Caring, which is a mainstay characteristic of nursing practice, has been christened as a complex process that is grounded on professional and ethical contexts. While examining the nursing ethos that safeguard the right of patients to human dignity, Judge-Ellis and Wilson (2017) identified caring as a primary moral obligation of the ethical frameworks underlying these ethos. I chose to become an advanced practice nurse because my demeanor and my disposition are adequately suited for providing this care.
Nursing philosophy is an integral element that helps in the identification of the approach that a nursing practitioner adopts towards delivering his or her professional obligations (Marchuk, 2014). The purpose of this paper is to outline my personal philosophy on advanced practice nursing and healthcare with respect to my future role as an advanced practice nurse. In this paper, my personal philosophy concepts that are specific to the nursing metaparadigms are established from published philosophies. Through evidence-based justification of theory, this paper explains how Peplau’s Theory of Interpersonal Relations relates to my future practice nursing role and my personal philosophy. To provide ethical and compassionate care to the patients in a healing environment, there needs to be reciprocity between the nurses and the patients, as this is the bedrock of patient-centered treatment care.
Advanced Practice Nursing Philosophy
With the implementation of the Patient Protection and Affordable Care Act of 2010, more emphasis has been dedicated towards identifying the roles of healthcare professionals in guaranteeing the safety and safeguarding the rights of the patients (American Nurses Association, 2018). Consequently, the American Nursing Association (ANA) has developed distinct definitions of nursing practitioners based on the roles that these professionals play in realizing the requirements that accrue from healthcare reform. Advanced Practice Nurses (APNs) include a range of nursing professionals identified as clinical nurse specialists, nursing practitioners, nurse midwives and nurse anesthetists. These professionals play an integral role in healthcare as they are the primary providers of care. Besides, Reed (2016) identifies advanced practice nurses as the pillars of providing preventive care services to the public.
According to the ANA guidelines, the primary function of APNs is to diagnose and treat illnesses, manage chronic diseases and provide expert advice on public health issues (American Nurses Association, 2018). Therefore, the ANA stipulates that my role as a nursing practitioner would be to provide acute, primary and specialty health through diagnoses, assessment and treatment of illnesses. Over the years, the ANA has led the path in advocating for healthcare reforms that would enable all people to access quality healthcare. Such efforts incorporate transcultural and multi-disciplinary collaboration as among my roles as a nursing practitioner.
My advanced practice nursing philosophy borrows a leaf from the roles of APNs stipulated by the ANA. According to Marchuk (2014), a philosophy is a product of thinking that involves the examination of ideas, meaning and processes in search for the truth. Based on the definition of philosophy, it is evident that a personal philosophy frames the behaviors and actions exhibited by an individual. There are specific factors that shape an individual’s philosophy including what the individual sees, the model of interpretation, degree of open-mindedness, assumptions, and personal values or belies and the perspective from which a person gauges something as either true of false.
Reed (2016) observed that the philosophies of nursing and medical practice are founded on traditional, doctrine and authority. As an advanced practice nurse, I plan on providing my patients with compassionate and holistic care, which are the primary foundations for the maintenance of optimal health. My nursing philosophy is established on the quest to address the specific needs of the patient, while blending the treatment plan with evidence-based approaches to care. I plan to ensure that the patients are educated and encouraged to take responsibility of their health not only through observing healthy life choices but also working with healthcare professionals.
According to the ANA, nursing practitioners are required to provide the patients with holistic care (American Nurses Association, 2018). Therefore, my philosophy of nursing is anchored on Florence Nightingale’s philosophy that values holistic treatment for the patient and provision of means through which the patient can realize wellness. The holistic care includes addressing the nutrition, exercise, environment and stressors to which the patient is subjected. Besides, my philosophy towards providing holistic care considers culture as an element that enables the client to realize wellness. Consequently, I intend to apply the cultural world view of the clients in ensuring that I deliver holistic care as per the requirements of my philosophy.
There are additional roles that come with being an advanced practice nurse. According to Judge-Ellis and Wilson (2017), the traditional philosophies of nursing did not envision nurses as professionals who could diagnose and treat patients, as this was a function preserved for physicians. I realize that the changing scope of nursing practice accompanies advanced roles such as diagnosing and treating patients, which require me to design and implement treatment plans. The expanding scope of roles and responsibilities of the advanced practice nurses require me to adopt evidence-based practice as a philosophy that enables me to deliver individualized and patient-centered care for the clients.
Peplau’s Theory of Interpersonal Relations is middle range descriptive classification theory that was developed by Hildegard. E. Peplau in 1952 (Deane & Fain, 2015). This theory was influenced by Neal Elger Miller, Abraham Maslow’s and Percival Symonds. Though it was developed over half a century ago, this theory is very popular among clinicians who are handling patients with psychological problems. This theory, which is also referred to as the psychodynamic nursing theory, is based on the understanding of an individual’s behavior (Hagerty, Samuels, Norcini-Pala & Gigliotti, 2017). This theory identifies the relationship between the nurse and the patient as important elements that determine the health outcomes. In developing this theory, Peplau hypothesized that nursing is a maturing force that is developed along with the development of one’s personality through interpersonal, therapeutic and educational processes. The theorist further explains that nurses establish a personal relationship with the patient to understand the specific needs of the patient.
The primary concept of Peplau’s theory is that nursing is required to help others to identify their felt difficulties (Hagerty, Samuels, Norcini-Pala & Gigliotti, 2017). The theory identifies the human relations principles that should be applied by nurses in addressing all the problems that accrue at all levels in the healthcare environment. The theory explains that nursing is a process that is established on the phases of interpersonal processes, as such identifying nursing as a therapeutic process that assists individuals in need of care.
The roles of the nurse in this theory develop gradually from the initial meeting between the nurse and the patient. In the first meeting, the nurse is a stranger who meets the patient in a manner similar to those of other life situations. However, the nurse is tasked with providing an accepting environment that establishes trust between the two parties (Deane & Fain, 2015). Once the trust is established, the nurse plays the role of a teacher, where the professional applies professional knowledge to assess the problem. The theory depicts the nurse as a resourceful person who disseminates specific information that is integral in developing an understanding of the problem. Additionally, the theory depicts the nurse as a counselor who provides the client with a guideline of the changes to make with respect to the current life circumstances of the patient. Overall, the nurse plays the leadership role, which enables the client to assume maximum responsibility for realizing the goals of treatment.
Peplau’s Theory of Interpersonal Relations identified four sequential phases, including orientation, identification, exploitation and resolution (Deane & Fain, 2015). The orientation phase is the phase in which the problem is defined. In this phase, the nurse is a stranger to the client. At the orientation phase, the nurse and the client develop a relationship that is based on the environment and the interaction between the parties.
The second phase is the identification phase. This phase involves detection of the problem and the appropriate services needed to address the problem (Deane & Fain, 2015). On one hand, the client conveys his or her needs and seeks assistance from the nurse. On the other hand, the nurse responds to the needs of the client. The nurse then selects the professional assistance that is relevant to the patient.
The exploitation phase envisages the use of professional assistance to identify the alternatives of solving the problem (Deane & Fain, 2015). The services identified are based on the interests and needs of the patient, thus the need to integrate the patient in identifying the alternatives. In this phase, the nurse assists the patient in exploiting the avenues of solving the problem. The resolution phase envisages the termination of the professional relationship. At this phase, the needs of the patients have been addressed through the relationship between the nurse and the patient. At this phase, the link between the nurse and the patient is dissolved, a stage that may present difficulties if the therapeutic relationship involved psychological dependence of the patient on the nurse.
Justification of the Theory
The goals of Peplau’s Theory of Interpersonal Relations are to establish a relationship between the patient and the nursing practitioner that enables the combined decision-making on the appropriate care for the patient (Hagerty, Samuels, Norcini-Pala & Gigliotti, 2017). Both the theory and practice goals are sequential and are identifiable with an intrinsic focus on establishing a therapeutic relationship. In relation to future advanced practice, the goals of this theory are integral in identifying the methods through which nursing practitioners can develop a relationship that guarantees patient-centered care.
The concepts of this theory relate to practice. Peplau’s theory of interpersonal relations contends that both the patient and the nurse share a common goal, which forms the basis of their interaction. To attain the common goal, this theory provides systematic steps of interpersonal relations that should be followed. The patient and the nurse work to establish a mature and knowledgeable relationship. This concept depicts the patient needs as the main reason for the interaction between the patient and the nurse, which is evidenced in practice. Besides, the roles of the nurse as provided in this theory are evidenced in practice. In practice, the ability of the nurse to provide an enabling environment as stipulated in this theory determines the health outcomes.
Peplau’s theory of interpersonal relations has been used in nursing research. In a study conducted by Deane and Fain (2015), the authors acknowledged the significance of the interaction between older adults and healthcare providers as an integral element in managing acute and chronic conditions. Consequently, the study focused on identifying the efficacy of Peplau’s theory of interpersonal relations to promoting holistic communication between older adults and nursing students. The study found that Peplau’s theory of interpersonal relations provides a framework for developing the nurse-patient relationship. Additionally, the study by Hagerty, Samuels, Norcini-Pala and Gigliotti (2017) discussed the application of the Peplau’s theory of interpersonal relations to nursing practice. The study found that the relationship between the nurse and the patient is pivotal in influencing the overall experiences of the patients, thus asserting the relevance of the theory in nursing practice.
Example of Theory to Practice
As an advancing practice nurse, I can apply the Peplau’s theory of interpersonal relations in providing care for the patients. This theory can provide me with problem solving techniques to ensure that I engage the patient with a wide range of alternatives to the healthcare problem. Both the theory and nursing practice employ recording and observation communication as basic tools, which are important in my practice as a nurse.
It is evident that nursing philosophy is an integral element that helps in the identification of the approach that a nursing practitioner adopts towards delivering his or her professional obligations. In this paper, I have explored my philosophy as a future advanced practice nurse. I have identified caring as the bedrock of my philosophy, and explained how Peplau’s theory of interpersonal relations can be applied to enhance my professional experiences in light of the quest to ensure the wellness and recovery of the patient. To provide ethical and compassionate care to the patients in a healing environment, there needs to be reciprocity between the nurses and the patients, as this is the bedrock of patient-centered treatment care.
1. American Nurses Association. (2018). Advanced Practice Nurses. Retrieved from https://www.nursingworld.org/practice-policy/workforce/what-is-nursing/aprn/
2. Deane, W., & Fain, J. (2015). Incorporating Peplau’s Theory of Interpersonal Relations to Promote Holistic Communication Between Older Adults and Nursing Students. Journal of Holistic Nursing, 34(1), 35-41. DOI: 10.1177/0898010115577975
3. Hagerty, T., Samuels, W., Norcini-Pala, A., & Gigliotti, E. (2017). Peplau’s Theory of Interpersonal Relations. Nursing Science Quarterly, 30(2), 160-167. DOI: 10.1177/0894318417693286
4. Judge-Ellis, T., & Wilson, T. (2017). Time and NP Practice: Naming, Claiming, and Explaining the Role of Nurse Practitioners. The Journal for Nurse Practitioners, 13(9), 583-589. DOI: 10.1016/j.nurpra.2017.06.024
5. Marchuk, A. (2014). A personal nursing philosophy in practice. Journal of Neonatal Nursing, 20(6), 266-273. DOI: 10.1016/j.jnn.2014.06.004
6. Reed, P. (2016). Philosophical Clarity and Justifying the Scope of Advanced Practice Nursing. Nursing Science Quarterly, 30(1), 73-76. DOI: 10.1177/0894318416680709