[VickyRN]

Discussion question for the month: what is professionalism?
How do you define this important concept in your own words?
And (most importantly), how can we (as educators) impart professionalism to the student nurses or staff nurses under our charge?

[renerian]

I will think on your question today and post to you about it. I need time to formulate it in my head.

renerian

[llg]

Great question -- and I'll probably "change" my response (at least in my head) 100 times as I read the responses over the next few days. But ... to start off the discussion ... here are my first thoughts.

When I think of "professionalism," I think of a sense of belonging to a group with an identified sense of values and an identified knowledge base. While we usuallly talk about the knowledge base, I think the values piece is where many of the problems and issues lie. In short, I don't think we all share the same core values about nursing and that leads to conflict.

For example, I think one of the core professional nursing values is/shoud be that when we are at work, we put our patient's needs above our own convenience. That means that if fake fingernails are found to increase infection rates, then we don't argue with policies that say "no fake fingernails." Or if certain types of shoes or clothing are considered by experts to be better for our patients, then we should cooperate and not claim, "but it's my right to wear/do whatever I want!" like a whining child. This also goes for a lot of issues, such as patient confidentiality, promptness in coming to work on time, refusal to take "your fair turn" at working some unpopular shifts or doing some unpleasant tasks, etc. etc. etc. When it becomes "all about me and what I want" instead of "mostly about the patient" that shows a loss of professionalism -- not becaue I overly cherish old-fashioned rules or a slavish devotion to "the system," but because as a professional nurse I/we have accepted the responsibility for caring for other people. When we accept that responsibility (and that paycheck), we must be willing to put their needs ahead of our own -- except in a few exceptional cases. It's a matter of having professional values.

Another professional value we should all share is the respect for on-going education. We need to keep educating ourselves so that we can provide the best care possible. Patients expect a high level of knowledge and care and they deserve to get it.

These are just the first 2 professional values I thought of. I'm sure there are many more. I would be interested in what values other people think belong on the list.

llg

[melsch]

I can only give a definition in context of nursing in Canada as that is where I have been trained and am working, but RNABC which is my nurses association defines professional conduct as:

Behaving in a way that upholds the profession. This includes but is not limited to , practicing in accordance with relevent legislation, the standards for registered nursing practice, and the Canadian nurses assocition code of ethics.

I personally agree with this definition, we need to be held accountable for our actions as a nurse and be self regulating as a professional body. I need to register every year to be called a registered nurse and meet certian standards of practice in order to continue to be able to register.

The professional standards that I have to meet are:

1 To be responsible and accountable for my actions as a
professional nurse.
2. Base my practice on a specilized body of knowledge.
ie. know where to get information and use this information
in my practice, also keeping current with the latest
information about my area of work. Professional nurses
never stop learning.
3.Use my knowledge in a competent manner.
ie. this is using my knowledge to assess my patients and
provide appropreate care to them.
4.Adhere to the ethical standards of nursing.
ie. the canadian nurses assocition code of ethics.
http://www.cna-nurses.ca/pages/ethics/ethicsframe.htm
5.Work with others in the health care team to provide care
to the public.
ie. communicate with doctors, therapist, aides, etc to
advocate care for my patients, as well as teach my
patients how to access other members of the health care
team.
6. Assumne the primary responsibility to maintain
competence and fitness to practice.
ie. keep educated and practice within my own level of
competence.
make sure that I am fit enough, mentally and physically,
to be competent at my job

I have to disagree with the previous poster comments about putting the patient 's needs above our own needs. This is just a way for nurses to burn out. As professionals we should be able to decide for ourselves what is in the best interest of our patients and act on it. That said I do agree with not having long fingernails as that would not be in the best interest of our patients, but to say not take my breaks because I need to give Mrs. Jones a bath, is not a requirement for professionalism. It is more professional to take my break and stay mentally fit to practice and ask another staff member to do the bath, if I don't have time to do it.

As professionals we need to prioritize what we are doing and not be afraid to ask for help and admit when we are over our heads in either workload or ability to do a skill. I think that this is what needs to be emphisized by educators, ask questions and as professionals be willing to share our knowledge with each other. Treat each other with respect and don't forget that we all needed to learn it at one time. Teach each other to support every other nurses practice, if you see someone struggling, help them don't knock them down, we all will benifit as a profession in the end.

Remember to ACT PROFESSIONAL. If all nurses acted professional we would be seen as professionals, not just handmaids to doctors, and slaves to managers and patients.

Melodie

[renerian]

I am sorry I have not yet posted to you on this question. I have a long drive today so by tonight I can formulate a response.

renerian

[Ben Huddleston]

:hatparty: Professionalism in the art of nursing is all nurses having the same standard of entery, following the sames standard of care, and being role models for the student nurses:
It is loving what you do- which is providing patient care.
It is providing the hightest standard of care to all customers/patients.
It is treating all customers/patients the way you would want to be treated.
It is not eating our young!
It is educating student nurses to take our place in the future.
It is motivating the future nurses to demand the highest standards of care for patients/customers.
It is giving of ourselves to patients/customers, and students.
It is having fun doing what we do (nursing).
It is caring.
It is being proud of what we do!

[llg]

Originally Posted by melsch

[/indent]I have to disagree with the previous poster comments about putting the patient 's needs above our own needs. This is just a way for nurses to burn out. As professionals we should be able to decide for ourselves what is in the best interest of our patients and act on it. That said I do agree with not having long fingernails as that would not be in the best interest of our patients, but to say not take my breaks because I need to give Mrs. Jones a bath, is not a requirement for professionalism. It is more professional to take my break and stay mentally fit to practice and ask another staff member to do the bath, if I don't have time to do it.

Melodie

I don't think we really disagree. I tried to use words and phrases in my post like "convenience" to suggest that my belief that we should put the patients' needs first was not absolute. I never said that we should ignore our own "needs." Certainly no one benefits when we burn ourselves out. We have an obligation to ourselves, to our families, AND to the patients not to burn ourselves out.

I apologize if I did not make myself sufficiently clear.

There definitely are limits as to how much we should sacrifice for our patients. But I do believe that when we accept the responsibility for the well-being of others, we owe them a certain amount of committment -- a committment to try to meet their needs even when it is inconvenient or unpleasant for us to do so. While "in the nursing role" we should only put our own needs first when they are truly "needs" and not just relatively trivial preferences and/or desires. That's where it gets tricky: some people define every desire they have as a "need."

llg

[steve0123]

Although carrying one's self in a professional manner is obviously an important attribute of a "professional person", an element that seems to have been overlooked so far is the ability of nurses to practice with autonomy. By definition (and I'm aware that definitions of what constitutes a "profession" vary widely), a profession is an occupation whose members have a unique knowledge base and skill set that equip them to provide a service that no other group is able to provide, and who are both autonomous and accountable in their actions.

I'm aware that many advanced practice nurses do in fact work with a high level of autonomy, but when looking at the nursing profession overall there is no doubt that our skills and knowledge base are almost inseparably tied up with those of the medical profession (primarily). While we are able to self regulate to a certain extent, there is no escaping the fact that by virtue of any number of factors, our professional practice always seems to rely on the knowledge base of other health disciplines - which in turn affects our claim to provide a unique set of services that no other occupation could provide.

I think that this is the cause of our lack of unity in our professional "sense of direction" that another member posted. Subsequently, we are fragmented and opinion about our role and services differs between the various sub disciplines. As far as the role of nurse educators in helping to develop professional practices in nurses (I'm not a NE, so forgive me if my remarks don't sit well...), I think it would be enormously helpful to foster a culture of pro-active development focusing on continuous upskilling (not "just" learning), so as to truly make our profession unique and indispensible in the services we provide. If that means stealing medicine's thunder, so be it...

PS: We are also too quick to offload potential nursing expertise to other occupations (think OT, Diet, etc).