My philosophy of nursing is centered on the needs of the patients; both physical and emotional. Patient’s needs are not just limited to their primary illness; but their needs include the whole person and their family. A nurse must have the ability to adapt to each patient’s situation and realize that although the core values of the care provided is theoretically the same; each patient requires an individualized plan of care. In my practice, I try to develop a good relationship with each of my patients.
In the operating room instilling a level of comfort that encourages them to voice their concerns about their care, upcoming procedure, and possible outcomes is vital to the patient’s wellbeing. Florence Nightingale’s theory involving the environment of care is the primary focus of my day to day nursing; however, Hildegard Peplau’s theory of the many roles a nurse must play when caring for a patient is paramount if I am to provide the best possible care to the surgical patient (Blais & Hayes, 2011). Healthcare and nursing were foreign to me when I entered nursing school. I was sure of two things when I started the program.
Feeling a sense of accomplishment at the end of the day was very important and I loved caring for others. As I continued my journey through nursing school and into the workforce I developed my own philosophy about nursing. In the operating room the controlled environment and the technical aspects of patient care are very important. If any one area is compromised, the outcome for the surgical patient could be poor. Florence Nightingale believed the environment of care affected the patient’s wellbeing and if one aspect was missing poor health or illness would occur (Blais & Hayes, 2011).
Florence Nightingale defined nursing a hundred years ago as “utilizing the environment of a patient to assist in recovery” (Blais & Hayes, 2011, p. 100). Nightingale believed that there PHILOSOPHY OF NURSING 3 were five environmental factors linked to a person’s health; pure fresh air, pure water, efficient drainage, cleanliness, and direct sunlight. If any of these five factors were lacking poor health and illness was sure to occur (Blais & Hayes, 2011). She refused the theories of contagions or germ infections.
She believed that diseases would develop on their own from lack of air, poor lighting, or an improper diet. Patient care came before anything and anything that interfered with that should be cast aside. Because of her concern for the welfare of her patients, she preferred her theory above the theory of “infections” (Benedict, 2012, p. 2). Nightingale also emphasized the importance of keeping patient’s warm (Blais & Hayes, 2011). It is the standard of care today for patients to be actively warmed during surgery from fluids or air convection.
Studies have shown these patients have shorter hospital stays and fewer postop complications, such as infections and postop pain. Nutrition was also another focus of Nightingale’s theory (Blais & Hayes, 2011). She taught others to make sure the sick patients ate well and in a timely manner. She believed wellness and healing was promoted by a healthy diet, “The role of proteins in the onset and progression of disease is important because of their enzymatic, transport, and recognition-receptor functions in cellular physiology” (McCance, Heuther, Brasher, & Rote, 2010, p. 12).
Hildegard Peplau was psychiatric nurse who in the midst of nursing theories relating to individual care delved into a theory encompassing “the client unit” (Forchuk & Dorsay, 1995, p. 2). Patient’s undergoing surgical procedures have many concerns and questions. The same is true for their families. The nurse must be able to establish a relationship with each patient which encourages freedom to ask questions without feeling “dumb”. Patient interviews must also be directed with broad open question to allow the patient to express their anxieties and fears (Forchuk & Dorsay, 1995).
PHILOSOPHY OF NURSING 4 Peplau also believed the nurse would have varying roles throughout the course of the patient’s care. “During the nurse client relationship, nurses assume many roles: stranger, teacher, resource person, surrogate leader, and counselor” (Blais & Hayes, 2011, p. 100). This theory is practiced more often in the mental health settings; however it is fitting for all aspects of nursing. Preoperatively nurses are the patient’s teachers and counselors, helping them to understand their upcoming procedures and cope with anxieties.
Intraoperatively the nurse is the resource person and leader, providing the needs and protecting the compromised patient. In the postoperative phase, the nurse is a resource person and a teacher for the patient and his or her at home caregiver or family member. In conclusion, Florence Nightingale and Hildegard Peplau both have relevant theories applicable to the modern nurse. As a surgical nurse I share the philosophy of Florence Nightingale, because of her rigorous belief in the affect the environment of care has on a patient’s health.
Peplau’s philosophy to develop relationships with the patient and the family is also part of my fundamental beliefs when providing patient care. As a nurse and most especially a surgical nurse I am all things to the patient and their family throughout the course of their surgical procedure. PHILOSOPHY OF NURSING 5 References Benedict, E. (2012). The Constant Flame… from the archives, three articles that explore the life and legend of Florence Nightingale. Canadian Nurse, 108(5), 18-20. Hayes, K. K. , & Blias, J. S. (2011). Professional Nursing Practice: Concepts and Perspectives (6th ed. ).
In K. K. Hayes, Professional Nursing Practice: Concepts and Perspectives (6th ed. ). Upper Saddle River, NJ: Pearson. Forchuk, C. , & Dorsay, J. (1995). Hildegard Peplau meets family systems nursing: innovation in theory-based practice. Journal of Advanced Nursing, 21(1), 110-115. doi:10. 1046/j. 13652648. 1995. 21010110. x McCance, K. L. , Huether, S. E. , Brasher, V. L. , & Rote, N. S. (2010). Proteins. In H. S. McCance Kathryn, Pathophysiology: the Biologic Basis for Disease in Adults and Children, 6th ed. (p. 12). Maryland Heights, Missouri: Mosby Elsevier.