“It is often thought that medicine is the curative process. It is no such thing; medicine is the surgery of functions, as surgery proper is that of limbs and organs. Neither can do anything but remove obstructions; neither can cure; nature alone cures. Surgery removes the bullet out of the limb, which is an obstruction to cure, but nature heals the wound. So it is with medicine; the function of an organ becomes obstructed; medicine so far as we know, assists nature to remove the obstruction, but does nothing more. And what nursing has to do in either case, is to put the patient in the best condition for nature to act upon him.”
– Florence Nightingale, Notes on Nursing: What It Is, and What It Is Not
As I progress through my career as a nurse, my nursing philosophy continues to evolve. I initially came to nursing because I wanted to learn more about health to provide better care for my own health, as well as loved ones. What I have discovered that nursing has provided a journey of career development, as well as personal development. It has opened doors to health and wellness that I never anticipated.
My experience working on a medical-telemetry unit in a hospital provided insight to acute care and chronic illness. Nurses are the front line in hospitals and have the most direct contact with the patient and their experience. I believe nurses should be supported in the many challenges they face working in the hospital environment. In these environments, nursing care is constricted due to demands of scheduling, costs, and resources. It very often does not allow even the best nurses to provide the support to the patients with the increasingly complex, chronic disease. I believe that supporting nurses is the key to providing quality care to patients. If nurses are supported in their own health, stress management, and wellness, they will be able to provide quality care to patients and everyone will benefit. So my nursing philosophy starts first with the wellness and self-care of the nurse.
Nursing is an art and a science. At this time, I believe the advancement of the profession of nursing is evolving and nursing is finally coming into it’s own. However, in this advancement, it is important not loose the key fundamentals that make the role of the nurse unique in the realm of healthcare providers. While nurses have medical knowledge and utilize research, nurses provide patient-centered care that focuses on compassion, therapeutic listening, safety, patient advocacy, critical thinking, and intuition. Nursing is a holistic approach, addressing the patient’s needs on a personal, family, and community level. Nurses provide care and interventions to the patient in light of the whole person. We assess the patient’s needs beyond a diagnosis in order to develop a plan to address these needs in the context of their life. As noted by Florence Nightingale, nurses provide the support necessary to, “put the patient in the best condition for nature to act upon him.”
Nursing also has a role beyond the bedside. As a result of the increase of chronic disease, patients are requiring increasing care outside the hospital to manage their disease to reduce readmissions. Nurses can play a key role to support patients to prevent chronic disease, slow the progress of chronic disease, or decrease admissions to hospitals. If nurses are empowered to practice to the full scope of their profession and supported to provide true nursing care, they have the ability to have a significant impact on the health and well-being of patients. Health coaching is one area that is advancing to address these needs. While there is a spectrum of roles for health coaches, nurses have many skills to support patients to achieve optimal wellness. Nurses as health coaches engage with patients as change agents to provide support for the changes that are often required for optimal health. It is a holistic model that integrates mind-body-spirit approaches with motivational interviewing techniques to transform health for each individual. Again, it is another way in which nurses continue to uphold the concept identified by Florence Nightingale, however, it expands beyond physical healing, to the healing of the whole person.
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