Personal Philosophy of Advance Nursing Practice Narrative

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Nursing theories are crucial, because they guide education, practice, and research in this field. However, any theory should be congruent with the metaparadigm of nursing in order to be accepted as a nursing theory. Metaparadigm of any discipline represents the broadest perspective on this discipline (Smith & Parker, 2015). Further, the metaparadigm defines concerns of the discipline and sets the boundaries of what is acceptable as a part of this discipline. Therefore, metaparadigm of nursing identifies its central concepts and themes. Concepts of nursing metaparadigm are used to enhance the knowledge base during the development of advanced nursing practices, which focus on health promotion, prevention of diseases, as well as on taking care of sick, disabled, and dying people (McGee & Castledine, 2003). An advanced nurse practitioner is responsible for the clinical decisions of the sick, disabled, and dying people as well as he/she is answerable to the patients, families, and professional organizations. Experience and professional growth have resulted in the fact that advanced nursing practices are a combination of art and science, which entails increased gaining of knowledge, applies evidence-based techniques, and requires complex decisions made through critical evaluations. Four metaparadigms of nursing include a person, nursing itself, health, and the environment, which are interrelated, according to the advanced nurse practitioner.


For an advanced nursing practitioner, it is necessary to consider the concept of a person. A person refers to individual clients, their families, and communities. People have inherent dignity, value, and entitlement to respect because they have unique physical, intellectual, emotional, spiritual, cultural, and social characteristics (Smith & Parker, 2015). Additionally, each person is entitled to self-expression and should participate in life to the fullest extent, depending on their perspective and experience. Consequently, clients should be allowed to take part in the development of their health care plans in order to be satisfied with the provided care. Further, advanced practice nurses ought to view their clients in a holistic manner with a clear understanding that a person comprises of many parts and should not be perceived just as a physical human being (Romaine-Davis, 1997). I believe that adopting a patient-centered approach ensures that everyone receives appropriate care, as well as shows respect and encourages patients to develop their full potential. Furthermore, an advanced practice nurse should recognize racial disparities and culture diversity, strive to care for each individual, establish trust, and build a relationship with patients and their families.


Health is the second concept in the metaparadigm of nursing. Good health is a balance between physical, mental, emotional, and spiritual well-being and is more than just an absence of a disease (Smith & Parker, 2015). Health is not constant, and it is changing during the whole life due to the interaction of environmental and genetic factors. The ability of people to afford health care services, their choices of health practices, as well as access to health care are some of the environmental factors, which influence health. Nurses should be aware of the fact that health is not constant and, therefore, they need to be good providers of health care to themselves and to their clients. Further, nurses should continuously learn about the latest technology in order to improve the provision of care to their clients at different levels of health. Additionally, nurses can assist people in remaining healthy through sharing information concerning disease prevention, child care, and nutrition (Sullivan-Marx, McGivern, Fairman, & Greenberg, 2010). Moreover, they can help in the implementation of such prevention programs as health screenings, immunization, and blood pressure checks. Nurses are trained to help patients, who cannot take care of themselves. In this case nurses prepare a plan, depending on the client's diagnosis and adjust it anytime it is necessary in order to achieve the optimal level of health for this client and meet his/her needs. The practitioner applies an integrative approach, which uses different treatment techniques in order to familiarize their patients with the available opportunities and ensure that the optimal care is delivered. The concept of health is related to a person, because it is the state of a person’s well-being.


In the advanced practice nursing the concept of environment is a broad term, which denotes physical, social, and cultural setting, in which patients live. Thus, environment refers to all internal and external surroundings of a person (Smith & Parker, 2015). Advanced practice nurses should follow healthcare delivery models, as well as they should implement new legislation, which is significant for a successful operation of the health care system (Romaine-Davis, 1997). By being aware of the environment, in which a patient lives, nurses can be able to invent new means of providing care to the community. For instance, the era of new technologies makes it possible to install applications that allow using home monitoring services, which are available to the entire community. The installation of such technologies, which are simple to use, can create an online environment that is focused on early interventions. It can help to prevent frequent visits to the emergency departments and inpatient admissions. Nurses have to consider cultural differences of their clients, while delivering care, and realize that what is culturally acceptable to them is not always acceptable to their clients (Sullivan-Marx, McGivern, Fairman, & Greenberg, 2010). Nurses should provide a comfortable healthcare environment to their clients, because it is crucial for the better care delivery and quick recovery.


Nursing is the final concept in the metaparadigm. It refers to the knowledge, obtained from theory development, logical analysis, and research (Smith & Parker, 2015). Nursing theories are significant for the development of advanced nursing practice. Advanced practice nurses apply critical thinking and clinical judgment during providing evidence-based care to individual clients, their families, and communities in order to attain an optimal level of client’s health in different nursing environments. I believe that the core purpose of advanced nursing practice lies in promoting health, preventing illnesses, increasing wellness, caring for the sick, and comforting the dying (McGee & Castledine, 2003). Nursing is both science and art, and each of these two concepts is essential in achieving the primary goals of the advanced practice nursing. The scientific part of nursing encompasses health care theories, which are applied in nursing if they are beneficial to health. On the other hand, the art part deals with providing care to clients. Theories teach nurses that each client has special needs. However, it is the art of nursing that involves the ability of a nurse to identify and satisfy the needs of a client as well as to determine necessary interventions that will help to improve patient’s environment and health. The advanced practice nurse is equipped with adequate knowledge, clinical expertise, and decision-making skills that are necessary for the provision of high-quality care to individuals, families, and communities. This concept is related to other metaparadigms, because nursing is aimed at promoting and maintaining health of a person through adjusting the environment to his/her needs.


Due to the constant changes, which occur in the healthcare system, there is a growing need for the advanced practice nurses, whose role is constantly increasing. As a nurse, I believe that the time spent with a client is more than just diagnosing and prescribing treatment. A nurse should provide holistic care to his/her clients in order to ensure their physical, mental, emotional, and spiritual well-being. It can be facilitated by establishing the relationships of mutual respect and reciprocity, which is necessary for building trust with the clients. Therefore, four metaparadigms of nursing are interrelated.