NURS 502 Week 2 Personal Philosophy Paper Example

Bearers of an Image, Present at the Bedside, Stewards of What We Know: A Personal Philosophy of Nursing

A philosophy of nursing is the set of beliefs a nurse brings to every encounter before any order is written or any assessment begins. Mine rests on a Christian worldview: that God created every person with worth, that God is present with people in suffering, and that knowledge and skill are gifts entrusted for the good of others. Shelly and Miller (2006) argue that a nurse's worldview answers the basic questions of who people are, what is wrong with the world and what can be done about it, and that those answers shape practice whether or not the nurse names them. This paper describes three components of my framework, how they fit the discipline's view of person, environment, health and nursing, and one encounter that tested them.

Component One: Every Person Bears the Image of God

The first component is that every patient bears the image of God and therefore has a dignity that does not depend on age, diagnosis, behavior or usefulness. Genesis records that God created humankind in the divine image (English Standard Version Bible, 2001/2016, Genesis 1:27), and Shelly and Miller (2006) describe this as the foundation for treating patients as whole persons rather than as conditions. The nursing profession reaches a similar commitment from its own tradition: the opening provision of the profession's code of ethics commits nurses to honoring the worth of each person they serve, whatever that person's circumstances (American Nurses Association, 2025).

In practice, this component governs small behaviors that are easy to skip on a busy shift, and it also shapes larger decisions, such as how I advocate when a patient who cannot speak for themselves is being treated as a problem to manage rather than a person to understand. It means introducing myself to a confused patient each time I enter the room, covering a patient during a bath even when the patient will not remember it, and speaking to a family about a dying patient as a person rather than a set of failing organs. It also governs how I respond to patients who are hostile or who have harmed themselves through their choices, because dignity that depends on behavior is not dignity at all.

Component Two: Presence

The second component is presence: being with a patient in attention and care, not only doing tasks for the patient. Presence also includes the family and the people who wait in the hallway, since a patient's fear often belongs to a whole household. When I cannot change a prognosis, I can still change whether a patient and family feel abandoned in it. Christian faith describes a God who draws near to people in suffering rather than watching from a distance, and Shelly and Miller (2006) describe nursing as a calling to share in that nearness through attentive care. Presence is not sentiment. It is a discipline of noticing, listening and staying when the instinct is to finish quickly and move on.

Presence has practical effects. Patients who feel heard are more likely to tell the nurse what is really frightening them, and that information often changes care. The nursing literature treats presence as part of caring practice, and theories that start from the patient's own view of the situation, such as modeling and role-modeling, build presence into their method (Erickson et al., 1983). I have learned that the five minutes I am tempted to save by leaving a room are often the five minutes in which the most important information is spoken.

Component Three: Stewardship of Knowledge

The third component is stewardship. If skill and knowledge are entrusted gifts, then a nurse is accountable for keeping them current and using them well. The parable of the talents describes servants judged by what they did with what they were given (English Standard Version Bible, 2001/2016, Matthew 25:14-30), and I read that as a call to competence, not only to kindness. A compassionate nurse who practices from outdated habits can still harm patients.

Stewardship is why I pursue graduate education and why I value nursing theory and evidence. McEwen and Wills (2014) describe theory as giving nursing a systematic basis for practice, and evidence gives that basis its current shape. For me, reading a new guideline, questioning a routine that no one can explain and teaching new nurses are all forms of stewardship.

The Framework and the Metaparadigm

The three components fit the four concepts of nursing's metaparadigm. The person is an image bearer with dignity, body, mind and spirit. The environment includes the relationships and community around the person, which presence must take into account. Health is more than the absence of disease; it is the fullest flourishing a person can have in the circumstances, including peace at the end of life. Nursing is the faithful use of knowledge and presence on behalf of the person's flourishing.

An Encounter That Tested the Framework

On a night shift on a medical unit, I cared for a patient in their sixties admitted with a severe exacerbation of chronic obstructive pulmonary disease and placed on noninvasive ventilation. Around 0200 the patient began pulling at the mask, breathing faster and saying it felt like drowning. The easiest response would have been to call for a sedative order. Instead I sat down, turned the room lights low, and asked what was most frightening. The patient said, through the mask, that a sibling had died on a ventilator and that the patient was sure the same thing was happening now.

Each component shaped what I did next. Dignity meant treating the fear as real and the patient as able to understand an explanation, so I explained what the mask did and what the numbers on the monitor showed. Presence meant staying: I coached the patient's breathing for twenty minutes, adjusted the mask fit with the respiratory therapist, and arranged for a family member to be called at a reasonable hour. Stewardship meant knowing the evidence on noninvasive ventilation and anxiety well enough to recognize that the patient's rising rate was more likely fear than failure, while watching the blood gas results closely in case it was not. By 0300 the patient was resting, and the morning blood gas had improved.

Implications for Advanced Practice

As an advanced practice nurse I will have more authority and less time, which will test this philosophy in new ways. Dignity will mean involving patients in decisions about their treatment even when a faster path exists. Presence will mean protecting time in visits for the question patients have not yet asked. Stewardship will mean basing prescribing and care plans on current evidence and accepting accountability when my decisions are wrong. My practice does not always match this philosophy; on busy nights I have left rooms too quickly. Writing it down gives me a standard to return to.

Conclusion

My philosophy of nursing rests on three convictions: every patient bears God's image and has dignity, care requires presence as well as tasks, and the knowledge entrusted to nurses must be kept current and used well. These convictions define how I understand person, environment, health and nursing, and they shaped my response to a frightened patient on a night shift. They will guide the kind of advanced practice nurse I intend to become.

References

American Nurses Association. (2025). Code of ethics for nurses. https://codeofethics.ana.org/

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Erickson, H. C., Tomlin, E. M., & Swain, M. A. P. (1983). Modeling and role-modeling: A theory and paradigm for nursing. Prentice-Hall.

McEwen, M., & Wills, E. M. (2014). Theoretical basis for nursing (4th ed.). Wolters Kluwer Health.

Shelly, J. A., & Miller, A. B. (2006). Called to care: A Christian worldview for nursing (2nd ed.). IVP Academic.