What is a Nursing Philosophy?

Defining your Nursing Philosophy?

Nursing philosophy is a set of values, assumptions, and beliefs that provide the foundation for nursing practice. In addition to providing an anchor of consistency from which nurses can exercise their professional judgment, it also provides guidelines by which nurse leaders may shape the profession’s identity.

In a recent survey of member organizations representing more than 2 million nurses in the United States, a number of guiding principles emerged. Nurses were generally in agreement that their profession should

• Uphold the worth and dignity of every person;

• Promote health care quality and cost-effective outcomes;

• Use good science to improve nursing practice and patient care;

• Advocate for and support nurses and their ability to provide high-quality, patient-centered care;

• Promote education and research;

• Uphold the integrity of the profession;

• Enhance economic viability for nurses and all health care providers. (1)

While such principles may be easily identified as guiding the profession, they are only as valuable as nurses’ ability to integrate them into daily decision-making and actions.

What do you think a philosophy of nursing is?

What are the key components, concepts, themes, etc.?

How would an individual know whether he/she had it?

How might this affect practice? Why?

What do you think a philosophy of nursing is?

Nursing philosophy explained

A philosophy of nursing is “a set of values, assumptions, and beliefs that provide the foundation for nursing practice.” (2) It provides nurses with an anchor to consistency from which they can exercise their professional judgment. (3) The American Association of Colleges of Nursing notes that it also provides guidelines by which nurse leaders may shape the profession’s identity. (4)

What are the key components, concepts, themes, etc.?

The National League for Nursing has developed a document of standards and core elements that address five major areas:

1. The Practice Environment,

2. Person-Centered Care and Nursing Practice,

3. Professional Nursing Organization and Role Management,

4. Health Policy and Regulation,

5. Education and Research

These categories provide a framework from which to develop a philosophy of nursing. (5) Each contains elements that can be used individually or in combination to develop a unique philosophy for any given individual nurse leader, organization, clinical practice area, or a variety of practice settings.

Key concepts include:

– The worth and dignity of every person;

– Promotion of health care quality and cost-effective outcomes;

– Use good science to improve nursing practice and patient care;

– Advocacy for and support for nurses in providing high quality, patient-centered care;

– Promotion of education and research; and,

– Uphold the integrity of the profession. (1)

How might this affect practice? Why?

A nurse’s practice is influenced by his/her philosophy regarding such things as caring for people with certain diagnoses, responding to patient requests for the medication(s), laboring women, etc. A nurse’s philosophy may be formed by personal experience, education, the type of organization in which s/he works, colleagues’ beliefs about patients and practice, etc. Nursing is an art as well as a science. Nurses are highly educated professionals who work to promote quality patient care within the context of caring for individual patients. Nurses accept responsibility for providing safe, competent nursing care that is based on knowledge and skills, ongoing assessment of patient responses to interventions, critical thinking, healing relationships with patients and families, collaboration with members of the interdisciplinary health care team, participation in ensuring quality health care delivery systems within organizations and communities.

Primum non nocere – first, do no harm;

non-maleficence – always acting in the best interest of the patient at all times; and,

beneficence – doing good. (6)

The concept of “doing good” for patients is considered by some to be the central unifying idea within nursing. (7)

The American Nurses Association developed the ANA Code of Ethics for Nurses with Interpretive Statements. It outlines seven key ethical domains: (8)

1. Promoting Health, 2. Managing Care, 3. Working with and Communicating with People, 4. Resolving Conflict, 5. Protecting and Advocating for Persons, 6. Stewardship, and 7. Enacting Professional Values.

Importance of a Nursing Philosophy

What are the benefits and/or detriments of having a philosophy of nursing?

Benefits: A philosophy of nursing provides consistency and helps to avoid inconsistencies in practice across settings, health care systems, and patient populations. It is flexible enough to address individual needs. It can serve as an effective tool for continuous quality improvement as it promotes collaborative leadership and decision-making.

Detriments: It takes a significant amount of time to develop a philosophy that is unique to an individual or organization. Developing a philosophy can become too focused on what to do rather than how, which may have the unintended consequence of creating an artificial division between settings in practice, e.g., a patient in a hospital may not be afforded the same level of care as a patient in a skilled nursing facility, even if their needs are relatively similar.

How should nursing philosophy be communicated to others? Who do you think should receive this information? What would provide the most benefit to them?

Nursing leaders should effectively communicate their nursing philosophy to others. This helps others understand the rationale behind practice decisions, which in turn encourages trust and respect between leaders and providers/employees. If an organization’s philosophy is not clearly stated or known among staff members, some may feel that they are being treated inconsistently across teams or patient populations, creating an environment where some patients do not receive the same level of care as others.

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