Jun 25, 2019 in Health

Concept Synthesis on Personal Nursing Philosophy

Nursing Autobiography

My name is Ignacio Alzugaray. I was born and raised up in a small town in Central Cuba. My father, Mattie Perry, worked as a retail businessman. My mother, Vera Cameron, was a social and community health worker. I was born the second among four children. Since my childhood and throughout my life, I have had a resilient desire of becoming a nurse. My parents revealed that I started fantasizing being a nurse when I was barely five years. They narrated stories of how I used to line up my dolls and stuffed animals and place sticks in their mouths to check their temperatures.

They also told me of how I used to cover them with bandages to cover their presumed injuries and wounds, and then hold them in comfort. These amazed me so badly. During my high school years, I started noticing that I had a dire passion to take up nursing as my career. I started selecting nursing subjects as my electives. Once in a while, the nursing students were required to visit the local hospitals once in a week to perform some fundamental care to patients. These moments increased my awareness and renewed my passion for nursing. Although I realized that nursing was not as glamorous as I thought, I still hoped to realize my dreams of becoming a nurse, and fulfilling my desire to serve people. 


Living in Cuba in my early years, I attended a nursing college where I enrolled on a nursing course, which I studied for three years. In 2004, I immigrated to Miami in Florida, USA. While here, I completed a nursing degree in 2006. Shortly afterward, I got to work with the Coral Gables Hospital as a home health provider. I later shifted my field to work in the management care field. Over the last six years, I have worked as a clinical advisor for the Humana Care Plus Medicare Advantage Plan at the utilization management department. 

To date, I have a cumulative experience of close to nine years in nursing. My experience also includes supervision in the clinical setting, complex case management, risk management, and coordination of clinical care. I have a passion to help and care for all people, and because of this, I hope to become a Family Nurse Practitioner and then a Doctor of Nursing Practice. With these qualifications, I hope to serve people in the rural areas better. Besides my nursing career, I am an enthusiast of various forms of sports such as soccer, boxing, baseball, formula one, and Moto GP. I also love traveling. I have a family composed of my wife and an English bulldog named Bully. 

The Four Metaparadigm Concepts in Nursing

Nursing is a professional discipline, which seeks to give patients a quality personalized care in meeting their individual needs. As a professional nurse, I am keen to remain within the scope of practice by relying on the four basic nursing metaparadigms, which act as a universal guide for the nursing profession. By definition, a nursing metaparadigm is a collection of ideas and theories, which provide the basic structure for performing the nursing practice (Blais, 2015). The nursing metaparadigm provides a holistic view of care where a patient’s well-being and medical health is linked to the paradigm’s concepts. The metaparadigm in nursing comprises four essential components namely patient, the environment, health, and nurse (Meleis, 2011). These elements are imperative to the nursing theory as they constitute the key areas of focus when it comes to patient care. 

The Patient/Person Component

The concept of the patient in the nursing metaparadigm emphasizes on the patient as the person receiving health care. Interactions with family members, friends, and other groups relevant to the patients are viewed as important influencers of the patient’s well-being and healthcare outcomes. The patient concept also takes into consideration the social, spiritual, and healthcare needs of the patient. Moreover, physical and social connected are considered to have a significant impact on the healthcare outcomes for the patient (Bonis, 2009). The concept posits that the provision of care is embedded in the belief that a patient is empowered to manage his or her well-being and health with dignity and self-preservation with helpful personal connections.

The Environment Component 

The environment aspect of the nursing metaparadigm centers on the settings that a patient receives health care services. It is held that the nature of the environment determines how good the medical outcomes are on a patient. The environment comprises both internal and external factors. The environment also encompasses a patient’s interaction with family, friends, and other groups. Moreover, it includes the economic conditions, geographical setting, cultural and social connections, and the technology among others (Bonis, 2009; Cody, 2011). The concept holds that a patient can significantly improve his or her health status by modifying the surrounding environmental factors appropriately. 

The Health Component 

The health component of the nursing metaparadigm looks at the ease with which a patient can access health care services and wellness programs. The health aspect reviews how the emotional, social, and spiritual well-being are incorporated for the best possible clinical outcomes and benefits (Bonis, 2009; Meleis, 2011). Patients can significantly improve their health status if they adjust appropriately to the prevalent factors named above. 

The Nurse Component

The component entails the delivery of optimal health outcomes for the patient through a valuable mutual relationship with the nurse or other health care professional in a safe and caring environment. The component integrates the principles of technology, skills, knowledge, professional judgment, communication, and collaboration (Cody, 2011). These aspects are vital as they enhance the nurse to perform all duties and responsibilities for achieving the best possible scenario in patient health outcome. The nursing concept values a high degree of service, and it integrates other metaparadigm components to promote patient’s well-being (Meleis, 2011). 

Practice Specific Concepts

Caring in the nursing field materializes when a nurse and a patient interact with hope and commitment to excellent health care outcomes. The primary goal of nursing is to help a patient achieve harmony holistically in the body, mind, and soul. In the nursing profession, education and nursing theories are integral to superior services as they guide the nurses’ actions within the clinical setting (Blais, 2015). These should be coupled with nursing-specific practice so as to attain the best possible health outcomes with competence and excellence. In the nursing field, the practice-specific concepts are specified and emphasized in different ways. In this paper, we discuss the concepts of clinical reasoning and decision-making, patient integration into self-care, and perfect skills in fostering safety and comfort. 

Clinical Reasoning and Decision-Making

In the nursing profession, healthcare professionals are supposed to employ multiple thinking strategies. The reason for this is that the practice is dynamic nature, and the environment is ever changing. These demand competence in dealing with complex emergencies (Cody, 2011). It is expected that clinicians and nurses have the ability to provide high-quality care based on skillful thought, reason, and judgment. Nurses are required to be flexible in their approach to critical thinking, reasoning, and decision-making. Lack of critical thinking and sound decision-making skills may have adverse impacts on the patients’ conditions (Benner, Tanner, & Chesla, 2009). Through this practice concept, nurses should collect clues, process the information, and have a sound understanding of the patient’s situation. Also, they should practice effective planning and implementation of interventions, evaluation of outcomes, and reflection and learning from the entire process. Critical reasoning and decision-making in clinical practices allows a health care professional to provide safe and high-quality care (Cody, 2011). Practicing the concept demands the use of intuition and knowledge to influence decisions based on the circumstances surrounding a patient’s conditions. 

Patients’ Engagement in Self-Care

Nurses and the related health care professionals are tasked with an important role in providing solutions for increasing and empowering patients through self-care whose outcomes are apparently better patient outcomes. Through the integration of health information systems into healthcare, healthcare providers can create patient portals, which enables nurses to provide patients with a wealth of relevant, easily accessed, and trusted educational resources. Similarly, patients and healthcare professionals can exchange documents, images, results, and messages, which lead to better understanding and engagement (Bonis, 2009). Moreover, patients can have an easy access to their medical records and specific care pathway overview. The process raises their awareness of tests and results and directly links them to their circle of care. Eventually, self-care and management increases the patient’s understanding and engagement with the health outcomes, which encourages them to moderate further their behaviors in alignment with their agreed care plan. 

Perfect Skills in Fostering Safety and Comfort

The concept of perfect skills in fostering safety and comfort is based on Catherine McCauley’s careful nursing model first developed in the 19th century. The concept holds that direct patient care begins with a nurse being professional and competent. ‘Perfect’ nursing skills are required for all forms of care ranging from simple forms of individual care to the most intricate interactions and techniques (Meleis, 2011). Professionalism and competence call for accuracy in tasks such as speculating the process of care, determining the approaches to diagnoses, and in selecting the correct techniques, achievable outcomes, and nursing interventions. Nurses are required to be ideally perfect in developing their professional skills over time (Bonis, 2009). Specifically, health care professionals are required to demonstrate perfection in the aspects of nurse-patient relationships, education to patients, and helping patients to plan for their discharge. Also, nurses are prompted to improve, sharpen, and perfect their clinical skills through critical reading of research and related pieces of literature coupled with critical thinking (Benner, Tanner, & Chesla, 2009). Moreover, nurses are required to be perfect in areas such as checking patient identity and administering medicines. In such and other aspects of practice, there should be no margins of error.

Another vital responsibility requires nurses to depict perfect attention to details when watching patients, assessing and recognizing psychological problems. Nurses’ complete caution is required so as to relieve the patient of suffering and complications that can be life-threatening. Nurses should ensure that the patient’s safety is at the best level possible. 

List of Propositions

Propositions also referred to as assumptions, are structural elements of a theory that propose the relationship between concepts. Based on the metaparadigm concepts of nursing discussed earlier in the paper, various propositions can be derived. 

  1. It is possible that any patient can manage his or her health status through a positive self-image and appropriate behavioral practices that promote good health and well-being.
  2. The environmental factors surrounding a person can be modified appropriately with the aim of improving a patient’s well-being and health status.
  3. Nurses should promote self-care and management among patients, which is fundamental to improved healthcare outcomes.
  4. Nurses should try as much as possible to practice professionalism and competence through continuous learning and research, which eliminates the chances of errors in care delivery.
  5. The physical, emotional, intellectual, and spiritual and social well-being must be incorporated into healthcare provision so as to influence the health status and well-being of the patient positively. 

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