The Tully Philosophy of Nursing

      My approach to nursing is continuously evolving, shaped through the integration of existing philosophical tenants and new experiences. The basic principles of two long-standing nursing theories, Hildegard Peplau’s Theory of Interpersonal Relations and Jean Watson’s Theory of Human Caring, provide the foundation upon which my approach is built (Hagerty et al., 20; Slade & Hoh, 2020). New personal, clinical, and educational experiences have been added to this foundation to develop my own personal nursing philosophy. My nursing philosophy is straightforward and provides a framework that guides the way in which I deliver care to patients and their families; In order to restore and optimize health, nurses must cultivate a caring and meaningful relationship that considers the uniqueness of the patient.

Philosophy Influences

      My nursing philosophy is largely influenced by two well-regarded theories, Peplau’s Theory of Interpersonal Relations and Jean Watson’s Theory of Human Caring (Hagerty et al., 2017; Slade & Hoh, 2020). The Theory of Interpersonal Relations requires the nurse to cultivate a therapeutic relationship as they navigate a three-phase process to restore the patient’s health (Hagerty et al., 2017).  The process includes the orientation, working, and termination phases (Hagerty et al., 2017).  I identify with Peplau’s theory because the orientation phase charges the nurse to respect the individuality and uniqueness of the patient. I am a firm believer that we all have different needs, and healthcare must be flexible to meet the individual needs of each patient, in order to reach the goal of optimizing health. 

      Another longstanding nursing theory that has served as a great influence on my nursing philosophy is Jean Watson’s Theory of Human Caring (Slade & Hoh, 2020).  This theory incorporates three major concepts that employ a caring mentality, engages patients on a physical and spiritual level, and helps them find meaning in their health that is long-lasting and impactful (Slade & Hoh, 2020). Watson’s theory has been influential to the way I practice as it has inspired me to use my caring demeanor to form more meaningful connections with my patients. As long as I am working in the healthcare profession, utilizing a caring attitude to develop meaningful relationship will always be central thesis of my nursing philosophy.

Conceptualization of Nursing

      The nursing paradigm consists of four domains that serve as a framework for the profession.  These domains include the human being, health, nursing, and the environment.  The nursing domain relates to all of the care, activities, and interventions rendered in an attempt to restore the patient back to health (Hopper, 2018).   The human being refers to the person, their family, or members of a community that are seeking and receiving treatment (Hopper, 2018). The health domain refers to treating patients physically, emotionally, and spiritually (Hopper, 2018). The environmental domain includes any aspect that contributes to health, including location, culture, financial security, and access to care (Hopper, 2018).  Nurses should aim to treat health holistically, ensuring that all four domains are in balance, as overlooking any domain can throw the paradigm out of balance and serve as a barrier to maximizing health.

      I have been treating a patient that survived being intubated due to complications of COVID-19 and recently noticed that being away from his family was impacting him emotionally.  This was causing issues in the human domain and throwing the nursing paradigm off-kilter.  After several deep conversations, I was able form a more meaningful connection with him to help restore his emotional health, and he has been working harder than ever to get stronger to make it home to his family.  By using a caring attitude and forging a more meaningful connection, I was able to address this patient’s unique physical and emotional needs.  Bringing balance to his physical and emotional domains allowed me to center the nursing paradigm and get him back on track to maximizing his health.

Evolution of Philosophy

      At the beginning of the program, my nursing philosophy was to report to work each day to provide the same care to my patients that I would expect for myself or my loved ones.  Since that time, I have expanded upon that philosophy to specifically incorporate employing a caring demeanor and celebrating the uniqueness of each individual.  I still practice with the intention of providing care equal to that of which I would expect for myself or loved ones.  The biggest lesson I have learned from this program is how to use therapeutic communication to forge more meaningful relationships with my patients.  Forging meaningful relationships has allowed me to gather more information about the patient, giving me a more detailed view of the individual and their unique needs. In return, I have been better suited to apply the appropriate interventions to meet the specific needs of the individual.

Conclusion

      My personal nursing philosophy, influenced by Peplau’s Theory of Interpersonal Relations and Watson’s Theory of Caring, serves as the basic foundation of the care that I provide (Hagerty et al., 2017; Slade & Hoh, 2020).  By putting this philosophy into action, I ensure that all four domains of the nursing paradigm are in balance, allowing me to maximize the health of the patients I encounter.  As a newer nurse, I understand that this philosophy is fluid and that new experiences will shape the way I see the profession.  I believe that new components will be added but that the foundation of my philosophy, to employ a caring attitude and develop a deep connection that celebrates the uniqueness of the patient, will always be a cornerstone of the care I provide. In the future, I hope to obtain a leadership position to help spread my nursing philosophy and be a change agent for the profession.

References

Deepika, Rani, S., & Rahman, J. (2020). Patient and Family Centered Care: Practices in Pediatrics. International Journal of Nursing Education, 12(4), 43–47.

Hopper, A. (2018). Connection of Advocacy and the Metaparadigm of Nursing. ISNA Bulletin, 44(4), 3.

Hagerty, T. A., Samuels, W., Norcini-Pala, A., & Gigliotti, E. (2017). Peplau's Theory of Interpersonal Relations: An Alternate Factor Structure for Patient Experience Data?. Nursing science quarterly, 30(2), 160–167. https://doi.org/10.1177/0894318417693286Links to an external site.

Slade, J. D., & Hoh, N. Z. (2020). Employing Watson’s Theory of Human Caring With People Experiencing Loss and Grief. International Journal for Human Caring, 24(1), 4–11. https://doi-org.liblink.uncw.edu/10.20467/1091-5710.24.1.4Links to an external site.