Are We Really a Profession?

[Q.]

In reading the literature lately, I've come across several definitions and evolutions of the term "profession," and have since conceded that based on those accepted defintions, a profession we are NOT.

First recorded use of the word profession was in mid-fifteenth century and was defined as a "learned vocation." Later, in 1977, profession was defined as a "controlling occupation which has a status of superiority and precedence within a division of work."

Rutty (1998) defined profession as:

"The knowledge accessible to a particular assembly of people, the conduct that is expected from this group and the power and authority the group has over its training and/or education which takes place over a recognizable period of time, along with state registration which permits entry to be prevented by others who do not correspond to the requirements, are attributes that collectively and commonly characterize professional status within the literature. These considerations provide the means for the profession to maintain dominance over the comtemporary work situation and to decide its conditions."

Seeing as we DON'T decide our conditions, DON'T have status of superiority and DON'T have control over our education, I have to ask...we don't even fit the definition of "profession," so are we really one?

[semstr]

A calling? Who called? Never heard her/ him.

Now, that makes me pretty sick and that is not professional to me!

The "calling" were for the nuns, but not for me a xx-years trained professional nurse!!

[MICU RN]

Yes, nursing is regulated like other professions. However, lets look at our origin in healthcare and where the unversities are trying to bring it. The push for a one entry point makes sense and would put us on par with other professions as for as becoming college educated professionals. But the other major problem is that nursing still lacks so much autonomy especially compared to traditional professions. In reality, we are still functioning as workers who carry out the physical aspects of a medical plan which is totally under the control of the physician. So it is hard to justify the role as a true independent profession. I think when we go to a university and receive a four year degree, which requires plenty of hard work to obtain, we natural expect to be treated as professionals; however, the role of most bedside nurses doesn't really require that much education to do the job correctly. What I am getting at is that we may be trying to make bedside nursing into something it was never intended to be. Now, some will say "what about advance nurse practices such as NP'S and CRNA'S? The reality is that in that role they are basically practicing medicine not nursing, all be it under the supervision of a physician. Another major problem is this notion by hospital admin.s that one nurse fits all and therefore we should all be paid about the same. In the state run hospital I work in the RN's that work in the outpatient doctor clinics make the same as I do and I have only worked in critical care areas. The knowledge base required to work in a ICU or ER is very exstensive and should require a min. of a 4 yr. degree, but I find it insulting to pay a RNs in a clinic functioning at a LPN level at best the same amount as critical care nurses. And that is another reason I don't consider bedside nursing a true profession. When I worked in one of the busiest ER's in the nation and we worked our asses off, we got paid the same as all the other RN's throughout the hospital. Now the ER certified docs made on average about twice as much as primary care docs. They were being recognized not only by having a cert. but in financial terms for their specialized knowledge. Many told me they would never work in the ER with all the stress and workload if they were not being compensated so well. Why should they? If they could find an easier job and get paid the same as the doctors who are specialized and work harder. So that problem needs to be adressed in nursing, the sooner the better.

[fergus51]

Originally posted by Susy K

No, but the docs control WHO is on call and WHEN. You don't have laypeople deciding when a doc is on call, do they? If the cops don't control scheduling, who does?

Whoever is in charge, just like the Nurse managers controls ours. I have a lot more flexibility in scheduling compared to my dad the ex cop. The docs do control who is on call, but I am in a smallish town and a lot of the times, they are not able to do that because they are in short supply and if their patient gets admitted I call them. Control is all relative. A lot of what nurses b!tch about having to put up with, they don't actually have to put up with, they choose to. I honestly feel I have more control over my career and its conditions than my father ever had. As for docs, it's iffy. The governement here didn't give in to their demands either.

[flowerchild]

We nurses didn't question weather or not we were professionals until after hospitals became a business.

15 years ago, other professionals questioned it, but not the nurses. We knew who we were and where we stood. It was docs, profs that I remember doing the questioning....they said that one must have at least a masters degree to be considered a professional. I their opinion, it was as cut and dry as that!

I am still a professional and always will be a professional registered nurse. If you are not in a position that you feel comfortable with yourself using professional to describe yourself b/c you are a nurse, then perhaps you should do what ever it takes to change that. Can we nurses tolerate this without a fight? According to this debate there are many of you who are saying that you are not a professional. That's really very sad, imo.

I guess I'm old fashioned, nursing is my calling, and the nursing process is part of me, my work, and my everyday life...it's ingrained. And yes, you can use the nursing process to do anything...and I do...but, do you know of any non nurses who use it like we do? NO! There is a organization called Baldridge, it has copied our nursing process, they call it PDSA I believe, it is a way for corporations, and other ventures to win an award for "Excellence". It is very elite and extremely rigid. IT IS THE NURSING PROCESS. To get a Baldridge award is a huge honor for a corp. There are a very FEW who meet the criteria. Nurses meet the criteria everyday, when given the chance.

I had to go to college to get my degree that allowed me to become a nurse. The level and intensity of education I received vs those of other degrees is not even comparable. The nurses had to study constantly. The people in my support courses that were not in nursing always commented on how much we had to study and how thick our books were as compared to what they were doing. Yes I believe that my course of study was advanced. At the time it was said that if you could get through the nursing program you could get through law school...meaning that the intensity and level of cognition and dedication that was required was similar.

I base my opinion on personal experience. I know I'm being far from scientific in my approach toward this "debate" but, I thought perhaps my post will win a point or two for my side. LOL.

I AM A NURSE THEREFORE I AM A PROFESSIONAL. :)

[ICUBecky]

hey everyone!

i just want to comment on the whole salary/ clock punching discussion. i have worked salary as a bedside nurse and to be honest, it sucked. i didn't get any compensation for staying an hour or two after my regular shift ended, no holiday pay, no shift differentials, no weekend differentials. now, i work on an hourly basis and IMO it is much better. you actually get compensated for the hours you work.

however, i think any nurse other than a bedside nurse should be paid salary...with overtime included of course.

as far as nursing being a profession...tough call. i'd like to think we all are...but most of the time, if not all, i don't think we are. we are very controlled and we don't have a lot of autonomy!

becky

[eddy]

This is a discussion that has no true resolution but...

I think we are PART of a profession. The medical profession. Nursing is not a specific profession in itself. Depending on how and what you do as a nurse decides what part of the medical profession you are actually a part of. A school nurse, an OR nurse and a Tele nurse are VERY VERY VERY different jobs/ vocations/whatever. They don't do the same thing, and one is not qualified (in general) to do the others job in the practical sense. However, all nurses are a part of the bigger picture of medical care. To really have a nurse profession, I think all nurses would have to be in large part interchangeable throughout.

When you get down to it, some of us are tools a doctor utilizes as an extension of care. Some of us are caregivers to elderly folks who are not so bad they need a doc. The list goes on. The reason I say this is not to belittle us, but to point out that we are merely PART of the equation of the bigger picture, the medical profession.

For instance, you have people in accounting which has been referenced...

A person who went to college and got their degree in Accounting and practices accounting as a STAFF ACCOUNTANT... They are a staff accountant that is a member of the accounting profession. Just as a CFO who is more or less the ultimate decision maker in terms of those financials that the staff accountant did is also a member of the accounting profession. A staff accountant is much like us as nurses. They do the number crunching front line stuff. The CFO does the analytical and diagnostic aspects using much of the info the staff accountant has provided for his company, which makes him quite similar to a doctor in this case. They are both members of the same profession. There is no staff accountant profession. The staff accountant is just part of the equation as is the CFO, but together as a goup they make up the so called profession.

Nursing is NOT a profession in itself. It is part of one.

[live4today, RN]

Originally posted by flowerchild

We nurses didn't question whether or not we were professionals until after hospitals became a business.

15 years ago, other professionals questioned it, but not the nurses. We knew who we were and where we stood. It was docs, profs that I remember doing the questioning....they said that one must have at least a masters degree to be considered a professional. It is their opinion, it was as cut and dry as that!

I am still a professional and always will be a professional registered nurse. If you are not in a position that you feel comfortable with yourself using professional to describe yourself b/c you are a nurse, then perhaps you should do what ever it takes to change that. Can we nurses tolerate this without a fight? According to this debate there are many of you who are saying that you are not a professional. That's really very sad, imo.

I guess I'm old fashioned, nursing is my calling, and the nursing process is part of me, my work, and my everyday life...it's ingrained. And yes, you can use the nursing process to do anything...and I do...but, do you know of any non nurses who use it like we do? NO! There is a organization called Baldridge, it has copied our nursing process, they call it PDSA I believe, it is a way for corporations, and other ventures to win an award for "Excellence". It is very elite and extremely rigid. IT IS THE NURSING PROCESS. To get a Baldridge award is a huge honor for a corp. There are a very FEW who meet the criteria. Nurses meet the criteria everyday, when given the chance.

I had to go to college to get my degree that allowed me to become a nurse. The level and intensity of education I received vs those of other degrees is not even comparable. The nurses had to study constantly. The people in my support courses that were not in nursing always commented on how much we had to study and how thick our books were as compared to what they were doing. Yes I believe that my course of study was advanced. At the time it was said that if you could get through the nursing program you could get through law school...meaning that the intensity and level of cognition and dedication that was required was similar.

I base my opinion on personal experience. I know I'm being far from scientific in my approach toward this "debate" but, I thought perhaps my post will win a point or two for my side. LOL.

I AM A NURSE THEREFORE I AM A PROFESSIONAL. :)

Couldn't have said it any better myself, flowerchild. You've won my heart! :kiss

[nimbex, RN]

Wonderful thread, have enjoyed reading the different views.

I don't wish to split hairs over professional vrs. profession, or discuss my bad spelling either:D

I am a licensed registered PROFESSIONAL nurse. I've both clocked in and not clocked in, been treated poorly and praised highly.

Regardless, I am a professional, I show up, act in a mannor that mirrors the way in which to be treated, participate in change to better our PROFESSION, join PROFESSIONAL organizations and acheive PROFESSIONAL certifications.

I see myself as a professional, NO-ONE's opinion, or rules like clock punching can take that away from me.

ps, also love all nurses, joining me in my PROFESSION:kiss

[jurbyjunk]

Hey SuzyK, don't want to get into unions, but just read your thought that a union was for non-professions. Many "professions" are actually unionized but prefer to call it something else. The "Association of Boeing Engineers" (Boeing aircraft company, Seattle, Washington) springs to mind. My aunt, an anti-unionist and bigot if ever there was one, used to rail to my mother about unions being "communist", that anyone with any ounce of integrity would not be unionized. At the same time, her husband, my uncle, was a member of the ABE bargaining committee, negotiating the engineers pay raise. Go figure.

[Q.]

The following questions I post here are actually the words of one helluva debater: Wildtime88. Some of you who are newer to the board might not know him, but if you do a search you will find that he often started debates just like this: this is what allnurses used to be about. So..in his honor, I will post these questions that I happen to agree with anyhow. I'd like someone to address these:

If we are a profession, then....

List the things a nurse at the bedside can legally do without an order.

Remind everyone about activity and nutrition orders and that oxygen can not be placed without an order to cover it.

Autonomy is only a courtesy that can be just as quickly redrawn if a non-nurse sees fit to do so.

[KarafromPhilly]

Personally, I got through law school. In contrast, nursing school reminded me of the eighth grade. NOBODY that I went to nursing school with would have lasted two weeks. Give me a break. Maybe the accredited four-year university where I earned my BSN was exceptionally lame, but I don't think so. And I don't think that you have to feel comfortable describing yourself as a "professional" in order to be proud of the work you do.

[MollyMo]

Originally posted by Susy K

A calling?! CALLING?!! Maybe I just wanted to be a nurse because I liked science, a bio major was too difficult and I liked Women's Health, and needed a job.

I'm not sure I like nursing associated with a "calling." To me that infers that we shouldn't demand higher pay and better conditions. Being a nun is a calling. Not being a nurse.

For me nursing was a calling because it was the very last thing I wanted to do. I wanted something else for my life. I was actually in pre-med when I first started college. But I believe--and this is just for me-- nursing is where God wanted me to be. Now understand, this is just me. And believe me when I say that I am one of the biggest mouths on my unit demanding better conditions and doing what I can to bring about change. I believe that all my steps are ordered by God. But I don't work for free. I expect to paid and paid well for my skills. I still call myself a professional. But by the definitions I posted earlier, I am not. We are not. But if one criteria in order to be called a professional is autonomy, what profession is truly autonomous? I can't think of one. We all have SOME autonomy, it's a matter of degree. Some have more freedom to think and act independently--or less restrictions--than others. But than shouldn't diminish the professionalism.