A Trojan Horse for Positivism? Essay Example

MY Philosophy

Being an adequate nurse is comprised of both formal education and experiences in life. My spiritual walk with God has had a tremendous effect on my life and is primarily why I chose the profession of nursing. Christians are taught that their overall goal in life is to win souls for Christ and help those who are in need. As a nurse I am able to allow people to see Christ in me by being humble and caring. When I come in contact with my passions, I look beyond their illnesses and see them as normal person. The role of a nurse is varied. Sometimes nurses have to play the role of comforter, friend, teacher, and even mother. Being able to effectively do this, a nurse must have agape love. The type of love Jesus taught during his earthly ministry. Being a nurse is a calling. One can’t just decide that he/she wants to enter this profession. Consequently, there is a large turn-over number in the field. Many people enter the field for the prestige of being called a nurse, but are unable to meet the demanding requirements of the job because their heart was not in it.  My philosophy of nursing is quite simple. A nurse is someone who embraces the difficulty that the task will prove to be, is willing to put the health and well-being of a patient above his/her own needs, has empathetic and caring ways that are easily detected by the people he/she encounters, and is a great communicator. When a patient is aware of these qualities in a nurse that is serving him/her, the patient will be more apt be confident in the services the nurse is providing.

Influences

John Dewey was a key philosophical influence on Donald Schon’s theory of reflective practice.  Dewey believed that reflection was an important aspect of education. He believed that people should reflect the things that learned and did during each day of their lives (Kinsella, 2010).When Dewy refers to reflect, he is referring to reflective thought.  The foundation of Dewey’s theory is that when a person uses reflective thought, he/she is eliminating the possibility of making impulsive decisions by ensuring that decisions are followed by intelligent actions (Kinsella, 2010). This philosophy has influenced me the most because it reminds nurses to remain human. Often nurses can become robotic when they are dealing with patients on a hospital floor. They enter the patient’s room with specific questions and follow a generic routine. This reminds nurses to treat each patient as an individual and not just another patient.

Philosophical foundations directly influence the way in which I provide care to my patients. All nurses have a set of moral values that govern their logic and the decisions they make. Respecting others opinion and being tolerable of other’s differences. Nurses must have willingness “to listen, reliance on persuasion rather than force and emphasis on communication over agreement and truth” (Isaacs, Ploeg & Tompkins, 2009). First of all, a nurse must be able to exchange meaningful dialogue with each patient. This eases the anxiety that patients are feeling if they are dealing with a new experience or facing devastating medical news or conditions. Having a foundation that is built upon caring, empathy, and communication has influenced the choices I make when caring for patients. One example of when my foundation was tested occurred when I was working in the emergency room. I had a patient who came in after over dosing on crack cocaine. Many of the other nurses that I worked with were complaining that the patient comes in often for the same reason. Most nurses believed that the patient was to fault and had no sympathy. When I went in to give him a dose of medication to counteract the overdose, he began to talk to me and it was clear that he was so embarrassed by his actions. He immediately told me that he did not want to hear my reprimands. He went on to tell me how he wanted to quit using drugs, but it was just so difficult. He told me that his wife had recently died from cancer and that he had a very difficult time coping with that. Using drugs was his way of coping, but it quickly got out of hands. By the end of the conversation, he thanked me for listening and not judging him. After having this conversation with the patient, I relayed some of the details to my fellow nurses. None of the nurses knew his background. Evidently, he did not feel comfortable enough to share this information with the nurses who had cared for him previously.

I had another patient who was severely overweight. She often came for services that stem from her diabetes and hypertension. She admitted that she over ate every single day. It was difficult for me to understand this because she was an educated woman. She had been a professor at a local college. She knew the ramifications of being overweight. I asked her the same questions each time she came in. We had the same conversations which usually ended with her saying that she loved food. Eventually, she lost her job at the college because she was unable to render adequate services. She missed numerous days from work; However, because she was so intelligent and such an asset to the college, they allowed her to teach online classes for them. I had come to the end of my rope with her and almost hated to see her name on my patient load. Often I would swap with another nurse just to avoid looking at her slowly dying. I felt helpless. This went on for several months. Finally, we received a health clearing notification from our healthiness center. She was joining an exercise class. Upon reading the information she had filled out, I learned that she was given up for adoption at birth and has spent many years homeless. She stated that food was her weakness because for so many years she had lived without adequate food. Now that she could afford to buy what she wanted, she ate everything she had always wanted. I realized at that point, that one of my preconceived notions had crept into mind and caused me not to provide her with the care that I agreed to give all patients I encountered. My grandmother died of health complications induced by over eating. At the time of her death, she weighed nearly five hundred pounds.

What is Philosophy?

Many people define philosophy as a way of life or living. Each person has his/her own philosophy about different aspects of life, others, and self.  Philosophy is birthed in one’s mind by thought and thinking patterns. The relationship between one’s philosophy and knowledge development is that philosophy determines the degree to which one’s knowledge is developed. For example, if a person believes that having sex prior to marriage is wrong, the person that does not believe it is wrong will have a difficult time trying to convince him/her that it is right. This is evident in my nursing practice daily. Throughout the years of my nursing, I have assisted with the birth of an Arabic couple’s three children. The couple has a total of six children. The last pregnancy was very difficult for the patient. She experienced nausea throughout the pregnancy to the point of dehydration and also suffered gestational diabetes. She was placed on bed rest for the last six months of her pregnancy, which I know did not happen because she had five other children to take care of. During delivery, the patient’s blood pressure rose to extremely high readings and an emergency C-section was performed. When the patient was in recovery, a social worker came to speak to her about having her tubes tied, but she refused. The patient is forty-one. Due to the religious beliefs in their culture, she cannot take any form of birth control nor have her tubes tied. She explained to the social worker that her god would take care of her and that she would have as many children as he deemed fit to give her.  I felt this was wrong because I knew that her health and life were possibly in jeopardy. I tried to explain the possible health ramifications behind the issue, but I could not convince her that her life was in jeopardy.

Positivism & Post positivism

The aim of all nursing research should be to influence and improve nursing practices. Positivism and post-positivism are explanations as to why certain stereotypes developed in the medical field and today’s efforts to remedy those misconceptions.  According to Racher& Robinson, “Nurses hold beliefs and assumptions that provide the foundation for their nursing practice and underpin their research activities… Human beings are in a state of ongoing reciprocity with their environments” (Racher& Robinson, 2003).  If the theory of positivism and postpositvism is assumed correct, it can be inferred that the goal of research is to explain, predict, and control by making generalizations as a direct result of cause and effect relationships (Racher & Robinson, 2003).  Most researchers have rejected this notion because to accept it would be to agree that people are able to make observations and predictions without any outside influences. Nurses are influences by outside factors that can affect their work both directly and indirectly. Some of the influences nurses face are cultural, environmental, or just conditioned through acquaintances.

Some time ago, when I was completing my clinicals, I worked with a CNA that refused to bath any person of the Caucasian race. She would feed them, walk them, even change a soiled bed of theirs, but would not assist in bathing them. She proclaimed that she was not prejudice, but believed that all Caucasian people smelled of “wet dog” when they were wet. She said it was a stench that she could not rid herself of if she came in contact with one during the bathing process. Oddly, she would be able to discern if a Caucasian patient had recently been given a bath upon entering his/her room. I later found out that the CNA had been influenced by some environmental factors. When she was growing up in the South during the Civil Rights Movement, her mom was a domestic worker. Her mom did washing and ironing for several Caucasian families, which was customary during this time frame. One of the families had several dogs that lived inside their home. The CNA often reminisced about how much she hated washing their clothes because they would be covered in dog fur. She assisted her mother wash these clothes by hand and hang them on a line to dry. She recalled that no matter how hot the washing water was, a faint “wet dog” sent remained even after starching and ironing them. Hence, she developed the notion that all Caucasians smelled of “wet dog”.

The postpositive nursing theory proves more effective because in centers around a collaborative relationship between the care giver and the patient. Often stereotypes and tainted notions can be dispelled when the two parties have a discussion. It would be of great benefit if researchers could work closely with nurses. The nursing field is one that is fast paced and demanding. I believe a researcher can learn more from being in the field than sitting at a computer reading and analyzing data. Nonetheless, first-hand experience will not eliminate all preconceived notions.

“The limitations of post-positivist approaches generally relate to the interactive and participatory nature of qualitative methods. In these types of studies, the researchers are, by design, close to the investigation. While attempts have been made to remove researcher bias from this investigation through peer review, a standing criticism of qualitative methods is that they are the interpretation of the research team and lack the ability to be reproduced or generalized” (Giddings & Grant, 2007).

Consequently, there is a trend of restoring positivism research methods.

Conclusions

In conclusion, my personal philosophy of nursing is that a nurse’s primary function is to give care. I believe that nurses must have certain characteristics in order to successfully provide care to patients from all walks of life. Nonetheless, nurses must be aware that their actions are influenced by various aspects of their lives from culture to childhood upbringings. Nurses must be aware when preconceived notions may be altering their thought or mode of care. Likewise, patients also have preconceived notions that can affect their willingness to receive care from a healthcare provider. The most important factor of nursing is remembering that the patients are human beings, not just room or bed numbers. Rorty described it best when he said, “Nurse scientists are interested in: that which has most meaning to the patient as much as to the nurse – the recognition of the person and of whatit means to be human” (Isaacs, Ploeg & Tompkins, 2009).

References

Giddings, L. S., & Grant, B. M. (2007). A trojan horse for positivism? A critique of mixed methods research. Advances in Nursing Science, 30(1), 52-60.

Isaacs, S., Ploeg, J., & Tompkins, C. (2009). How can rorty help nursing science in the development of a philosophical ‘foundation’?. Nursing Philosophy, 10(2), 81-90. doi:10.1111/j.1466-769X.2008.00364.x

Kinsella, E. (2010). Professional knowledge and the epistemology of reflective practice. Nursing Philosophy, 11(1), 3-14. doi:10.1111/j.1466-769X.2009.00428.x

Racher, E & Robinson, S. (2003). Are phenomenology and postpositivism strange bedfellow? Western Journal of Nursing Research, 25(5) 464-481.