Personal Philosophy of Nursing Philosophy Research Proposal

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Stressors in the environment encompass the health condition necessitating the dialysis but also the stressors of the procedure itself, which can be profoundly disruptive to the patient's sense of dignity and control (Hagopian, 2009, Slide 51). Responding to and adapting to the environment might encompass improving the comfort level of the patient, distracting the patient with positive talk, providing emotional counsel, and noting alternations in the patient's overall state of mental or physical wellness that might require additional treatment.

Health

Health may be defined by the patient's state of relative physical, emotional, and sociological well-being (Hagopian, 2009, Slide 7). Questions that might arise when assessing the patient's health are: How functional is the patient? How positive is his or her mindset? What sort of social and financial resources does he or she have to improve his or her treatment? All of these factors affect one another. For example, someone without adequate health insurance may have a less positive attitude about his or her treatment than someone with the same medical condition. Patients may have different definitions of what constitutes a 'quality' life that will affect their response to and desire for treatment. A nurse must respond to these different health indicators in a holistic fashion. Additionally, familial perceptions of the patient's health will have an impact upon the patient. Health is individualized and culturally bound ideal as well as a medical concept. A former athlete might experience a more profound loss of identity and self upon being ill than someone who is sedentary and different cultures may have different concepts of when an elderly individual should relinquish some of the decision-making about their treatment at the end of life.

Nursing as a scientific discipline

A nurse is the ultimate 'first responder.' A nurse must observe the patient empirically and humanely, and different situations will call forth different aspects of nursing.

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The nurse must adapt, and help the patient adapt, to changes in the patient's environment, treatment, and help. This adaptation will be affected by the patient's past history, identity, and the patient's social environment of family and friends

Responsiveness in my own practice

As a dialysis nurse, I must constantly be aware of every element of my surroundings. A sudden drop in blood pressure on part of a patient requires an immediate response -- yet the discomfort of a first-time patient also requires an immediate response of an emotional, as opposed to a medical, nature. Responsiveness is also demanded of a nurse in terms of the patient's response to dialysis treatment -- a new patient may want everything carefully explained, so he or she knows what is going on, a more experienced patient may want the nurse to provide a distraction in the form of conversation. Also, the family dynamic may be such that the family is automatically integrated into the patient's decision-making and care, while other patients may need more distance and dignity in the context of the process.

Conclusion: Strengths and limitations

My theory is heavily influenced by one of the most inspiring and practical nursing theorists: Betty Neuman, who stresses the need to strive for a state of homeostasis on the part of the patient, in the context of his or her environment. Although my theory is flexible, which may be seen as a weakness, it is also resilient in the face of the diversity of needs and situations with which modern nurses must cope. Finally, although it is responsive, it is not merely reactive -- part of responsiveness is knowing when to be firm in the face of a patient's reluctance, shyness, or noncompliance.

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