, while simultaneously incorporating the concept of nursing as art, has enabled me to gain insight into nursing as a profession.  This enlightenment has further prompted me to be introspective [hopefully] in an objective manner, honestly look inside myself, meld both views into one unified vision of nursing and provide to myself a clearly defined map for direction to personally practice an all encompassing holistic approach to the care of patients.  I now understand the rationale behind incorporating the studies of psychology, biology and culture into the nursing curriculum.  Without this strong foundation it would be near impossible to impart comprehensive care.  This melding of science and art has better equipped we students to understand our patients as they traverse the health continuum between wellness and illness.

     Taking into consideration the above thoughts, I am able to formulate a basic Mission Statement that will drive the underlying rationale of my Nursing Philosophy Statement.  Every patient is a unique individual with unique practices, environment, habits, culture, wants, desires and what they consider important at any given point in time.  Keeping these truths in mind, I will employ evidence based interventions, the environment, and the patient’s culture in conjunction with my dedication and caring to return the patient to an optimum state of functioning in order to return that patient to their family, community and society or to offer that patient compassion and dignity when faced with the inevitable prospect of death. 

     My Nursing Philosophy Statement contains many facets, that when viewed collectively, construct a scaffold from which I intend to practice nursing.  First, I must give recognition to an original philosopher, Hippocrates, and adopt [from the medical profession] the tenets of his oath.  The most famous of which states that I will practice the art of nursing “to the best of my judgment and ability and abstain from what ever is deleterious or mischievous” (crip.org).

     Foremost, I must know myself.  Hildegard E. Peplau in her Theory of Interpersonal Relations (Videbeck Pg. 10, 51; A&T pg. 54) stressed that we as nurses should know ourselves, understand our own motives, be aware of our own culture and how these considerations influence our decisions.  Deliberately query yourself: Is what I want what the patient wants? Is what I need what the patient needs?  Is what I choose what the patient would choose?  Is what is important to me, important to the patient?  We must remove ourselves from the equation and set aside our own personal beliefs, wants, desires, health practices and focus on the patient.  If, after asking these questions of myself, I do not know what is important to the patient, there is a simple solution; I will ask.

     At this point in time I have completed four clinical training rotations.  Even at this fledgling stage of my nursing career, having these varied experiences under my belt, I can state that I will incorporate into my personal nursing practice Cultural Sensitivity as a fundamental cornerstone.  The needs of the patient will be the compass that guides my decisions.  Intent observation in the clinical setting has taught me that it is important to proffer respect to all people from all walks of life, respect for every patient’s ethnicity, culture, color, beliefs, religion, diet and health practices at all times.  Cultural Sensitivity will go hand in hand with knowing my self.  I have learned that to understand others is to understand my self.  Imparting Culturally Sensitive care is a Brobdingnagian feat however, I will strive to live up to this challenge.  As Madeleine Leininger postulated, the return to health is as much attributable to the patient’s culture, beliefs and practices as the employment of nursing knowledge.  According to the online resource Nursing Theory:

“In 1995 Leininger defined transcultural nursing as a substantive area of study and practice focused on comparative cultural care (caring) values, beliefs, and practices of individuals or groups of similar or different cultures with the goal of providing culture-specific and universal nursing care practices in promoting health or well-being or to help people to face unfavorable human conditions, illness, or death in culturally meaningful ways (Leininger’s Culture Care Theory).”

Madeleine Leininger’s words resonate and hold a powerful key to successful nursing practice.

     Pursuit and acquisition of knowledge will also contribute to my practice of nursing; education will be a vital aspect in the performance of my job.  It is vital to keep up with current medical practices, information, technology, methods, trends, and the philosophies of nursing theorists to effectively treat illness, patients, families and the community.  These studies will enhance my performance as a nurse.  The pursuit of knowledge is also inextricably intertwined with the ability to be an effective teacher.

     Education [the acquiring of and the dissemination of] is a nursing imperative, an integral aspect of the practice of nursing.  When a patient comes into contact with a medical professional who imparts teachings about a condition, surgery, recovery, signs of infection, complications, that professional may be encountering the patient at an inopportune time when the patient may be too filled with anxiety to absorb the teaching.  It is my responsibility as a nurse to provide comfort, reduce stress, relieve anxiety and then reiterate the teachings provided by the medical doctor, at a time when the patient is more ready to absorb the information provided.  If I do not possess the knowledge relevant to a patient’s condition, it is my duty to first educate myself, and then provide essential teaching to the patient.

     In tandem with HIPPA, I will be a staunch defender of privacy and confidentiality.  Whether it is the physical act of providing privacy by drawing a curtain, closing a door or speaking in hushed tones far from the prying ears of persons who do not “need to know”, or by electronic password protection; I will treat all patient’s equally.  Each patient has the right to be treated with respect, compassion and dignity.  I will do everything in my power to not breach the trust of any patient in my care.

     I will be an effective communicator.  The ability to communicate is essential to imparting accurate, effective nursing care.  The patient has the right to understand what I, as a Nurse am doing on their behalf, what interventions will be performed, what outcome will be expected and what alternative interventions can be employed to achieve a desired outcome.  If I do not speak the patient’s language, I will employ a translator.  Providing communication in the patient’s own language is yet another way of offering of respect.

     Unconditional non-judgmental care will be proffered to every patient irrespective of the patient’s socioeconomic background, ethnicity, culture, beliefs, race, creed, color of their skin, station in life, educational level or religious beliefs.  During my clinical rotations as a student, I had the good fortune to be exposed to patients from all walks of life.  These experiences have ingrained in me a deep appreciation for the importance of imparting non-judgmental care.  Every patient has the right to expect to be treated equally, and receive the same quality of care as the person in the next bed.

     Compassion I will offer freely without regard to compensation or reward.  The delivery of competent nursing care revolves around the nurses’ ability to maintain his or her humanity, without becoming cold or detached.  When we cease to care, we cease to perform our profession effectively.  As nurses, we encounter people at their most vulnerable, when they are sick, worried and stressed.  Compassion offered unconditionally serves to alleviate anxiety, assuage fears and reduce stress and ultimately aids on the road to the patient’s recovery.

     Caring and compassion go hand in hand.  In order to offer a patient compassion, I must maintain my sense of engagement in my profession; I must care for myself, my profession and for my patients.  I will maintain a deep sense of passion for the act of caring for another. Without caring, a nurse risks becoming detached from the very patient’s to whom we are dedicated.  I will always strive to maintain a sense of connectedness, without which the delivery and quality of care will falter and be rendered ineffective.

     I will own the responsibility to advocate for those who cannot speak for themselves.  We meet people at times when they are most vulnerable.  Patient’s may lack the ability to communicate, may be too young to make legal or ethical decisions or may be incapacitated by injury or disease.  Without regard for my wants, desires, beliefs or health practices, I will counsel the patient and/or his or her family or any member of the interdisciplinary team about available treatment options and consequences.

     Finally, when all avenues to attain health have been exhausted, I will proffer to patients dignity; dignity in what remains of life and dignity in dying.