Nursing as a Profession

Ram Sharan Mehta, Ph.D.Medical-Surgical Nursing

DepartmentB.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 withdead canvas or cold marble,compared with having to do with theliving body - the temple of God's spirit?

It is one of the Fine Arts;I had almost saidthe finest of the Fine Arts

- Florence Nightingale

• Profession is defined as "a vocation requiring advanced training and usually involving mental rather than manual work, as teaching, engineering, especially medicine, law“

-Webster1989.

Profession

• Professions are those occupations possessing a particular combination of characteristics generally considered to be the expertise, autonomy, commitment, and responsibility.

• A profession is an occupation based on specialized intellectual study and training, the purpose of which is to supply skilled 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.

• Is basically intellectual• 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)

Profession

Professions vs OccupationsProfessions

• College or University• Prolonged education• Mental creativity• Decisions based on science or

theoretical constructs• Values, beliefs & ethics integral

part of preparation• Strong commitment• Autonomous• Unlikely to change professions• Commitment > $ reward• Individual accountability

Occupations • On the job training• Length varies• Largely manual work• Guided decision making• Values, beliefs & ethics not

part of preparation• Commitment may vary• Supervised• Often change jobs• Motivated by $ reward• Employer is primarily

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 all 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: continually. • 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.

CollegialityStandard of ANA – Scope and Standards of Practice, 2004

According to Bruhn - 2001• Be civil• Be ethical• Be honest• Be the best• Be consistent• Be a communicator• Be accountable

•Be Be collaborativecollaborative

•Be forgivingBe forgiving

•Be currentBe current

•Be involvedBe involved

•Be a modelBe a model

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 intellectual 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 will be available for them.

What the Public Believes About Nursing

• RNs ranked highest among all 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 skills rather than critical thinking• Knowledge is power

Communicating with Physicians

• Factually 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 illness care• Nurses believe in themselves and their

colleagues

Barriers to Professionalism

• Variability in educational preparation• Gender issues• Historical influences• External conflicts• Internal conflicts

Thank you