My nursing philosophy is based off on the Buddhist core values, believes, and wisdom. I was born and raised as a Buddhist follower. I believe Buddha is one of the most exceptional compassionate human beings on the earth that has ever left such a positive impact on millions of lives individual life. Instead of having complicated philosophy, as the Buddha mentioned in his teaching, “Each morning we are born again, what we do today is what matters the most.” The Buddhist leader, Dalai Lama, also said, “Our mind and body are like temples, and positive use of it could be as a medication for someone else to reduce their pain, suffering, and sickness.”
I admire their wisdom and unconditional love towards all living Since I realized the difference one could make in an individual life with kindness and care; it became my nursing philosophy too, while scientific knowledge my perspective on health, sickness, disease process, death, and dying has changed. I admire their wisdom and unconditional love towards all living beings. I believe, as a nurse, I might not have the ability to cure the disease; it would take its own time, but I am there to ease their recovery.
My nursing philosophy reminds me of what I should be doing for that day, that would make someone smile, make him or her feel special, and cared for with a compassionate heart. As a nurse, I believe it is so important to acknowledge and each person as an individual. Educate them on their disease process by information as best of my knowledge. My goal is to treat each person with respect and kindness regardless of their religious background, physical, psychological, social, and financial situations.
According to Hood, “A personal nursing philosophy an individualized perspective for nursing practice, research, and scholarship; philosophy combines the way of doing with the way of being.” (Hood, 2014, pg. 64).
I graduated with a proficiency level in nursing in Nepal in 1998. I worked as a staff nurse in one of the best University Teaching Hospital for two years. Then I moved to the USA. I studied nursing and graduated with an associate degree from the Borough of Manhattan Community College in Dec 2006. After three months of graduation, I took my NELEX test, and I received my Registered Nurse licensure. I did not realize the importance of a bachelor’s in nursing degree; I worked as a home health RN for many years. Just after two weeks of hands-on training, it was challenging to work independently with a complete ventilator-dependent patient. I had to learn how to use the LTV ventilator (a type of portable ventilator). Pt was completely bedridden, I learned ways to prevent from getting bedsores and care for PEG, and tracheostomy using aseptic techniques. I had to make sure enough oxygen supply, feeding, and medications are delivered at home on time. I also had to learn how to coordinate with Doctor’s clinic, social worker, case manager, and vising home nursing serves to provide updates on patient conditions.
Under my care patient was free from pressure ulcers, no unpleasant incidents occurred. The patient family was so happy with the care I rendered. I learned in and out of the home care process. I am so proud of myself; I learned not just taking care of documenting provided cares, coordinate interdisciplinary team members but, also developing an interpersonal relationship while being professional with a family. I encouraged the family to involve inpatient care as much as they could. It enhanced the bonding relationship between family members. Soon, I became part of their family. After working for three years, I realized that I was feeling stock, not learning anything new, so I decided to look for another job.
Then, I worked for a nursing home next to my home. I took care of 40 residents. There were two registered nurses on the floor for 40 residents. One would take charge and the other as a medication nurse. I was charge most of the nurses taking care of all the outpatient clinic follow up appointments, dialysis schedules, physical therapy, and recreational schedules of those residents. As a charge nurse, I also had to assess wound, document, and provide suggestions for further evaluation and request for treatment orders from assigned doctors. Soon, I realized that it was no different from home care; it was just lots of residents to care for in a limited time period. I felt so guilty and inadequate from not being able to educate on their daily prognosis, treatments, and care modalities as much as I wanted to. Despite shorts staffing, lack of resources, and limited time, I would provide the best possible care I could to the residents, but most of my time would take on charting and filing of those papers. I became very good at time management. Every morning, I was thrilled to work with enthusiasm, but at the end of the day, I felt losing the sense of my nursing philosophy because, as a charge nurse, my daily duty was to document and file the medical records. So, within a year of working, I was feeling fulfilled and dissatisfied with my role as a nurse from not being able to develop individualized interpersonal human to human relationships.
Then I resigned from the position, and I started to work in Lutheran Hospital; I chose to work on a cardiac floor as a telemetry nurse. Most of the patients admitted there were due to chest pain, dizziness, passed out, or fell due to their heart conditions. I would hook each patient on a heart monitor, then I would monitor heart rhythm and rate very carefully, and if any changes occur or patient develops chest pain, I would assess patient and notify the provider and start treatment according to the order, such as performing 12 EKG, sending cardiac enzymes every 6 hour and giving heart medications as prescribed. Every morning, and evening we had a team rounding where we would assess each patient and discuss each diagnosis, disease process, treatment options and modalities, and future prognosis. Then we would set the goal for the day and plan individualized care, implement nursing interventions to achieve the goal for the day by involving family members and all the interdisciplinary team members such as a physical therapist, pharmacist, social worker, case manager, and spiritual service. In the evening rounding, we would then reevaluate our goal. If the goal met, we would continue the care, and if not, we would reset the goal with new care plans and intervention. Working on the telemetry floor, I learned an evident understanding of our vital organ, heart.
After working five years in the cardiac unit, I received training for cardiac catheterization recovery nurse. I would receive two patients every day to recover after their diagnostic or percutaneous coronary intervention (PCI) with cardiac stent placement to reopen diseased arteries in the heart. I had to closely monitor for possible complications such as chest pain, heart rhythm changes, site bleeding, swelling, and intervene appropriately. Pt would get discharged home within twelve hours of the procedure. It is so rewarding to see patients them being discharged home with a newly revascularized heart, thanking the God and health care providers. I was able to understand fully how heart failure could lead to the malfunction of the rest of the organ systems in the human body. So, I would educate patients and families on how to keep their heart healthy and prevent preventable heart diseases.
After working for two years, I chose to be an intermittent Intensive care unit (IICU), nurse. Currently, I am working as a Board Certified IICU bedside nurse. Daily, I do evaluate each of my daily patient prognosis, and I put forth my suggestion, care plan for the day that would guide the provider for further treatment. For example, I would suggest doctors and interdisciplinary team members if a patient requires a higher level (ICU) care or lower level (medical-surgical) care. I work on the floor that navigates individualized patient care according to their disease process, level of acuity. Working in different levels of settings and facilities gave me a strong communication skill, in prioritizing patient care, and managing my time very well to provide the best possible care for my patients.
Recently, I was working in the COVID unit; due to the overflow of COVID-19, we had a patient admitted from the Emergency room with LTV (portable) ventilator. While getting the report from night nurse, the ventilator alert went off, it read, the vent was malfunctioning, and a resident walked into the room and checked on vent but, he seemed he is not familiar portable ventilator. So, I called Rapid to respond team right away, while we were waiting for the respiratory therapist and team to come and fix the ventilator, I disconnected the ventilator from the patient and connected to Ambu bag to provide 100 oxygen via Ambu bag. The resident screamed at me why I disconnect the patient from ventilator tubing. He said, “I am trying to figure out to fix the vent.” I said vent alert says it is not functioning, and patient oxygen saturation is dropping to 80%. While you are trying to figure out, the patient needs oxygen to breathe. While I was supplying oxygen through the Ambu bag, the saturation slowly started to improve to 90%. The resident was still trying to figure out the vent setting. Meanwhile, the rapid response team an attending for the day walked in with COVID PEE and saw me, assisting the patient to breathe, he put his both thumbs up and said, “Good continue bagging, respiratory is coming with new ventilator machine.” The resident looked at me and smile. I knew I did the right thing at the right time because that patient lived for the day. I am sure, and it’s my experience in working so long on a different level of care setting really helped me to intervene promptly.
Since I graduated from BMCC, I have continued educating myself through many different conferences, e-learning, and finally, committed to go back to college. I believe, Bachelors’s in Nursing (BSN) degree classes has given me a better understanding of recent, relevant scientific knowledge and technology. It has increased my level of confidence to provide evidence-based practice care to all my patients. The BSN classes that I am taking right now already have broadened my nursing perspective and career opportunities to a whole new level.
References:
Hood, J.L. (2014). Leddy & pepper’s conceptual based on professional nursing (8th ed.)
Philadelphia, PA: Lippincott Williams & Wilkins. Pg. 64
Huston, C.J. (2020). Professional issues in nursing: challenges and opportunities.
Philadelphia, PA: Wolter Kluwer.
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