Concept Synthesis Paper on Personal Nursing Philosophy Ancelle Jackson South University Advanced Theoretical Perspectives for Nursing NSG5002 S09 Dr. Susan Stear Running head: CONCEPT SYNTHESIS PAPER ON PERSONAL NURSING CONCEPT SYNTHESIS PAPER ON PERSONAL NURSING Concept Synthesis Paper on Personal Nursing Philosophy The purpose of this paper is to identify, describe, and apply the concepts that underlie my personal nursing philosophy. I will give a brief overview of my nursing background, identify and describe the four metaparadigms of nursing, provide two other practice specific concepts that apply to my practice, and include a numbered list of five propositions that apply to those concepts. Nursing Autobiography When I was little, I dreamed of becoming a flight attendant, a lawyer, an architect, and a doctor. I never saw myself become a nurse someday. I must admit that my only motivation for pursuing a nursing degree in college was to get to the United States and make good money. But I didn't think that I would someday love the profession I never even imagined doing. It is for this reason that I believe that nursing is a calling. Being a nurse has its bittersweet moments and surely takes a lot of compassion, patience, empathy, and strength. While it's true that the long hour shifts can be physically exhausting, it's witnessing the most devastating situations in life that make this profession very challenging. On the contrary, our ability to heal, save lives, and make a difference in our patients' lives and their families, truly is very rewarding and incomparable to nothing. Being a nurse for almost five years has opened my eyes and changed my views about life and all other things. I first started working on a Telemetry/Neuro floor for about a year and a half before I decided to venture out and ended up working in an extremely busy ER in downtown Jacksonville, FL. I worked there for two years, and though it was a highly stressful environment, I enjoyed almost every minute of it. The ER has the kind of culture that is fast-paced, task-oriented, informative, and team driven. Having passed my certification in emergency nursing (CEN) recently, I can say that my knowledge base, assessment, and critical thinking skills, which I often use to guide me in my clinical decision making, have significantly improved since I became an ER nurse. It has molded me into a strong, hard-working, and competent nurse that I am today. The Four Metaparadigms of Nursing A metaparadigm is referred to as the global concepts and propositions that define a particular discipline and describes their distinction from other professions (Fawcett, 2000, p. 4). It consists of four stipulations: (1) a domain different from other disciplines, (2) all phenomena of interest to the discipline (3) a neutral perspective, and (4) a scope that’s international in nature (Fawcett, 1996, p. 94). In nursing, there are four common interconnected basic concepts that include patient, ...

1. Concept Synthesis Paper on Personal Nursing Philosophy
Ancelle Jackson
South University
Advanced Theoretical Perspectives for Nursing
NSG5002 S09
Dr. Susan Stear
Running head: CONCEPT SYNTHESIS PAPER ON PERSONAL
NURSING
CONCEPT SYNTHESIS PAPER ON PERSONAL NURSING
Concept Synthesis Paper on Personal Nursing Philosophy
The purpose of this paper is to identify, describe, and apply the
concepts that underlie my personal nursing philosophy. I will
give a brief overview of my nursing background, identify and
describe the four metaparadigms of nursing, provide two other
practice specific concepts that apply to my practice, and include
a numbered list of five propositions that apply to those
concepts.
Nursing Autobiography
When I was little, I dreamed of becoming a flight attendant, a
lawyer, an architect, and a doctor. I never saw myself become a
nurse someday. I must admit that my only motivation for

2. pursuing a nursing degree in college was to get to the United
States and make good money. But I didn't think that I would
someday love the profession I never even imagined doing. It is
for this reason that I believe that nursing is a calling. Being a
nurse has its bittersweet moments and surely takes a lot of
compassion, patience, empathy, and strength. While it's true
that the long hour shifts can be physically exhausting, it's
witnessing the most devastating situations in life that make this
profession very challenging. On the contrary, our ability to
heal, save lives, and make a difference in our patients' lives and
their families, truly is very rewarding and incomparable to
nothing. Being a nurse for almost five years has opened my eyes
and changed my views about life and all other things. I first
started working on a Telemetry/Neuro floor for about a year and
a half before I decided to venture out and ended up working in
an extremely busy ER in downtown Jacksonville, FL. I worked
there for two years, and though it was a highly stressful
environment, I enjoyed almost every minute of it. The ER has
the kind of culture that is fast-paced, task-oriented, informative,
and team driven. Having passed my certification in emergency
nursing (CEN) recently, I can say that my knowledge base,
assessment, and critical thinking skills, which I often use to
guide me in my clinical decision making, have significantly
improved since I became an ER nurse. It has molded me into a
strong, hard-working, and competent nurse that I am today.
The Four Metaparadigms of Nursing
A metaparadigm is referred to as the global concepts and
propositions that define a particular discipline and describes
their distinction from other professions (Fawcett, 2000, p. 4). It
consists of four stipulations: (1) a domain different from other
disciplines, (2) all phenomena of interest to the discipline (3) a
neutral perspective, and (4) a scope that’s international in
nature
(Fawcett, 1996, p. 94). In nursing, there are four common
interconnected basic concepts that include patient, nurse,
health, and environment (Peterson, 2016). It is through these

3. concepts that nurses can have a unified description of their job
functions, limitations, purpose, and professional identity (Butts,
2015).
Patient
Patient refers to all individuals, families, communities, and
other members of the society involved in nursing care (Fawcett,
2000, p. 5). It refers to all human beings as recipients and the
primary focus of nursing care. In nursing practice, patients are
viewed holistically as unique entities with biological,
psychological, sociological, and spiritual needs (Masters, 2011).
It is important that all these basic needs are met to achieve
optimal health and well-being.
Nurse
Nurse refers to the discipline that takes care of patients. The
nurse’s role is to assess patient needs and assist patients in
meeting those needs through supportive and therapeutic
interventions (Masters, 2011). Nursing, as defined by the
American Nursing Association (ANA, 2001), is “the protection,
promotion, and optimization of health and abilities, prevention
of illness and injury, alleviation of suffering through the
diagnosis and treatment of human response, and advocacy in the
care of individuals, families, groups, communities, and
populations” (Massachusetts Department of Higher Education,
2010, p. 5).
Health
Health pertains to a patient’s state of well-being and lies
anywhere on a broad spectrum of high-level wellness to
terminal illness (Fawcett, 2000, p. 5). Health is a state of human
wholeness and integration (Roy, 2009). The goal of nursing is
to promote an optimal level of health and wellness and
encourage positive behaviors that will help maintain an overall
equilibrium and stability in patients (Masters, 2011).
Environment
Environment refers to a patient’s physical surroundings and
includes all aspects of local, regional, national, cultural, social,
political, and economic conditions (Fawcett, 2000, p. 5). It

4. involves all internal and external factors, conditions, and
circumstances that influence a patient’s health and behavior
(Masters, 2011). Nurses improve patient health and comfort by
implementing certain changes, whether physical or
psychological, in a patient’s environment.
Practice Specific Concepts
As an ER nurse, the two most important concepts I value and
apply in my nursing practice every day are clinical judgment
and self-care. I believe that patients have a lot to contribute to
the improvement of their health and well-being just as much as
they need competent nurses to take care of them at the time of
their illness or vulnerability. Successful patient outcomes
require mutual, participatory, and collaborative process between
the nurse and the patient .
Clinical judgment, as defined by Hardin (2016), is the clinical
reasoning utilized by a health care provider; and consists of
critical thinking and nursing skills acquired through the
integration of formal and experiential knowledge. (p. 295). It is
an important skill that every nurse needs to possess and
develop. In a fast-paced environment where lives are often at
stake, critical judgment is a must in almost every situation.
Some aspects include prioritization, anticipation, and time
management. Prioritization is always utilized both individually
and systemically. The triage nurse assigns the level of acuity
based on the patient’s appearance, the severity of presenting
symptoms, and the patient's risk factors. The sickest patients are
always given the utmost priority and attention so life-saving
measures may be initiated as soon as possible. In any trauma
patient, prioritization starts with assessing the airway,
breathing, circulation, disability, and environment; followed by
the secondary and tertiary survey. As in any given situation, an
anticipation of the worst case scenario is the key to prompt and
efficient treatment. It is a skill that can be honed over time. It’s
the ability to form preconceived diagnoses based on the
patient’s signs and symptoms and proactively intervening. As
with any adult complaining of chest pain, EKG and serum

5. troponin are the definitive tests to rule out myocardial
infarction and thus, need to be initiated even prior to the
physician’s orders. Mastery of this skill doesn’t only help to
improve patient outcomes but also helps with time management.
In an environment where time is of the essence, organization
and task delegation are imperative for effectively managing
one’s time. As the saying goes, “Work smarter, not harder.”
Excellent time management skills don't only prevent the nurse
from being too overwhelmed. But through a timely disposition
of patients, patient overcrowding in the ER may also be
avoided.
Self-care, according to Shah (2015), refers to practices
performed by mature and maturing individuals to maintain life,
health and well-being (p. 39). It’s based on the belief that
human beings have an acquired ability and need to care for
themselves (Orem, 2001). Self-care doesn’t only mean eating a
healthy diet and maintaining a healthy lifestyle. It also means
compliance with the prescribed treatments and medications,
keeping up with annual physicals and screenings, staying well-
informed, being proactive and taking control. Evidently
speaking, patient outcomes are increased when they can
independently care for themselves. The theory suggests that
“nursing is required in case of inability to perform self-care as a
result of limitations” (Masters, 2011, p. 57) One of our roles as
nurses is health promotion, and the way to achieve this is to
reinforce self-care and independence in our patients. Our job is
to assess for any factors that might be affecting a patient’s
ability to care for him or herself. Some of these factors include
socioeconomic factors, cultural beliefs, health conditions, and
other environmental factors (Orem, 2001). In the ER, we try to
figure out why an alcoholic patient can’t maintain their
sobriety; why a patient with diabetes is noncompliant with his
medications; or why a patient diagnosed with a chronic
condition in the ER doesn’t have a primary care provider or has
never been to a doctor. We, then, consult case manager if
necessary, refer them to other healthcare providers or

6. organizations, provide them with a list of resources, and educate
them. Only through the identification of these barriers can we
guide, direct and provide our patients with the resources they
need to help them get back on their feet (Masters, 2011).
List of Propositions
According to Meleis (2004):
“Human beings have capabilities to provide their own self-care
or care for dependents to meet universal, developmental, and
health deviation self-care requisites.These capabilities are
learned and recalled” (as cited in Masters, 2011, p. 59).
“Therapeutic self-care includes actions of nurses, patients, and
others that regulate self-care capabilities and meet self-care
needs” (as cited in Masters, 2011, p.59).
According to the American Association of Critical Nurses
(AACN, 2006):
“The needs or characteristics of patients and families influence
and drive the characteristics or competencies of nurses” (p. 1).
“Synergy results when the needs and characteristics of a patient,
clinical unit or system are matched with a nurse's competencies”
(p. 1).
According to Hardin (2016):
“The core of nursing is clinical judgment, which is grounded in
the nursing process of assessment, planning, intervention, and
evaluation” (p. 300).
The concepts and propositions I’ve gathered, evidently, are a
combination of AACN’s synergy model and Dorothea Orem’s
self-care model. As mentioned earlier, I strongly believe in the
importance of good clinical judgment in nurses and self-care or
care participation in patients, families, or caregivers. Mature
and maturing human beings are capable of caring for themselves
to meet their basic, developmental, and health needs imperative
for their well-being, quality of life, and survival (Masters,
2011). Even some disabled individuals are capable of self-care.
It is innate for us human beings to be independent. However,
self-care is another thing and it's a trait that needs to be
reinforced even at a very early age. The theory of self-care

7. suggests that nurses play a role in helping patients who are
unable to take care of themselves as a result of limitations
(Masters, 2011). Therapeutic self-care is best achieved when
nurses, patients, and everyone else involved in the patient’s
care, such as family or caregiver, work together to meet the
patient’s self-care needs (Meleis, 2004).
Nursing practice, though a care-driven profession, is also based
on clinical judgment through the integration of critical thinking,
knowledge and experience (Hardin, 2016). Through problem
solving and critical thinking, nurses are able to identify problem
areas and come up with an intervention that would be beneficial
for the patient. It only makes sense that a patient with a very
complicated condition will have very complex needs and in turn
requires a proficient nurse to address and solve those issues
(AACN, 2006). Optimal outcomes are achieved when a nurse's
competency is able to complement a patient's needs (AACN,
2006).
Conclusion
Adaptability is an innate quality in us humans. We adapt to
survive and improve our quality of life but also need the help of
others to adapt. Needless to say, both the nurse and the patient
have significant roles in enforcing effective adaptive measures.
The nurse-patient relationship is a kind of relationship that is
based on coalition and partnership that requires the skills of a
nurse and a patient or family’s cooperation to meet relatively
optimal goals.
As nurses, it is our job to use our best clinical judgment when
caring for our patients. But it is also important that we sincerely
empathize and genuinely care for our patients. After all, trust is
the key to establishing any kind of harmonious relationship.
And through these harmonious relationships, we’re able to make
a huge impact in our patients’ lives. This is what nursing is all
about. And I couldn’t be prouder that this profession has chosen
me to fulfill such an influential and special role in our society.
References

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