Nursing as a Profession Ram Sharan Mehta, Ph.D. Medical-Surgical Nursing Department B.P. Koirala Institute of Health Sciences
• One of my favorite quotes: Nursing is an art; and if it is to be made an art, it requires as exclusive a devotion, as hard a preparation, as any painter's or sculptor's work; for what is the having to do with dead canvas or cold marble, compared with having to do with the living body - the temple of God's spirit? It is one of the Fine Arts; I had almost said the finest of the Fine Arts - Florence Nightingale
• Profession is defined as "a vocation requiring advanced training and usual y involving mental rather than manual work, as teaching, engineering, especial y medicine, law“ -Webster1989.
Profession • Professions are those occupations possessing a particular combination of characteristics general y considered to be the expertise, autonomy, commitment, and responsibility. • A profession is an occupation based on specialized intel ectual study and training, the purpose of which is to supply skil ed services with ethical components and others.
Occupation • Training may be on job and duration varies. • The values, beliefs, and ethics are not prominent features. • The commitment and identification: varies. • In occupation people often change Job. • Accountability rest on employer.
Profession • Is basical y intel ectual • Is based on a body of knowledge that can be learned. • Is practical rather than theoretical. • Can be taught through a process of professional education. • Has a strong internal organization of members. • Has practitioners who are motivated by altruism (desire to help others)
Professions vs Occupations Professions Occupations • College or University • On the job training • Prolonged education • Length varies • Mental creativity • Largely manual work • Decisions based on science or • Guided decision making theoretical constructs • Values, beliefs & ethics not part • Values, beliefs & ethics integral of preparation part of preparation • Commitment may vary • Strong commitment • Supervised • Autonomous • Often change jobs • Unlikely to change professions • Motivated by $ reward • Commitment > $ reward • Employer is primarily • Individual accountability accountable
• Genevieve and Roy Bixler, a husband and wife team of non-Nurses who were nevertheless advocates and supporters of nursing, first wrote about the status of nursing as a profession in 1945
• They appraised nursing according to theire original seven criteria, noting the progress made in nursing, as a profession.
• Abraham Flexner (1910), conducted study of medical education and went on to study other disciplines and latter, in a paper about social work published a list of criteria that he felt were characteristics of al true professions. Flexner's believed in professional work
Criteria of profession: Abraham Flexner (1916) • Intellectual (opposite of physical). • Based on body of knowledge, that can be learned. • Practical rather than theoretical. • Can be taught through a process of professional education. • Has a string internal organization of members. • Has practioner
William shepherd (1948): • Based on scientific principles. • Demands: adequate pre-professional and cultural training. • Demand: specialized and systematized knowledge. • Must give: evidence of needed • Scientific technique: tested experiences. • Time judgment / duty Performance. • Beneficial work. • Group consciousness: scientific knowledge. • Sufficient self impelling power. • Obligation to society: code of ethics.
Kelly: - 1981 • Service provided is vital to humanity and welfare of society. • Special body of knowledge: continual y. • Intellectual activity: accountability. • Educated in institutions. • Relatively independent: autonomy. • Motivated by job / service. • Code of ethics: to guide decisions. • Organization (association): to encourage and support practice.
Collegiality Standard of ANA – Scope and Standards of Practice, 2004 According to Bruhn - 2001 • Be civil •Be collaborative • Be ethical • • Be honest Be forgiving • Be the best •Be current • Be consistent •Be involved • Be a communicator •Be a model • Be accountable
Nursing is gaining recognition as a profession based on the criteria that a profession must have: - • A well defined body of knowledge. • A strong service orientation. • Recognized authority by a professional group. • A code of ethics: ICN. • A professional organization that sets standards: NNC / NAN. • On going research. • Autonomy. Hence, nursing is a Nobel profession, Recognized internationally.
1. A profession utilizes in its practice a wel- defined and wel-organised body of specialized knowledge. 2. A profession constantly enlarges the body of knowledge it uses and improves its techniques of education and service by the nurses of the scientific method. 3. A profession entrusts the education of its practitioners to institutions of higher education.
4. A profession applies its body of knowledge in practical services which are vital to human and social welfare. 5. A profession functions autonomously in the formation of professional policy and control of professional activity thereby.
6. A profession attracts individuals of intel ectual and personal qualities who exalt service above personal gain and who recognize their chosen occupation as a life work. 7. A profession strives to compensate its practitioners by providing freedom of action, opportunity for continuous professional growth and economic security
Image Makers of Nurses • Nurses of America Campaign – convey to public that RNs are expert clinicians – raising consciousness of invisibility of nursing in the news media
Public Concern with Nursing • What is the image of nursing being created today? • Saint vs. Sinner image • “Can I trust my life to this RN? • Public want to believe that knowledgeable, caring, committed and dedicated RNs wil be available for them.
What the Public Believes About Nursing • RNs ranked highest among al professions for the highest professional standards of honesty and ethics • Public seek advice in 4 areas: – self-care or immediate post op care – health care products – administration and SE of prescription drugs – interpreting physician-provided information
Business Model of Health Care • Shift from altruistic to business model – Mismatch: nursing care marketed and nursing care provided • Competitive Marketplace – scarce resources – unlimited wants
Nursing’s View • Female dominated by persons socialized to be anti-intellectuals • Focus on skil s rather than critical thinking • Knowledge is power
Communicating with Physicians • Factual y document medical problems in patient care terms • Stay on the issue, not personality • Appropriate communication – do not allow inappropriate interruptions
Creating a New Image • Nurses value nursing and image it daily • Nurses take themselves seriously and dress the part • Nurses recognize the value of caring, health promotion, health teaching, and il ness care • Nurses believe in themselves and their colleagues
Barriers to Professionalism • Variability in educational preparation • Gender issues • Historical influences • External conflicts • Internal conflicts