Nursing Philosophy
New Mexico State University-Alamogordo, located in the southwest region of the United States, has a multiplicity of cultures. These cultures result in wide variations in lifestyle, values, goals, wellness practices, and role expectations for both clients and healthcare providers. To function effectively in this setting, the nurse must have an understanding, acceptance, and respect for the uniqueness of the individual. This uniqueness implies an awareness of self and knowledge of different wellness care practices, and alternate methods of wellness care between cultures.
Consistent with the mission of New Mexico State University-Alamogordo (NMSU-A), the faculty of the nursing program accepts the primary responsibility for the preparation of nursing students from diverse and multicultural backgrounds. This charge is undertaken in an environment that promotes challenging experiences, personal satisfaction, and lifelong learning. The practice of nursing is an integration (of the concepts) of caring, holism, and wellness, in conjunction with a high level of specialized knowledge taken from the sciences and humanities, to assist the client to achieve an optimal level of wellness. The client must be viewed as an unique individual and deserving dignity and respect–and as a member of a family, community, and a culturally diverse society. (S)he is the sum-total of a variety of factors (nutrition, culture, self-responsibility, physical wellness, environmental influences, spiritual, and psychological make-up, past experiences, etc). To treat one factor in the absence of the others is to neglect the person as a whole.
Essential concepts (EC) of the NMSU-A Associate Degree Nursing (ADN) philosophy and program are:
Caring (EC1)
Caring is the central and unifying domain for the body of knowledge and practice in nursing. It includes those cognitive and culturally learned behaviors, techniques, processes, or patterns that facilitate an individual as a member of a family and a community to increase, maintain, or cope with levels of wellness throughout the lifespan.
Wellness (EC2)
Wellness is the subjective, dynamic state of the client interacting with their internal and external environments in the progression toward higher levels of functioning and well being. Wellness is considered individually for each client according to that clients particular needs, joys, hardships, disabilities, problems, and potentials. The goal of wellness care is to achieve a balance between the internal and external environments of the client.
Holism (EC3)
Holism is the philosophic view that an integrated whole (the individual) has a reality independent of and greater than the sum of its parts. The parts are dynamically interrelated and interdependent. The individual is the locus of control and is primarily responsible for maintaining personal wellness. The individual is viewed with respect to their physical, emotional, social, economic, cultural, and spiritual values and needs as they facilitate and enrich his/her level of wellness.
Nursing Process (EC4)
Nursing process is the mechanism used to implement the philosophy of caring while facilitating optimum levels of wellness with the client. The nursing process consists of assessment, nursing diagnosis/problem, planning, implementation, and evaluation and is essential to provide a professional approach to client care delivery. Application of the nursing process employs the use of critical thinking skills at each phase of the process. Critical thinking is characterized by careful analysis and purposeful judgement. By focusing on critical thinking as a process of purposeful judgement, the emphasis is placed on decision-making in the context of an identified problem, goal, desired outcome, or purpose.
Nursing Practice (EC5)
Nursing practice is an interactive process. It incorporates collaboration with members of other disciplines and the client. Compassion, competence, confidence, conscience, and commitment are the expressions of caring that are specific to the practice of nursing. The nurse ultimately must be responsible and accountable for nursing judgements and actions. Wellness care is the mutually agreed upon changes in behavior, designed to achieve optimum levels of wellness for the client. It does not constitute an opportunity for the nurse to impose his/her value system on the client.
Nursing Program Philosophy and Essential Concepts
The faculty at New Mexico State University-Alamogordo will implement the Nursing Program Philosophy through a comprehensive course of study that centers on the concepts of Caring, Holism, Wellness, Nursing Process (Critical Thinking), and Nursing Practice. Graduation from the NMSU-A Associate Degree Nursing Program denotes the successful completion/demonstration of specific competencies and signifies the preparation of the graduate to apply the nursing process in the delivery of nursing care in a structured setting.
Nursing Education
Nursing education and teaching strategies are based on adult learning theory. The strategies used incorporate the principles of lifelong learning, analysis of experience, and the need for self-direction. The concepts of learning are derived from the model which views nursing education as moving from the novice level to expert level. The graduate will demonstrate advanced beginner competence in the roles of member within the discipline of nursing, provider, and manager of care. These three roles frequently cross-traditional boundaries, are interrelated, and, therefore difficult to consider in isolation. Eight core components have been identified as essential to successfully prepare for these roles and form the essential framework for the Associate Degree Nursing Program (NLN Council of Associate Degree Programs Task Force on Educational Outcomes of ADN Programs; Roles and Competencies, 1999). The eight core components are:
- Professional Behavior
- Communication
- Assessment
- Clinical Decision-Making
- Caring Interventions
- Teaching and Learning
- Collaboration
- Managing Care
Each core component is composed of several practice or outcome competencies; the successful demonstration of which form the basis for graduation from this NMSU-A program.
Nursing education will take place within the mainstream of collegiate education and will incorporate the physical and social sciences and the humanities with an emphasis in nursing knowledge and practice. The goal of nursing education is to prepare critically thinking, skilled nurses who act to promote, maintain, and restore wellness through collaborative partnership with other healthcare professionals, wellness care team members, clients and their families, and the community.
The faculty is committed to the creation of an educational climate that encourages students to attain their maximum potential and fosters originality, creativity, and intellectual inquiry. Therefore, the faculty will provide sequences of instruction and experiences to enhance learning by incorporating the three domains of learning: cognitive, affective, and psychomotor. Learning is facilitated from simple to complex; concrete to abstract, and direction-following to problem-solving. Attention is paid to individual styles of learning, talents, and the cultural experiences and backgrounds that can have a positive impact on the student=s educational experience. Both instructor and learner share accountability for learning and the responsibility for facilitating the process with the mutual recognition that differences exist among learners and within the same learner at different times. However, as an adult learner, the student is expected to take the responsibility for individual learning.
The nursing program consists of a holistic curriculum organized around life phases (adults, childbearing family, and children) and includes alterations in wellness related to the psychological, physical, and transpersonal domains. Ultimately, the aim of NMSU-A curriculum is to facilitate the student nurse=s caring and effective interaction with the whole person during a time in the life process when the clients readiness for change has been identified and a change in the level of wellness may occur.
The NMSU-Alamogordo Associate Degree Nursing Program is an eclectic mix of philosophical beliefs and theoretic ideologies taken from the following sources:
Benner, P. (1984). From Novice to Expert, Addison-Wesley Publishing Company: Menlo Park, California.
Dossey, B., Keegan, L., Guzzetta, C.E., & Kolkmeier, L.G. (1988). Holistic Nursing: A Handbook for Practice, 2nd Ed. Aspen Publication, Inc.: Rockville, Maryland.
Knowles, M. (1990). The Adult Learner: A Neglected Species. Gulf Publishing Company: Houston, Texas.
Leininger, M. (1988a). The Essence of Nursing and Health. Wayne State University Press: Detroit, Michigan.
Leininger, M. (1988b). The Phenomenon of Caring: Importance, Research, Questions, and Theoretical Considerations in Qualitative Research. Green & Stratton: Orlando, Florida.
Maslow, A. H. (1970). Toward a Psychology of Living. Van Nostrand: Princeton, New Jersey.
NLN Council of Associate Degree Programs (1990). Educational Outcomes of Associate Degree Nursing Programs: Roles and Competencies. National League for Nursing Press: New York.
NLN Living a Caring Based Program (1994). Ed. Ann Boykin. National League for Nursing Press: New York, NY.
NLN Teaching in the Community: Preparing Nurses for the 21 Century (1997). Ed. M. Elaine Tagliareni. National League for Nursing Press: New York, NY.
Roach, M.S. (1984). Caring: The Human Mode of Being: Implications for Nursing. Toronto: University of Toronto.
Swinford, P.A. & Webster, J.A. (1989). Promoting Wellness: A Nurse=s Handbook. Aspen Publications, Inc.:Rockville, Maryland.
Waters, V. & Limon, S. (1987). Competencies of the Associate Degree Nurse: Valid Definers of Entry-Level Nursing Practice. National League for Nursing Press: New York, NY.
Watson, J. (1985). Nursing: Human Science and Human Caring. Appleton Century-Crafts: Norwalk, Connecticut.
Approved as Philosophy and Framework by the Faculty Organization, November 21, 1991; Approved Revisions by the Faculty Organization, July 15, 1992; Approved Revisions by Curriculum Committee, September 17, 1992; Approved Revisions by Curriculum Committee, Spring, 1996; Approved Revisions by Curriculum Committee, November , 1997; Reviewed, Spring, 1998; Approved Revisions by Curriculum Committee and Faculty, 1999; Reviewed Summer 2000; Revised Summer 2001.
