As a registered nurse, I am in a profession that has marked confusion as to what it really means to be a nurse. The general public and even nurses themselves truly do not understand what their job is. Clarification of nursing as a profession will have a positive effect on the nurse’s and patient’s view of nursing as a true profession (Kearney-Nunnery). To fully understand my view of nursing and myself as a nurse I must examine my philosophy of nursing, my professional status and future goals. The purpose of this paper, is through self examination and literature analysis, is to understand myself as a part of the nursing profession and to help provide a clear idea of what nursing means.
According to Kearney-Nunnery, a philosophy of nursing represents a particular nurse’s belief system, the nurse’s personal definition of nursing (2008). Philosophy can be thought of as each individuals unique idea of what the term nursing encompasses. Understanding how one views their profession helps to strengthen the profession by causing that individual to relate on a personal level with their career and colleagues. Philosophy is considered to be the first part of the hierarchy of modern nursing knowledge (Kearney-Nunnery, 2008). Each nurse holds a different philosophy of their profession. The nurse’s setting, client population, and role shape the meaning of nursing. Considering the variety that the nursing profession consists of, it is an accurate assessment that nursing is a mosaic of uniqueness and individuality. To grow as a professional nurse one must assess their own belief system to contribute to the growth of nursing as a profession and to provide the consumers of nursing care with an accurate representation of what nursing means.
An interactive class exercise was completed to help evaluate individual nursing philosophy. The exercise assessed my view of the recipient of care, the environment, personal definition of health, personal definition of nursing, and assumptions concerning professional nursing. I view the recipient of care as an the individual and the family involved, or anyone in direct contact with the patient. To me the environment is the physical, emotional and spiritual setting. Health is perceived to be the overall general physical, social, psychosocial, and spiritual wellbeing of an individual. Human beings need the nursing care that I provide to restore and maintain their health and maximum functionality. On a personal level nursing means helping to care for the whole person in a compassionate manner. The exercise involved stating what the concept of people means to nurses and characteristics associated with nurses. To me people represent the client population. Characteristics that I associate with nurses are critical thinking, compassion, competence, caring, determination, respect, and creativity. Nursing is a unique profession because nurses provide direct patient care and they begin to learn their patients and are able to watch the patient progress. This assignment started my self assessment of my professional philosophy. Understanding how I feel about my profession allows me to identify my feelings and declare my standing. Developing my philosophy opens the door for personal and professional growth that will enhance the care that I provide to my patients.
Nursing is a broad term that has various meanings to me. When I hear the word nurse, I automatically think of helping people. The image of a compassionate and caring individual enters my head. I see someone who is confident and their primary concern is for the patient. Nurses are like guardian angels in a way. During the shift the nurse guards and monitors her patient’s status, all with one goal to provide the best of care to the individual. I consider nurses to be a vital link between the patient and their healthcare provider. As a nurse I carry out doctor’s orders within reason. I feel that it is necessary to question orders that compromise the safety of the patient. Nurses are not doctors and should not diagnose or self treat a patient without a doctor’s orders. Several patients have asked exactly what is a nurse. I often reply that a nurse is an order processor. I read my orders, check them for relativity, validity, contraindications and error. Nursing is a wide open profession, with many avenues for careers. Each setting that the nurse works in shapes his or her view of the nursing profession. A floor nurse holds a different philosophy than an emergency department nurse, thus creating the mosaic of nursing. As a new nurse, I am still building on my philosophy. I have limited clinical experience to draw from. In my opinion experience is what makes a nurse. All the books in the world do not hold the value of experience.
My philosophy and professionalism in nursing are very weak at this moment. I need to strengthen these areas in order to fully become a member of the nursing community. To strengthen these areas I need to understand what constitutes nursing as profession. In doing so I need to evaluate my professional status along with the characteristics of the nursing profession.
According to Kearney-Nunnery, the nursing profession is unique and nurses must disclaim traditional analysis of professional and professionalism by other disciplines as the only method to determine definitions and characteristics of professionalism in nursing (pp. 7, 2008). Nine categories are considered as the characteristics of professional nursing. The first of the categories is educational background. “ The educational background required for professional practice is tailored to ensure safe and effective care” (pp., 2008). The education required for entry level nursing varies. Mainly an associate degree in nursing or diploma education are required. Educational opportunities extend up to the doctoral level. The curricula of each program are guided by national standards. Adherence to a code of ethics is the second characteristic associated with professional nursing. It is important that all nurses be familiar with the code of ethics and allow the code to guide their practice. Kearney-Nunnery noted that most professional nurse respondents did not have a copy of the ethical code, and many were unfamiliar with the document (pp. 8, 2008). This a disappointing finding. Another characteristic pertaining to the nursing profession is participation in professional organizations. Participation is quite important because these organizations bring nurses together and allow for collaboration on key issues, nationally and internationally. The fourth characteristic encompasses continuing education. Nursing is an ever changing profession that requires nurses to keep up with the latest information. “Remaining current with ideas presented in the nursing and scientific literature is an important component in continuing competency as a professional and to incorporate evidence based practice” (pp.8, 2008). Communication and publication are labeled as the fifth characteristic of professional nursing. This category stresses the importance of communicating new ideas within the profession (pp.8, 2008). Autonomy and self regulation are considered to be the sixth characteristics. Being autonomous is important because nurses need to practice independently within the scope of their practice. Community serve has been suggested as the seventh characteristic. Reaching out to the community with health promotion and prevention are vital in the preservation of wellness. Theory constitutes the eight characteristic. Various theories exist concerning the nursing profession. The final characteristic is evidence based practice. Kearney-Nunnery considers evidence based practice to be the integration of the best research with clinical expertise and the client’s values for optimum care as well as participation in learning and research activities (pp. 11, 2008). Meeting the nine characteristics of professional nursing are vital in maintaining professionalism. Each nurse should evaluate their practice in each of the mentioned areas to refine professionalism and further the growth of nursing.
A class assignment required me to complete a self assessment of my professionalism in nursing. The assessment questioned my educational background, knowledge of codes of nursing, continuing education pursuits, literature review, research participation, publications, autonomy, future plans and participation in professional organizations. I graduated from an Associate Degree Nursing program that was very clinical oriented. Theory was taught and applied during theory. I considered this a strength, as I was able to see theory in practice and gained a better understanding of many nursing concepts. I realized that I have a moderate understanding of the American Nurses Association’s Code of Ethics for nursing and that I use it in practice. To my dismay, I am currently not involved in any professional organizations. I need to become more involved. Professional organizations maintain and assist in further growth of a profession. The phrase “Strength in numbers,” describes the importance of organization membership. I have done minimal amounts of continuing education, just enough to maintain my license. As a new nurse, I realize that I need to actively seek educational opportunities to broaden my knowledge base and build my experience. Occasionally I read scientific journals pertaining to nursing and evidence based practice. Future plans for me include finishing my bachelors degree, becoming a nurse practitioner, and obtaining membership in professional nursing organization. Autonomy describes me. I am a self starter. I do not have any publications nor have I participated in any research trials. My self assessment reveals that as a new nurse I am weak in professionalism and need to work on many areas in order to build my professional status.
Analyzing my practice in concordance with nine characteristics of professional nursing reveals several strengths and weaknesses. I have a strong educational background. My institutions prepared with me the knowledge of theory and the clinical experience to support that knowledge. Autonomy is a strong point in my clinical practice. Participation in professional organizations, publications and communications, and research participation are weaknesses. I currently am not involved with any professional nursing organizations. Only having my nursing licenses for four months, I have not participated in research or published any materials. From this assessment I see that it is important to allow the nine characteristics of nursing to guide my practice to ensure the best care for my patients and enhance the growth of the profession. To fully understand professionalism in nursing, it is advantageous to research what is already known about the topic. Conducting a literature review will allow me to develop an informed definition of professionalism and to identify areas that may need further research.
A literature search and review was conducted to find out what information existed on professionalism and nursing Online databases where queried in order to obtain peer reviewed articles that were relevant to my research. Searching for nursing and professionalism via EBSCO HOST through the Williamson Randall Library eResources returned 213 results. Results were peer reviewed articles ranging from 1979 to 2009. After skimming several of the articles, five were chosen based on their currency and relativity.
The article by Hwang, Lou, Han, Cao, Kim and Li presents the most recent information concerning professionalism in nursing. Professionalism is described as how nurses perceive their work and professionalism serves as guide to a nurses practice to maintain patient safety and to provide the best care (Hwang et. al, 2009). Hwang et. al notes that the attributes of nursing professionalism encompass education, training, theoretical knowledge based skills, a code of ethics, professional organization, and community service (2009). These attributes are what distinguish nurses from other professional workers (Hwang et. al, 2009). It is noted that increased commitment to the nursing profession leads to a higher level of professionalism and satisfaction in the work place (Hwang et. al, 2009). In summary, this article portrays professionalism as a adhering to a code ethics, providing community service, involvement in professional organizations, education, and theory, in order to ensure patient safety and maintain satisfaction among nurses.
The article by Rutty discusses what the term profession means and how this relates to professionalism. (1998). According to Rutty a profession is a controlling occupation which has a status of superiority and precedence within a division of work (1998). Professionalism is considered to be the process in which occupations move through in order to become a profession (Rutty, 1998). A profession is considered to have certain components. Rutty notes that a unique body of knowledge, altruistic service, a code of ethics to govern practice, lengthy socialization and autonomy of practice are the characteristics of the nursing profession. The article describes each characteristic in detail as to what it means. Two major factors are noted as the way to strengthen and expand nursing as a profession. Rutty states that expansion of knowledge base and colleagueship among the medical profession are necessary in order to grow the nursing profession. This article mentions how much time and effort that nursing has contributed to the subject of professionalism and the controversy that has been generated by these efforts.
The third article by Fetzer it is noted that Nursing leaders have stressed the need for professional attitudes and behaviors among members of the profession since the end of the 19th century (. This demonstrate the importance and relevance of professionalism in nursing. Many definitions of professionalism have been suggested since this time. Fetzer notes that professionalism is not an all or nothing concept, rather it is many pieces that come together as the profession grows (2003). Five attitudes are used to describe professionalism, belief in public service, participation in professional organizations, sense of calling to the profession, self regulation, and autonomy. Fetzer discusses the difference in professionalism among associate degree nurses and baccalaureate prepared nurses (2003). RN-BSN students have already developed a sense of professionalism before the baccalaureate program due to working and going to school simultaneously. Baccalaureate students have not yet developed this sense of professionalism due to the limited clinical practice. A strong point of this article is that it examines the levels of professionalism in the nursing profession and how important professionalism is to nursing.
The fourth article by Servodidio reviews how to maintain professionalism in daily clinical practice (2008). Servodidio reports that nursing scored higher than any other healthcare profession on the Today/Gallup Poll for public perception of honesty and ethics (2008). This article considers components of professionalism to be treating patients with kindness, dignity and respect (2008). A survey was conducted and the results revealed a significant relationship between professionalism and nursing experience (Servodidio, 2008). It is recommended that professionalism should be instilled in nursing students from the very beginning of training (Servodidio, 2008). Participation in professional organizations is stressed as a key method in developing professionalism. Several suggestions are mentioned in the article on how to enhance professionalism. Among the methods mentioned are to be timely in work, open communication, being self-sufficient, and maintaining a positive attitude (Servodidio, 2008). To me this article was very beneficial because it was easy to understand. I gained a better idea of how to enhance professionalism in my practice. The terminology was easy to manipulate and I did not get bogged down trying to look up words that I did not understand. The article is very applicable to clinical practice.
The final article by Pinkerton addresses the future of professionalism in nursing (2001). Pinketon notes that their are six characteristic commonly used to assess whether a job is a profession: educational background, having a code of ethics, receiving compensation commensurate with the work, being organized to promote a needed service, having autonomy in practice, and being recognized by the government with licensure (2001). Many of these characteristics have been recognized in nursing for many years (2001). A broad base of nursing knowledge has been developed over the years which supports nursing education. The idea of a code of ethics dates back to the 1900’s (Pinkerton, 2001). Registered Nurses are required to obtain a license to practice. Autonomy is present in nursing. In clinical practice nurses must exercise autonomy in making clinical judgements. Pinkerton notes that compensation has lagged behind the other attributes of a profession (2001).
Professionalism has many definitions and various characteristics are employed to distinguish a profession. A commonality noted in the five articles reviewed are autonomy, self regulation, education and knowledge and a code of ethics. These four characteristics remained constant through my literature review. Compensation and liscensure were only mentioned by Pinkerton (2001). Hwang, Lou, Han, Cao, Kim and Li offer the most current view on professionalism and the definition that I identify with. After reviewing the articles I have developed my own definition of professionalism. Professionalism consists of various components that may or may not all be present. As a profession grows, the more characteristics are present. The characteristics of a profession, to me, are education, training, a knowledge base, adhering to a code of ethics, communication, altruistic service, professional organizations, and honesty and integrity. Nurses should strive to maintain professional behavior and allow the characteristics of professionalism to guide their clinical practice. a part of professionalism is preparing for the future. Planning for the future allows the nurse the chance to grow in the profession and aid professional growth.
Nursing is a career pathway that offers many avenues. One can work in a hospital, from home, doctors office, or school. The possibilities are endless. As for me, my future plan for my nursing career is to someday become a nurse practitioner. I am not sure what field that I would like to specialize in yet. From this assignment and other class assignments I see that my professional status is weak. These assignments have been beneficial to me because they have allowed me to understand what professionalism is and how that I need to change my practice to aid in the growth of the nursing profession. Self assessment is the key for personal growth and this is what the assignments helped me to do. The areas that I need to improve in are participation in professional organizations and choosing continuing education for my own personal interest and not just doing the minimum. I plan to join the American Nurses Association as a way to become involved in organizations. For my continuing education I am going to meet my requirements and then make an effort to keep up with scholarly reading and remain current on the latest in clinical nursing profession. Conduction the literature review helped to gain the skills necessary to read peer reviewed articles and understand the content as well as apply them to my professional career. With little experience in literature reviews, this gave me a chance to conduct a search, skim the articles and choose the ones that were most relevant to my search. Being able to sort through and understand scholarly journal articles is necessary to grow as a nurse.
The purpose of this assignment was through self examination and literature analysis, is to understand myself as a part of the nursing profession and to help provide a clear idea of what nursing means. Through the class exercises I conducted a self assessment. I was not aware of this while I was doing the work. When I read the results I realized what the questions were doing. I learned what my strengths and weaknesses were in regards to professionalism and began to craft my personal philosophy of nursing. In conclusion I see myself as a part of the profession and now have a better understanding of what nursing means. I can answer my patients honestly now. Nursing means being educated, remaining current with the latest research, following a code of ethics, assisting with research, providing the best care possible and maintaing patient safety. To sum it all up, nursing is the model of compassion and caring.
References
Fetzer, S. J. (2003). Professionalism and Associate Degree Nursing Students: The Role of Self Actualization. Nursing Education Perspectives, 24(3), 139-143. Retrieved on October 8, 2010 at EBSCO Host.
Hwang, J. I., Lou, F., Han, S. S., Cao, F., Kim, W.O., & Li, P. (2009). Professionalism: The Major Factor Influencing Job Satisfaction Among Korean and Chinese Nurses. International Nursing Review, 56(3), 313-318. Retrieved on October 8, 2010 at EBSCO Host
Kearney-Nunnery, R. (2008). Advancing Your Nursing Career: Concepts of Professional Nursing. Philadelphia: F.A. Davis Company.
Pinkerton, S. (2001). The Future of Professionalism in Nursing. Nursing Economics, 19(3), 130-131. Retrieved on October 8, 2010 at EBSCO Host.
Rutty, J. E. (1998). The Nature of Philosophy of Science, Theory, and Knowledge Relating to Nursing and Professionalism. Journal of Advanced, 28(2), 243-250. Retrieved on October 8, 2010 at EBSCO Host.
Servodidio, C. A. (200). Maintaining Professionalism in Your Daily Nursing Practice. ONS Connect, 23(4), 19. Retrieved on October 8, 2010 at EBSCO Host.
