Nursing as a profession

1. Nursing as a Profession
Ram Sharan Mehta, Ph.D.
Medical-Surgical Nursing
Department
B.P. Koirala Institute of Health Sciences

2. •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

3. •Profession is defined as "a vocation
requiring advanced training and usually
involving mental rather than manual work,
as teaching, engineering, especially
medicine, law“
-Webster1989.

4. 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.

5. 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.

6. •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

7. Professions vs Occupations
Professions
•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

8. •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

9. •They appraised nursing according to
theire original seven criteria, noting the
progress made in nursing, as a
profession.

10. •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

11. 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

12. 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.

13. 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.

14. Collegiality
Standard 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 collaborativeBe collaborative
•Be forgivingBe forgiving
•Be currentBe current
•Be involvedBe involved
•Be a modelBe a model

15. 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.

16. 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.

17. 1.A profession applies its body of
knowledge in practical services which are
vital to human and social welfare.
2.A profession functions autonomously in
the formation of professional policy and
control of professional activity thereby.

18. 1.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.
2.A profession strives to compensate its
practitioners by providing freedom of
action, opportunity for continuous
professional growth and economic
security

19. 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

20. 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.

21. 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

22. 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

23. Nursing’s View
•Female dominated by persons socialized to be
anti-intellectuals
•Focus on skills rather than critical thinking
•Knowledge is power

24. Communicating with Physicians
•Factually document medical problems in
patient care terms
•Stay on the issue, not personality
•Appropriate communication
–do not allow inappropriate interruptions

25. 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

26. Barriers to Professionalism
•Variability in educational preparation
•Gender issues
•Historical influences
•External conflicts
•Internal conflicts

27. Thank you