Professionalization of Nursing

• What is nursing?• Is nursing an art or science?• Is nursing a profession or an

occupation?• What factors are affecting the

emerging of nursing as a profession?

• Does nursing posses a unique body of knowledge?

Why define Nursing???

• Defines parameters of the profession• Clarifies purposed and functions of the work• Guides educational preparation• Guides research and theory development• Provides visibility and value to general public

and policy makers

Definition of Nursing

• No single definition even by nurses themselves• A major factor in difficulty is that it is taught as

encompassing theories and practical aspects, but it is pursed primarily through practice

• Early definition: the nurse is a person who nourishes, foster and protect a person who is prepared to care for the sick, injured and aged.

• "put the patient in the best condition for nature to act upon him" Nightingale, 1954.

• Have been affected by technology• Art and science• Art: composed of skills that require expertise

and proficiency for their competent education.

• Science: requires systemized knowledge derived from observation, critical thinking, study and research

Nursing and the title "profession"

• The meaning of professionalism has been a subject of debate for many years

• Evidences suggested that from an early dates the word "profession" was associated with nursing

• Some critics believe that nursing fall short of fulfilling a professional role.

• Other nurse are working to advance the standing of nursing by: development of a code of ethics, standards of practice

Each nursing theorist had own definition

• Nightingale: to put the patient in the beast condition

• Peplau: interpersonal process involving interaction between 2 or more individuals

• Wiedenbach: helping, nurturing, caring services

• Abdellah: service to individuals, families, and society based on an art and science.

• Henderson: Assist the individual (sick or well to carry out activities)

• Watson: the central focus in nursing is caring

Orem: Nursing is concerned with the individual needs for self care action

Critical Thinking Assignment

• Develop your own definition of nursing and discuss it on the electronic discussion board (compare it to those of theorist and to those of your classmate)

Characteristics of a Profession

• Abraham Flexner – Early 1900’s• Richard H. Hall – 1968• Task Force on Professionalism -

2000

Abraham Flexner

• Intellectual (as opposed to physical)• Body of knowledge through research• Practical as well as theoretical• Highly specialized professional education• Strong internal organization of members• Altruism (a desire to provide for the good of

society) be the motivating force of group members

Richard H. Hall

• Professional organization• Belief in value of public service• Belief in self regulation• Commitment beyond economic incentives• Sense of autonomy in practice

Task Force on Professionalism

• Prolonged specialized training• Service orientation• Ideology based on original faith• Binding ethic• Unique body of knowledge• Technique formed by set of skills

Task Force on Professionalism (con’t)

• Guild of those entitled to practice• Licensure or certification• Recognized setting• Theory of societal benefits

Major Similarities

• Service/altruism

• Specialized knowledge

• Autonomy/ethics

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

Distinguishing Nursing from Medicine

The purposes and goal of each professionThe educational preparation

Medicine Nursing

Concerns Dx, Tx, cure caring

Education 6 years 4 years

Historically Men women

Evolution of a ProfessionProfessionalization

• Practitioners perform full-time work in the discipline• Determine work standards, identify a body of knowledge and establish

educational programs• Promote organization into effective occupational associations

(licensure/certification)• Establish codes of ethics

Barriers to Professionalism

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

What about Nursing???

Profession

or

Occupation

Nurses Code of Ethics

– American Nurses Association– 9 provisions– Fundamental values and commitments of the

nurse– Boundaries of duty and loyalty– Duties beyond patient encounters– Entire document at:www.nursingworld.org/ethics/code/ethicscode150.htm

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

Collegiality (con’t)

• Be collaborative• Be forgiving• Be current• Be involved• Be a model

Nursing as a Profession: Status Today

1. Theory

2. Social Values

3. Education

4. Motivation

5. Autonomy

6. Commitment

7. Community

8. Code of Ethics

International and local Nursing Organizations

1. American Nurses Association (ANA)2. Canadian Nurses Association (CAN)3. National league for Nursing (NLN)4. International Council of Nurses (ICN)5. Jordanian Nursing Council (JNC)6. Jordanian Nurses and Midwives

Council (JNMC)

Nursing in Jordan

• Nursing in Jordan has developed rapidly especially since the seventies. It has achieved a good status compared to other countries in the region.

• This development was supported by – affiliating schools of nursing with universities; – the emergence of baccalaureate programs which

led to the preparation of nurses at the higher education level and

– the identification of entry level to nursing practice as well as the emergence of strong leadership.

• Educational and health institutions have provided golden opportunities for nurses to seek their higher education or specialization in nursing outside the country .

Nursing in Jordan

• These achievements were pursued by the unity of committed nurses in the absence of a strong regulatory body prior to 2002.

• The perseverance of the group, the strong political leadership commitment and the support of the public led to the foundation of the Jordanian Nursing Council in 2002 with the solid support and commitment of Her Royal Highness Princess Muna Al Hussein, the shaker and mover of health and nursing issues at the national, regional and international levels.

Reference• Chitty, K.K. (2005). Professional nursing:

Concepts and challenges. 4th ed. Philadelphia: Saunders.

• Fadia Hasna (2008). Trends and Ethics in Nursing. Presentation at Philadelphia University.

• Arwa Oweis (2007). Profession Nursing: Historical Perspective, Image, and Evidence Based Practice. Presentation at Philadelphia University.

• Diala Tawalbeh (2009). The development of nursing as a profession. Presentation at Philadelphia University.