The Philosophy And Concepts Used In My Practice

Abstract

Since perceptions and observations are influenced by how we view the world, my practice of nursing as a profession and a science are influenced by my environment. By utilizing a mixture of theories, I attempt to promote the most extensive practice module relevant to the largest population of clients. Guided by the nursing metaparadigm and influenced by a perceived theory, my practice encompasses a variety of thoughts on nursing. To follow, is a discussion of my practice and the philosophy and concepts I use to perpetuate my profession. Although I relate my personal philosophy to my specific practice, many parts of it will relate to a larger population of nurses and can be used in multiple settings and multiple nursing roles.

The Philosophy and Concepts Used in My Practice

Personal Philosophy and Conceptual Model

It has been my experience that a concrete methodological stance on nursing philosophy is limiting. Empirical knowledge, though useful, is only a small part of nursing. A mixture of theories will promote the most extensive practice module relevant to the largest population of nurses. Hard data, however useful and informative, relates only to the context of human science and human nature it is employed in. I believe in my own practice that Grand theories exist mainly among scholars and researchers, while the Middle Range theories provide a more practical application to everyday practice and management of clients and nursing staff. I work with a very specific population and practice, and outpatient ambulatory surgery center with only four specialties. In my practice, microtheories prevail. Nursing is an art, never an exact science, since no client is alike. It has been my experience that nursing is ninety percent creativity and 10 percent science. My philosophy of nursing is a profession that involves science, art, practical application and caring. Our goals are to care for the well and the sick providing quality of life and helping people to live the best lives they can by maintaining and recovering health while reducing and alleviating symptoms (Thorne et al., 1998). I believe that the perceived view on nursing is the easiest to subscribe to. The nurturing nature of nursing as a practice leads to this philosophy. Again, while empirical knowledge is us useful, it is difficult to put into practice without the knowledge of the perceived view of science.

The conceptual model by which I practice is person, health, environment and nursing (Fawcett, 2000). It is with this nursing metaparadigm that I base my knowledge and experience. Each interacts with the other and without one, taking a holistic approach to nursing is lacking. While I do see the need for this model to expand its horizons, it seems to encompass the whole person, physical and psychological and intellectual. I like this model, but I also use a softer science in my own practice using multiple truths and subjective data.

Major Concepts and Definitions Used in My Practice

My practice at this point in my career targets specific clients, relatively healthy adults and children, with minor disease processes that are often resolved with elective surgical intervention. The major concepts that I use daily in my practice are anxiety, pain, healing and quality of life. In my field, anxiety and pain are both subjective and somewhat difficult to measure. Pain can be defined as pre-operative and post-operative. Pre-operative pain is the discomfort perceived by the client prior to surgical intervention. It can be subjectively measured by a 1-10 pain scale. Along the same lines, post operative pain can also be measured by the pain scale, although due to other post operative factors, i.e. anesthesia, narcotics, the subjective data are often "fuzzy" and skewed.

Anxiety is more difficult to measure and generally behavior driven with some physiological aspects. In an ambulatory surgery center, anxiety is produced by multiple factors; surgical intervention, anesthesia, perceived pain, loss of control or function.

The definition of Healing in the context of an ambulatory surgery center is the physiological event of wound healing post operatively; the body recovering back to a state of wellness and function without complication i.e. infection.

Lastly, Quality of Life for my clients is returning them to a state of wellness that preceded their injury or anomalies or promoting the wellness that they will achieve post operatively. For example, a tonsillectomy and adenoidectomy to eliminate sleep apnea in a child, or repairing a torn meniscus in a client's knee to eliminate pain after an injury.

Relationship of Concepts in My Conceptual Model

The main concepts in my practice are associated primarily by subjective means using associational statements (Reynolds, 1971; Walker & Avant, 2005). Anxiety and pain both have a positive correlation in that an increase in anxiety often leads to increased pain. In the same respect, increased healing will ultimately lead to a higher quality of life. For example, a child arriving for a tonsillectomy and adenoidectomy often is significantly anxious. They exhibit this anxiety by crying, clinging to parents, aggressive or withdrawn behaviors, and often difficulty following directions. This increased level of anxiety pre-operatively carries over to their post operative phase with increased levels of pain and more difficulty controlling pain. They often will wake up crying, combative and unable to gain control of their emotions. This lends itself to a more difficult acute recovery period for the child in that they are unable to efficiently maintain adequate levels of post operative pain control. Along those same lines, an adult with an injury