Medicine has been my profession since my early age. I graduated from Medical Science University of Cuba, as in General Medicine 24 years ago, but my specialty has always been Internal Medicine. In 2008 I came to this country looking for new opportunities to continue contributing my knowledge in the healthcare profession and providing the care human society needs. In 2011 I decided to study at the University of the Sacred Heart of Puerto Rico, graduating with a Bachelor degree in 2013. I have been practicing as a Nurse in Critical Care and Telemetry for almost 6 years. I currently work as a Supervisor and decided to improve myself in this country full of opportunities to anyone that’s wants to take its advantage, since I have always wanted to become a “Family Nurse Practitioner”. This school has given me the possibility to continue studying to achieve my goals and fulfill my dreams. My profession is my biggest enjoyment and during all this time it has given me its benefits. Interacting with patients and comprehending their different personality it has increased my apprehension in my everyday living.
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During my career in Cuba, I went through many experiences and tough decision some were good and others sad, but always leading to my full potential and proving the best I could. As of right now I am working in a respiratory Hospital, in which I have to evidence and treat many different cases each day. Being part of this career is what I always wanted to do in my life. Providing the care to someone’s needs makes me feel complete as a health care professional. Nevertheless, I have decided to continue this magnificent career expanding my knowledge to the next level. Family Nurse Practitioner is my biggest dream it elaborates the ability of learning and doing more as a healthcare professional. It will be my biggest success knowing that becoming a Family Practitioner; will enhance my skills by providing the best healthcare services to the community. Thanks to computer expertise’s and technologies advances I am able to take online classes and fulfill my dreams as a Family Practitioner.
Four Metaparadigms of Nursing
Nursing is one of the oldest professions in the world that revolves around caring for the sick and bringing them back to health. Despite the differences in cultures, timelines, and geographical locations, the basic principles of nursing appeared to have transcended the borders of space and time. Evidence-based nursing identifies these principles as four metaparadigms of medicine: Health, Nursing, Person, and the Environment. The purpose of this paper is to identify, discuss, and document my personal perspective on these major concepts.
Identification of the Four Metaparadigms
Nursing is the first metaparadigm of medicine, which establishes a relationship between all the parties involved, with a high degree of emotional attachment (Alligood, 2017). The concept defines the responsibility of a nurse to use all of their knowledge and skill to achieve a lasting state of physical, emotional, and cultural well-being.
The second metaparadigm is that of Person, which is very important in medicine, as it defines the object of the discipline’s existence (Alligood, 2017). It acknowledges the inherent value of every individual, which is not affected by appearance, age, race, gender, and social background.
The third metaparadigm is Health, as it identifies the physical and psycho-emotional states of the patient while making an important distinction between health, illness, and disease (Kelly, Dowling, & Millar, 2018). The concept of Health is different from that of well-being, as the former is an objective term, whereas the latter describes the patient’s subjective assessment of oneself. Illness and disease share a similar relationship when it comes to definitions.
Finally, the fourth metaparadigm is the Environment, which acknowledges the influence of numerous external factors on a patient’s health (Alligood, 2017). It also accounts for not only the immediate physical environment surrounding the patient, but also the abstract surroundings, such as the economic, ethical, and psychological spheres of influence.
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Discussion of the Importance of Paradigms
The four metaparadigms of nursing form not only the basis for the practice as a whole but also a framework for nearly every existing theory of medicine. Although these theories have different views and approaches that define their application, all of them begin with addressing their perception of the pillars of nursing (Alligood, 2017). No matter the definition, these concepts cannot be excluded from the practice, as the entire discipline would then fail to make sense. Nursing, Patient, Health, and the Environment are always at play when someone is performing a nursing duty, be it a civilian assistant or a highly-trained professional nurse.
Documentation of Personal Perspective
I have a clear view of the four metaparadigms of nursing and can imagine the ways to apply them in my practice. As a nurse, I will implement the first concept by providing physical and emotional care to my patients while using all of my available knowledge and skills to bring them back to health. The Person paradigm, for me, means a focus on patient-centered care and innate respect of their individuality, which will not be affected by their personal characteristics. The concept of Health will be my end goal, as I would want all of my patients and their communities to be healthy and well. Lastly, I would influence the surrounding environment in accordance with best practices and clinical guidelines, while reaffirming my commitment to patient-centered care by changing the abstract environments through advocacy and affirmative action. The implementation of the four metaparadigms will help me become a better nurse.
I believe that all the four metaparadigms are to be addressed with responsibility to ensure the best patient outcomes. Therefore, the concept of accountability is vital for every nurse. The concept emphasizes the importance of being responsible for one’s “judgments, actions, and omissions as they relate to lifelong learning, maintaining competency, and upholding both quality patient care outcomes and standards of the profession” (Krautscheid, 2014, p. 46). In other words, all nurses are to be held accountable for the consequences of their decisions. Therefore, they should commit to professional development in order to use the latest knowledge to ensure the best quality of care. In short, I believe that accountability is the cornerstone of evidence-based practice.
Due to the tendency towards patient-centricity in model healthcare, the concept of advocacy becomes central. According to Abbasinia, Ahmadi, and Kazemnejad (2019), patient advocacy means safeguarding, apprising, valuing, mediating, and championing social justice in the provision of healthcare. Indeed, nurses are to be able to protect their patients from incompetency, provide complete information about the diagnosis, treatment, and prevention, and respect patients’ values, culture, beliefs, and preferences. Nurses are expected to be the voice of their patients to communicate their interests with all the other care providers. Nurses should also be vocal about any injustice in policies or rules for all the patients being fairly treated. In brief, advocacy is central for patient-centered care since it ensures that patients’ interests are a top priority.
- Nurses are to be held responsible for the outcomes of their clinical decisions.
- A life-long commitment to learning and professional development is vital for evidence-based practice
- Nurses should aim at protecting their patients from medical errors, misconduct, or ill judgment of their co-workers.
- Nurses are to respect the diversity of the patient population and communicate all the preferences and values of their patients to other care providers.
- Nurses are expected to evaluate all the administrative regulations to ensure that rules do not discriminate against any population group.
Present Clinical Example
In my nursing career, I do my best to adhere to all the principles of accountability and advocacy. For example, one of my patients was a Jehovah witness, which meant that he was firmly against blood transfusion. However, he was scheduled to undergo surgery, which may have needed a blood transfusion in case of an emergency. I refreshed my knowledge about blood management in perioperative care and read the article by Baikady and Eeles (2017) to make sure I have the latest knowledge in the matter. After that, I informed the patient about the possible consequences of the rejection with due respect to the patient’s values and beliefs. I informed all the concerned staff about the preference and made appropriate notes in the documentation. In simpler words, I used the concept of advocacy for my patient and accountability for translating the latest knowledge.
Personal philosophy is of extreme importance for nurses since it helps to identify the key concepts which should guide the decision-making process. My nursing philosophy is a fusion of metaparadigm and the concepts of accountability and advocacy. My working experience has confirmed that this approach is the key to the best patient outcomes, improved patient satisfaction, and professional development. Moreover, the principles described in the present paper adhere to the idea of patient-centered evidence-based care.
Abbasinia, M., Ahmadi, F., & Kazemnejad, A. (2019). Patient advocacy in nursing: A concept analysis. Nursing Ethics, 096973301983295.
Alligood, M. R. (2017). Nursing theorists and their work. New York, NY: Elsevier Health Sciences.
Baikady, R., & Eeles, A. (2017). Peri-operative blood management. Indian Journal of Anaesthesia, 61(6), 456.
Kelly, M., Dowling, M., & Millar, M. (2018). The search for understanding: The role of paradigms. Nurse Researcher, 25(4), 9-13.
Krautscheid, L. (2014). Defining professional nursing accountability: A literature review. Journal of Professional Nursing, 30(1), 43-47.