Originally posted by Linda Jackson:
I am writing a paper on my philosophy of nursing as it applies to my nursing practice and must support with at least three articles. I would be interested in hearing what you the real working RN's feel about your philosophy of nursing as it applies to your practice in today's marketplace.
Sorry, I am not an advanced practice nurse nor am I in the nurse management field. Just a humble staff nurse with a BSN. I work in an acute care hospital and have worked in med-surg, telemetry, and the units. To us staff nurses nursing theory is the stuff of PHD's and doctorial thesis presentations...sorry to say it has no place in the everyday work environment. Every couple of years we are forced by management to update or manufacture so called "care plans
" in an effort to apply the window dressing needed to pass the JACHO inspections. It might actually be nice to see someone like Florance Nightengale be put into practice. ....Just imagine the patients are put to sleep at 10 pm sharp (no 2400 hour meds, no early morning phlebotomy attacks, no EKG tech at the bedside at 5am; all of the confused, disoriented, sometimes violent--placed in soundproof rooms, each with their own personal sitter to watch over them and ensure no injuries in a restraint-(both chemical and physical)free environment. How about a clock in every room, a calander on the wall that each patient can see. How about food that is individually prepared with the patients likes and dislikes in mind as opposed to some 5 basic item cookie-cutter, cost saving meal plan. How about a staff the changes bed linens every day instead of the MWF routine so many hospitals have adopted lately. How about individual temperature controls for each patient.... need I go on.
Sorry to say, it ain't going to happen. Hospitals are BIG BUSINESS. They can say they are community service minded, but they are only so as long as it does not effect the bottom line.
So my feeling is that nursing theory in the nursing trenches is that "pie in the sky" stuff that administration does not give you the time or the latitude to implement. You are too busy wondering if pt 1's cardiologist knows about his ST elevations, or if pt 2 gave you a complete list of all his medications for your admission assessemnt, or if you will get a chance to take a break, or if they are going to enforce manditory overtime, and make you work into the next shift.
My philosopy of nursing is to provide to best care that I can, and provide as much emotional and supportive care that I can in an environment that can be humiliating and downright mean to todays patient.