professionalism in the nursing profession

This week, we will examine various aspects of professionalism in the nursing profession. As we consider these areas, we can renew our commitment to our great profession.

Key Issues of Professionalism in Nursing

Characteristics of a Profession

Professions have many characteristics, including the following.

  • Growing and separate body of knowledge
  • Formal plan of education in institutions of higher learning
  • Specific competencies regulated by the profession
  • Control over the profession and performance
  • Legal mandate for professional standards
  • Practice in an ethical manner
  • Collegial relationships
  • Acceptance by society
  • Commitment to the profession
  • Societal service
  • Commitment to lifelong learning

(Blais & Hayes, 2011; Hood, 2018; Masters, 2017).

Nursing includes all of these characteristics and more. Professional nurses must remember to continually uphold our ethics, values, characteristics, and commitment in order to propel the profession forward. “Professional values and their associated behaviors are foundational to the practice of nursing” (American Association of Colleges of Nursing, 2008, p. 26).

Autonomy relates to independent functions where the professional nurse can use nursing judgment to make a decision and implement it in accordance with the laws of the state (Hood, 2018).

Professional nurses have independent, interdependent, and dependent functions. Match the following activities with the type of function.

Nursing Functions

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Independent Nursing Actions

Dependent Nursing Actions

Interdependent Nursing Actions

Collaborate with health providers

Give drug ordered by physician

Use nursing process to plan care

Teach patients and families

Turn and reposition patients

Delegate to unlicensed personnel

Perform lab test on a patient

Some nurses consider standing orders from providers to be a form of autonomy. In reality, these are merely another way of following orders from the provider without contacting them directly. This does not represent nursing autonomy. Consider the following example.

The Question

The patient has a physician’s order that reads “Lisinopril 20 mg by mouth daily for blood pressure over 140/90.”

During the nurse’s morning patient assessment, the patient’s BP is 150/100. The nurse administers the Lisinopril 20 mg.

Is this an example of nursing autonomy? Why or why not?

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Accountability has been likened to responsibility. Professional nurses are responsible and accountable for both their actions and their inaction. The Nurse Practice Act (law and rules governing the practice of nursing) of each state includes statements about what nurses are responsible and accountable for in their professional practice. “The Nurse of the Future will demonstrate accountability for the delivery of standard-based nursing care that is consistent with moral, altruistic, legal, ethical, regulatory, and humanistic principles” (Massachusetts Department of Higher Education Nursing Initiative, 2016, p. 14).

 

  • What are professional nurses accountable for?
  • To whom are professional nurses accountable?

Delegation of patient care tasks to unlicensed assistive personnel (UAPs) is a legal issue. Professional nurses use nursing judgment in delegation. However, the laws regarding nursing delegation lack specificity in many states’ nurse practice acts. The National Council of State Boards of Nursing (2005) defined delegation as transferring authority to perform a nursing task to another person while the nurse maintains accountability. Be sure to return to Week 2 Lesson to review delegation resources from National Council of State Boards of Nursing (n.d.).

Consider This

How do autonomy, accountability, and delegation interrelate?

Nurses must be familiar with Nurse Practice Acts (NPA) in states where they are licensed, because they will be held accountable to follow the law and rules or risk the loss of licensure and/or legal action. NPAs do change over time. If you have not recently read the NPA for your state, please go to the NCSBN website in the Weblinks, locate your state’s board of nursing, and read the NPA, being particularly attentive to the following.

  • The definition of nursing
  • Differentiation between nursing and medical practice
  • Scope of nursing practice
  • Requirements for continued licensure
    • Practice
    • Continuing education
    • Other
  • Disciplinary actions
  • Impaired -nurse (substance abuse) issues
  • Professional boundaries
  • Delegation rules

Theories to Guide Practice

There are a number of theories that address the changes that nurses undergo during their professional development. Just as a child masters how to sit, crawl, stand, walk, and run, so do nurses gain skill and confidence in their practice.

Benner’s landmark work, From Novice to Expert (1984), studied the responses of critical care nurses who were asked to describe incidents that required their intervention. Benner discovered that the focus of the nurses varied depending upon their placement on a continuum of knowledge and expertise. She placed nurses into one of five stages of clinical competence.

Novice to Expert: click on each concept to review the definition

Novice
▼Advanced Beginner
▼Competent
▼Proficient
▼Expert

Benner (1984) also pointed out as nurses began practicing in new areas of nursing, they moved backwards on the continuum. For example, an expert obstetrical nurse was not necessarily an expert emergency department nurse. Each specialty has its own body of knowledge to master. The good news is that there is usually a portion of knowledge that can be transferred from one area to the next, and this speeds up the process of gaining expertise.

It is interesting to note that some nurses never become experts, but remain stalled at the competent or proficient stage.

 

Consider your nursing practice.

  • How would you rate your stage of clinical competence using Benner’s scale?
  • Are you an expert in some areas but a novice in others?
  • If you are a novice, what is your plan to gain expertise?

Nursing theories guide on professionalism in the nursing profession care by providing a framework for practice. Theories allow nurses to see relationships among parts of a situation and to guide solutions to issues that arise in a given situation. Nursing theories allow professional nurses to organize the holistic care of clients and groups rather than focus on tasks to be performed.

Four theories are the focus of this course.

  • Systems theory (as cited in Hood, 2018)
  • Roy’s adaptation theory (as cited in Hood, 2018)
  • Orem’s self-care deficit theory (as cited in Hood, 2018)
  • Benner’s novice to expert theory (as cited in Hood, 2018)

As you read about each of these theories, consider how you would apply each one in your own nursing practice.

There are many more nursing theories that can be explored in your textbook, online, and in books and professional nursing journal articles. Once you study the ones selected for this course, you’ll want to investigate others.

Ethical Concerns

 

As you read the ICN Code of Ethics, consider how you uphold the statements in your nursing practice.

Nursing ethics involves the profession’s codes of moral conduct and values. Professional codes of ethics are statements written by professional organizations. Ethical professional nursing practice includes being caring and knowledgeable, having integrity, and doing the right thing in all situations. Nurses are held to a higher standard than the general public. Ethical principles in nursing practice include sanctity of life, autonomy, veracity, justice, respect for beliefs, nonmaleficence, beneficence, confidentiality, and fidelity (Hood, 2018, p. 27).

The International Council of Nursing (ICN) revised its Code of Ethics in 2012 (International Council of Nurses, 2012). This guide helps nurses worldwide to maintain ethical nursing practice. You may review the ICN Code of Ethics by clicking on the link below.

https://www.icn.ch/nursing-policy/regulation-and-education (Links to an external site.)

A code of ethics offers general, ethical guidelines rather than giving advice about how a nurse should act in a specific situation. These broad statements and principles serve as frameworks to guide individual decision-making.

See how well you understand some of the most important ethical principles in nursing by dragging each principle to its description.

Ethical Principles

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Doing no harm

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Providing care to all

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Telling the truth

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Respecting privacy

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Do good

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Freedom to make decisions

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Care with dignity

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Faithfulness

Beneficence

Confidentiality

Respect for life

Veracity

Justice

Nonmaleficence

Autonomy

Fidelity

Summary

This week, we have explored the topic of professionalism in nursing and its many components. As you continue to grow in your professional nursing career, many of these aspects will come into sharper focus for you.

Test Your Knowledge on professionalism in the nursing profession

 

professionalism in the nursing profession

professionalism in the nursing profession

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