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Nurse practitioners are mostly used in delivering of primary care and they are sufficient since they are not expensive. They also work by attending to all patients needs rather than specializing in curing of the diseases. I have been working as an oncology nurse for seven years and I want to work as one always. One of the difficult kinds of patients’ care that I have encountered in my career life is offering cancer care. This is because of patients’ need of education, palliation, psychological support and clinical skills. An oncology nurse must always be prepared to handle his or her patients in different settings. The roles of an oncology nurse in the clinical setting can only become successful when collaborative practice model is applied which calls for responsibility sharing, goals sharing, accountability, and a shared philosophy of practice.

The goals of nurse practitioners are many but the most important goal is offering quality patient care. A nurse practitioner has the following strengths: ability to educate the patients, duration of visits, communication, and strict following of the practicing guidelines. Nurse practitioners do promote a complete effective approach to provision of quality health care and stress on the well-being of their patients. The roles of nurse practitioners are changing continuously following the changes in societal and health care needs. They are dedicated to searching of quality health care knowledge and sharing the same in order to deliver quality health care to their patients and eventually positively impacting the clinical outcomes. The search and sharing of clinical knowledge is accomplished by starting and being involved in: health care forums, health care research programs, and health care surveys. The knowledge gained is then applied to the clinical practice. Nurse practitioners must also act as the advocates to the patients in terms of ethical and legal advocacy. This means that they are the ones to participate in making health policies on the local, state, national and international levels.

Since the roles of nurse practitioners are restricted to primary and acute health care, they then assume the roles of: providers, mentors, administrators, and researchers. It is the key role of the members of the profession to aid and guide the nurse practitioners and to ensure that high standards of the clinical profession are maintained and service delivery channels are streamlined. 

Philosophy

Nursing philosophy can be termed as a guide in the nursing field. It is a core factor that dictates on how various processes in the nursing profession are carried out. Being such a valuable element in nursing, it has fully influenced, motivated, and enriched various perspectives in nursing such as: nursing education, nursing science, and health care practice. In order to develop an effective framework for delivering of quality health care, a strong nursing philosophy must be established. There is no way quality health care can be delivered without there being strong philosophy. Nursing knowledge is founded on the nursing philosophy theories and these theories when coupled with their philosophical bases and disciplinary goals act as nursing frameworks (McCurry, Revell& Roy, 2010). In most cases, the clinical nurses are expected to come up with their philosophy in order for them to meet clinical, educational and managerial objectives.

The nursing practice is founded on the following values: integrity, excellence, teamwork, collaboration, and stewardship. Becoming a nurse practitioner indicates that one is ready to become a servant of the society but be in line with the values of the society in question.

Integrity must be maintained in the nursing profession. This ensures that patients are safe and the health care provided to them is of high quality. Integrity shows the ethical commitment of the nurses in the provision of quality health care. It also shows that the one in the nursing profession values the privacy and the worth of each patient.

Teamwork is another core factor that advances the results in the nursing profession. It shows how nursing values interdisciplinary relationship and cooperation with patients and their families in order to deliver positive results.  Teamwork is important in provision of quality patient care and ensuring that the patients are safe. It has also been noted that when teamwork has been applied in the nursing profession, it promotes job satisfaction (Beatrice, Kalisch& Kyung Hee, 2001). Excellence acts as a motivator to perfecting the roles of the nurses. When a nurse practitioner succeeds at one time, he always tries to achieve much more in the later days.

My future philosophy of nursing targets on the provision of quality health care to all my patients and their families by: promoting of quality healthcare, prevention of diseases, applying critical thinking, and using the best decision-making skills to enhance the outcomes. It is important for me as a nurse practitioner to provide a respectful healing environment, which can only be obtained if I deliver the highest quality nursing care. I embrace the fact that the nursing profession is both an art and science in the field of clinical practice. This means that I must employ both the clinical and administrative leadership in service delivery. It also calls for one to be a scholar in order to find quality academic knowledge, which is vital in quality service delivery. The basis of nursing philosophy is understanding of the patient’s situation which means that delivering of quality nursing care demands interpretation, understanding, and hermeneutic experience (Austgard, 2008).

What Values/Beliefs Will Guide Your Practice?

Provision of care and the nursing profession always go together. Many people are into the nursing profession because they feel that it is an opportunity for them to take care of other people. Nursing is a noble profession and requires the people in it to be caring. This makes care the greatest value in the nursing profession, health legislation, and codes of ethics for nurses. In actual sense nursing care is portrayed as a holistic act. It takes place at each and every time a nurse pays a visit to a patient. According to Watson (2003), caring can exist without the patient becoming cured, but a patient can’t be cured without being taken care of.

It is therefore evident that caring is the core concept in delivering of quality oncology care. The humanistic nature of the nursing profession is well illustrated in the caring model. In this model, the oncology patients and nurses were selected in a random manner. According to this model, the patients who we offered high quality care, were responding well compared to those who were not.

Ethical Values. 

Beneficence.

This is the act of preventing the occurrence of harm or evil to befall a certain group or individuals in question. It also involves protecting and defending the rights of other people. This promotes the good of all people in the society. It involves comparing benefits of a certain action with the risks and the costs associated with the same. It calls for positive acts while the comparison of benefits with risks and costs ensures that the act is good. Actually, beneficence targets the patient but not the nurses.  The beneficence principle acts as the basis of the principle of caring ethics since the nurse is expected to act or work at the best interest of the patient (Kennedy, 2004).  This has worked more so when applied to provision of care to cancer patients.

Justice.

This is applicable when offering support or care. It focuses on equal treatment of all parties by giving them equal access to health care and dividing the available scarce resources among the patients equally. Justice in the field of nursing can be a challenge since it is a basic human need. This is because in nursing, justice is founded by ethics and law as compared to the individual patient care (Johnstone, 2011).

Veracity.

This is a core part in the principles of nursing that demands that the nurses must always tell the truth. It is strongly founded on the respect for other people. Trust is the confident belief that the other party will tell the truth. It indicates that the nurse practitioner will act with good will and will be able to secure the interest of the patients since they need their help (Carter, 2009). Being an oncology nurse, one is expected to be trustworthy and should act to the best interest of their patients. This relationship is a firm basis for provision of care and hence of healing. 

Autonomy.

Autonomy is the right to self-determination. This involves the freedom of one to make a decision about their lives without being interfered by another party.  For this to be achieved, one must have self-rule and be free from being controlled by others and other personal hindrances which might prevent one from making the right choice.  Oncology nurses must always apply the rule of autonomy in their day-to-day operation. During the treatment of cancer by use of radiation and chemotherapy, a patient must be given this option.

The Theory Fitting My Philosophy of Nursing Practice

Personal framework for nursing is founded on various theories: Kristen Swanson’s theory and the transtheoretical model of behavior change. The transtheoretical model of behavior change is one of the models that have been the foundation of behavior change in the nursing profession. It was developed by Prochaska and DiClemente.  This theory focuses on the individual’s experiences, i.e. how they develop new behaviors, modify their behaviors, and/or stop their problematic behaviors.

The greatest bases of this theory are: the stages of change, the scale of decision balance, the weak and strong theory, self-efficacy, and the course of change. The research that has been done indicates that there exist ten processes needed for a change to occur. These process produce progress when they have been coupled with temptations, self-efficacy and the decisional balance. This theory indicates that for a change to be achieved there must be a perfect match between the intervention needs and the stage of change that the person in question is. It also indicates that the balance between the positive and negative attitude must exist. Self-efficacy helps the cancer patients to adjust to their situation and hence becomes an important factor when the patients move from one stage to the other.

The TTM fits in this framework because the patients are moving from one stage to another and hence need to change their behaviors in order to fit in the next stage that they are in that is their sickness stage. They need to adopt a new lifestyle which is dictated by their disease condition. It is also vital for providing explanations to the changing health behaviors of the patients. This has been used in various programs such as genetic testing for colorectal cancer, prevent obesity and maintain health, smoking and alcoholism cessation, and mammography adoption. TTM theory uses self-reevaluation and self-liberation in providing a positive change to an individual. It must be noted that change of behavior is a major point when a patient is in a disease condition and in maintaining health. TTM can also be used by health practitioners in explaining the differences in how patients respond to treatment in relation to any psychological problems that might exist (Ames, Hart, Moore, Thombs & Werch, 2009).

As per Kristen Swanson’s theory of caring, caring is the foundation of nursing. As per this theory, caring is “A nurturing way of relating to a valued others towards whom one feels an individual sense of commitment and dependability”.  The theory focuses on the five processes of caring. These are: knowing, being with, doing for, enabling, and maintain belief. These processes must interact with each other in a hierarchical manner for quality results. Knowing is trying to understand why a situation is important to the other person. Being with involves opening up emotionally to the other person which in turn increases the chances of understanding the other person’s position. Doing for incorporates helpful, protective, and comforting actions. These include all actions that the person would have done if at all it was possible for him to.  Enabling is helping the other person’s passage through the difficult transitions of life. Maintaining belief is helping one to keep up their faith even though the situation is not promising. This keeps up the hope of a patient and helps them face the situation positively.  According to Swanson, caring goes with the concept of the person, the surroundings, health, and the actions of care put in place.

Swanson’s theory of caring provides a structure of high quality health care which must be applied in the field of nursing. Her theory clearly explains what is means for nurses to offer their services in caring way. It provides a way of dealing with a disease condition and the subsequent healing by the close friends and the family members of the patient. This theory goes beyond the physical aspects that health care practitioners consider to promote emotional healing from the effects of the disease condition.

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