After seventeen years in the nursing profession I realize each day is a learning experience. As my experiences evolve so do some of my beliefs and values. However, I believe nursing at its core has fundamentals that are unwavering. The essence of nursing: Caring, empathy, honesty, trust, communication, and respect have transcended all theories. What follows will be a discussion of how I was called to nursing and my vision for my future in the nursing profession. I will also discuss my beliefs and values and how they relate to patients, families, and health care providers.
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Choice of Nursing
I was called to nursing. I always had a desire to care for others, to comfort, and to listen. As a child I spent summers with my grandmother who was also a nurse. I would watch her show honor in the way she wore her uniform. Before she left for work she made sure her uniform was clean and pressed. She proudly wore her nursing cap. I was able to visit the patients as she made her rounds. As I observed her care I witnessed the understanding, the compassion, and the commitment of a professional nurse. To my surprise and from my experiences my grandmother planted a seed of a nurse’s integrity, honor and loyalty to the care of others. When I was sixteen years old and in the tenth grade I became pregnant. I dropped out of high school but was determined not to be a statistic. Before my daughter was born I completed my GED and three months after her birth I start taking classes at the community college. I knew I had more to offer. I had always been an active part of the community and had an interest in helping others. The career counselor at the community college suggested that I attend nursing school. My grandmother agreed and informed me of a nursing rule. A nurse cannot leave the profession until she finds another nurse to take her place. Five years, two children and one divorce later I finished nursing school. I truly believe it was a calling or I never would have finished. Nursing continues to call me seventeen years later. It calls me to learn more, to do better, and to encourage others. Nursing has now called me back to further my education and obtain my BSN and MSN in the next phase of my career.
Essence of Nursing
The core of nursing should be more than a career or a means to monetary gain. Nursing at its core is caring, empathy, honesty, trust, communication and respect. I believe the fundamental core of nursing is caring. If you cannot give of yourself to others you are missing the essence of nursing. “In 2003 the ANA stated that an essential feature of professional nursing is the provision of a caring relationship that facilitates health and healing” (as cited in Meyer & Lavin, 2005, para. 1). Another fundamental core of nursing is respect. The nurse must have respect for the patient and their beliefs. Without this basic respect there will remain a lack of trust on the patient’s part to divulge necessary information that can facilitate their recovery. Listening encompasses both verbal and nonverbal communication between the patient and nurse. Developing a relationship based on trust helps foster communication between the patient and nurse. Listening helps identify issues that can hinder the accomplishment of goals that have been set for the patient’s recovery. Jean Watson’s Caring Theory is comprised of ten carative factors that can foster a caring relationship between the patient and the nurse. According to Chantal Cara (A Pragmatic View, Introduction, para. 2) “upholding Watson’s caring theory not only allows the nurse to practice the art of caring, to provide compassion to ease patients’ and families’ suffering, and to promote their healing and dignity but it can also contribute to expand the nurse’s own actualization”.
The politics of nursing can adversely affect the core of nursing. Hospital politics can affect the lives of patients, families, staff, and the community at large. Hospital politics affect intra-departmental relationships and staffing ratios. The quality of the relationships and communication skills can affect the perception of the hospital as a whole. Witnessing negative relationships and poor communication skills may cause the community, patients, families, and other staff to feel nursing is unqualified or uncaring. These perceptions once perpetuated are difficult to change.
Beliefs and Values
I believe patients have the right to decide what happens to their bodies; however, many are still under informed due to lack of education. In Texas, a large number of first generation Mexican immigrants have not been afforded a complete education in their home country. Although educational opportunities are improving census data indicated that Mexican “males got 8.8 years of education in 2010 while females got 8.5 years” (2010 Census data, 2011, para. 1). However, in some indigenous areas of Mexico the education level is as low as 2.5 years (2010 Census data, 2011, para. 4). “To improve informed consent comprehension, federal agencies such as the FDA, Office for Human Research Protection, and National Cancer Institute (NCI) recommend 6th to 8th grade reading level consent forms” (Hochhauser, 2007). There is a disparity in the recommendation of these agencies and the consents they produce for their own clients. Hochhauser stated,” agencies should follow their own advice … but five NCI documents averaged a grade 14 reading level”.
Families share an important role in health promotion and decision making. A patient’s cultural beliefs and values can greatly affect the family’s perception of the health care system and the individual roles family members assume in a time of illness. In the Gypsy culture hospitals are feared and avoided whenever possible. “Most Gypsies will go to a hospital only if they are in serious danger of dying or if they view the situation as a crisis” (Sutherland, 1992, p.278). “For Gypsies, illness is not just the concern of the individual, it is a problem of broader social importance. Families coming together when someone is ill is one of the strongest values in Gypsy culture” (Sutherland, 1992, p.277). Hispanic immigrants may be reluctant to seek medical attention because of their immigrant status. “They may be afraid of the clinical staff and may consider them members of a government agency such as INS” (Poma, 1983, p. 945). Among Hispanics, the support provided by the extended family is very important. In 1986 Reinert stated “important decisions are made by the entire family. Family decisions may supersede decisions made by the health care provider” (as cited in Gordon, 1994, pp. 309-310).
I believe health care providers have become overly specialized and no longer treat patients holistically. The movement toward Advance Practice Nurses as primary health care providers will alleviate this problem and the patient will be treated in a more holistic approach. Many nurses begin their professions as staff nurses in the hospital setting. Following Watson’s carative theory we strive to help the patient meet their physical, emotional, and spiritual needs. “The nurse guided by Watson’s work has responsibility for creating and maintain an environment supporting human caring while recognizing and providing for patients’ primary human requirements” (Chitty & Black, 2007).
As I reviewed my own health I realized I was not a good steward for the nursing profession. I have educated my patients about diet modification and exercise regimens. I have advised them to keep regular doctor appointments and receive annual physicals. I was not following my own advice. I began to account for my nutritional intake and workout every morning before work. I received an annual physical to assess my lab values and discuss with my health care provider a plan of care. I believe as a nurse I should be my best and I am willing to except whatever my best is at forty-one years old.
Vision for the Future
My goal is to complete my BSN by the end of 2013. I am a staff nurse in PACU within the Perioperative Services Department of our hospital. My responsibilities include direct patient care, relief charge, staffing, and conflict resolution. Within two years, I plan to receive certification in my specialty through ASPAN and pursuing my MSN degree. My hospital is growing and the Perioperative Services Department is under expansion and
will double in size and patient capacity over the next three years. In my profession I see potential for growth that will include my future goals.
I love to precept new nurses and students, encourage others, monitor quality indicators, and formulate policies and procedures. Within five years, I would like to have completed my MSN degree as a Clinical Nurse Leader and working in a permanent preceptor position for Perioperative Services.
In ten years I hope to have found my niche in my profession. I would like to be molding the future of nursing even if it is one nurse at a time. I plan on working as a nurse as long as my body allows.
My strengths are my determination, ability to adapt to changing situations easily, love of learning and organizational skills. The support I have received from family and friends has been paramount in allowing me to succeed in my endeavors. The support and encouragement I have received from my peers has heightened my determination to complete my degree.
Stress will be the greatest limiting factor in attaining my goals. Balancing school, work, family, and friends is always a challenge. It will be important for me to prioritize my activities and manage my time wisely over the coming year. I look forward to these challenges as I pursue my BSN degree.
2010 Census data show a significant improvement in Mexican education. (2011). Retrieved November 16, 2012, from http://geo-mexico.com/?p=4048 Cara, C. A pragmatic view of Jean Watson’s caring theory [PDF document]. Retrieved November 15, 2012 from Lecture Notes Online Web site: http://www.humancaring.org/conted/Pragmatic%20View.pdf Chitty, K.K., & Black, B.P. (Eds.). (2007). Chapter 13: Nursing theory: The basis for professional nursing. Professional Nursing: Concepts and Challenges (pp.328-348). Philadelphia: Elsevier. Gordon, S.M. (1994). Hispanic cultural beliefs and folk remedies. Journal of Holistic Nursing. 12(3),
307-322. doi:10.1177/089801019401200308 Hochhauser, M. (2007). Consent forms: No easy read. Applied Clinical Trials, 16(5), 74. Retrieved November 17, 2012 from http://libproxy.uta.edu:5745/ehost/pdfviewer/pdfviewer?sid=dd795158-f393-4eb8-b67b-8a1cc3b595fd%40sessionmgr104&vid=4&hid=121 Meyer, G., & Lavin, M.A. (2005). Vigilance: The essence of nursing. OJIN: The Online Journal of Issues in Nursing, 10(1). doi:10.3912/OJIN.Vol10No03PPT01 Poma, P.A. (1983). Hispanic cultural influences on medical practice. Journal of The National Medical Association. 75(10), 941-946. Retrieved November 17, 2012 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2561612/pdf/jnma00233-0029.pdf Sutherland, A. (1992, Sept.) Cross-cultural medicine: Gypsies and health care. The Western Journal of Medicine. 157(3), 276-280. Retrieved November 17, 2012 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1011276/pdf/westjmed00085-0066.pdf