Philosophy of Nursing
Gregory Cahill
Lakeview College of Nursing
N200
December 12, 2011

Philosophy of Nursing
The purpose of this paper is to define nursing, health, environment and patient.  I will also describe how each of these elements fits into my personal nursing philosophy and how this philosophy will affect my nursing practice.
	Although not always defined, everyone conducts themselves by a philosophy or a set of values.  We have been asked to define our philosophy of nursing, which will guide us in our careers, before we are even nurses.  This philosophy is bound to change throughout our schooling and careers as we discover what nursing entails and also as we learn more about ourselves and the world.  The International Council of Nurses (2010) defines nursing as follows: “Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles.”  When you look up a word in a dictionary the definition is usually a word or two but as you can see by this long definition nursing is difficult to define.  In my opinion this is because nursing has evolved over the years and continues to evolve.  Nurses have gone from being the handmaiden of doctors to autonomous professionals, the view of nurses still needs to evolve as the nursing profession has but the perception of nursing is a topic for another paper.  Defining nursing for me would be to state that a nurse promotes health, advocates, and teaches patients while maintaining a caring attitude.  For a broader definition of a nurse I would include the previous statement and add that a nurse assesses the needs of the patient or community and implements strategies to help in the best way possible.  
	Health is a relative term meaning different things to different people.  Some people view health as the absence of disease while others view health as a feeling of wellbeing or healthiness.  What one person considers healthy another might consider unhealthy.  The World Health Organization (2011) defines health as “the state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”  According to this definition I do not know very many healthy people.  I would use the World Health Organization’s definition to define optimal health, as everyone has some stress in their life, or a couple extra pounds they would like to lose that would keep them from a complete well-being.
  The absence of pathology is only a beginning definition of health.  Two people can both be free of disease, illness and impairments but not have the same level of health.  Health not only includes a person’s biological wellbeing but also their mental and spiritual wellbeing.  Health is a sliding scale; on one side is the optimal level of health and on the other is disease, illness or impairment.  On the sliding scale of health you can be healthy without being at an optimal level of health or be unhealthy without having disease, illness or impairments.  The purpose of health is not to live forever but to have the best use of our bodies and minds while we are still alive.  
	Depending on your view point you can take a macro or micro view of someone’s environment.  Environment is the area in which you live, which can include your home, place of work, the community you live in and the circumstance or situation you are in.  My immediate environment is what surrounds me at this very moment but when looking at the universe as a whole the entire Earth could be considered my environment.  Depending on the topic you are dealing with the size of the environment will change.  If you are talking about Egypt’s revolution the environment could include all of Egypt, all of the people of Egypt, the political climate and many other factors.  If you are talking about an epidemic the environment might include a community, state or region of a country.  Other environments include the political environment and the social environment.  Different environments while affect your patients differently and as a nurse you need to know how your patient’s environment is affecting them.
	A patient is someone who receives medical or nursing care.  This can be a single person or a group of people.  As a nurse your patients would be anybody under your care as a professional licensed nurse.  
	 Myra Levine’s conservation model serves as a good model for me to build my nursing philosophy on.  The model focuses on adaptation and wholeness of the patient, which help the patient conserve: physical, structural and social integrity as well as conserve energy.  The four pillars of the conservation model are to help the patient conserve energy by avoiding fatigue, promoting exercise and nutrition; to conserve structural integrity to prevent breakdown and promote healing; conserve personal integrity by giving respect to patients and realizing a patient’s need for selfhood; conserve social integrity by helping the patient to maintain their place in their family or community ("Nursing theories: Myra," 2009).  The nurse helps the patient to achieve optimal health based on these four pillars.  It takes into account not only the physical aspects of health but also the mental and social aspects of health.  This philosophy is a good model to follow for bed side nursing as it is a holistic approach to patient care.  The model has been criticized for not addresses what happens before or after the patient leaves your care.  The healthcare industry is moving to a focus on health and not only treating disease/illness.  To modernize the conservation model it would need to be expanded and adapted to include a focus on health promotion and disease prevention instead of just treating ill patients.  
	Part of nursing philosophy is the process the nurse uses to make decisions.  The nursing process, which was adapted from the scientific method, is assessing, diagnosing, planning, implementing and evaluating (ADPIE).  In between the diagnosing stage and the planning stage the outcome identification stage has more recently been added.  I use the acronym ADPIE because you cannot plan anything without having a goal.   Outcome identification or planning goals is naturally a part or subset of the planning stage.  Ida Jean Orlando helped define the nursing process as a deliberative nursing process that is used to help nurses use prudent judgment.  Orlando originally had 4 of the 5 stages of the nursing process with the diagnosis stage added at a later date ("Nursing theory ida," 2011).  This model gave nurses a way to think through their patient’s problems rationally and deliberately to come up with the best interventions for each individual circumstance.
My personal philosophy of nursing encompasses these definitions of nurse, health, environment, patient and the conservation model.  The medical team including the nurse cannot make anyone healthy; the nurse’s role is to help their patients obtain optimal health by giving the patients the tools to keep themselves healthy.  The nurse assesses the patient and environment to help the patient make the right choices about their health and helps the patient when the patient cannot help themselves.

References
Defintion of nursing. (2010, April 12). Retrieved from http://www.icn.ch/about-icn/icn-definition-of-nursing/ 
Nursing theory ida jean orlando. (2011, February 4). Retrieved from http://nursing-theory.org/nursing-theorists/Ida-Jean-Orlando.php
Nursing theories: Myra levine. (2009). Retrieved from http://nursingtheories.blogspot.com/2009/07/myra-levines-conservation-theory.html 
World Health Organization. (2011). Definition of health. Retrieved from https://apps.who.int/aboutwho/en/definition.html