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Is Nursing a Profession?

Nurses Article   (2,001 Views 43 Replies 995 Words)

MrTim RN NREMT-P specializes in ICU/Traveler.

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What Does it Mean to Be a Nurse?

An insightful first hand look at the question of nursing being a profession for my tell the world project.

Is Nursing a Profession?

Telling the World

In preparation for a project in my BSN program at James Madison University, we were given the assignment, "Tell the World," what it means to me being a nurse. Then, present it publicly for all to read. “Blow my horn," they said, this is not something I’m comfortable with and finding a way to do it wasn’t an easy process. During a discussion assignment on defining nursing, one question we were asked to reply to was, "Is nursing a profession?" To search for the answer to this question, I turned to read "From Silence to Voice," a text for this course, I would suggest all nurses read. This book has some insightful thoughts and suggestions all nurses need to consider along with a chapter on the DAISY dilemma. That single question stuck with me. How could it be possible that nursing isn’t a profession? This I continued to ask myself.

As a nurse, I sat back and thought about that question often afterward. Of course, it's a profession; I’m a professional, so it must be. Working a prior life of EMS and being a professional firefighter before my nursing career, I am a professional by definition, right? Well, maybe not. Webster's dictionary's (1997) medical definition of a profession is as follows:

  • A calling requiring specialized knowledge and often long and intensive academic preparation.
  • The whole body of persons engaged in a calling.

From this definition, I am all that, right?

The Answer

So after hours of thoughts, research, and painstaking debate, the answer was right in front of me. On top of my dresser sits my DAISY award sculpture and, thus, my opportunity to “blow my horn." I received this sculpture while working in the Cardiothoracic Post Operative Intensive Care Unit (TCVPO) at the University of Virginia. Being a DAISY Award recipient,along with what the family wrote, answers this definition of a profession. Amongst every employee and nomination at such a large facility, I received this award for my care and professionalism.  Here I will share what this thoughtful family wrote of my nursing care and, in turn, tell the world. 

Quote

My father has been in the ICU for two weeks and counting and we have been fortunate to have Tim as our nurse a number of times. He obviously sees very sick patients every day, but we only know the single one: our Dad. Tim approaches patient care as if my Dad is the most important patient he's ever had. He has even stopped by to say hello when he's assigned elsewhere and has offered an extra pair of hands to other nurses many times. His dedication to the care of our whole family, in addition to the minute-to-minute medical challenges presented by an 82-year-old man with multiple heart issues, are impossible to overstate. My Dad has been sedated, on a ventilator and continuous dialysis, yet Tim speaks directly to my Dad, explaining procedures and in every situation displaying extraordinary kindness to a man who may not even be aware of it. But as we, his family, sit by his bedside, we are aware of the compassion Tim provides to our Dad and others.The prognosis for my Dad was bleak even before surgery. And the multiple heart problems during and following surgery created an incredibly unstable situation for the first week that my Dad was in ICU. From cardiac arrest the first day to unpredictable drops in blood pressure, kidney shutdown, pneumonia, and other complications, the road for my Dad was rocky with no clear happy ending for some time. I believe that Tim's medical knowledge and his astute attention to the patient, not just the numbers on a screen, gave my Dad a chance that he might not otherwise have had. Tim has just been amazing to watch with my elderly father.  Tim has been respectful of my Dad, and so compassionate in the care he has provided.  He seems very worried about him and watches his screens for any sign of distress. Tim spends much more time in the room with my Dad than anyone else.  I know they are watching the monitors from the station, but Tim is watching his face and his hands, the motions of his legs for any signs of a need or a change in his condition.  I can't tell you how reassuring this was for all of us, particularly during the first week post surgery.Tim is obviously very well regarded by the doctors and other nurses too.  They ask him his opinion on things and take his recommendations in terms of pain relief and positioning my Dad for his ultimate comfort.  For example, Tim was a big proponent of not waiting through the weekend to have my Dad's vent relocated from his mouth to his neck.  Tim knew doing this would ease my Dad's discomfort considerable and he was vocal about this with the doctors when they came through (What is the DAISY Foundation?, n.d.).

Does that Say Nursing is a Profession?

Arguably I must say “YES”, all nurses are professional, and by definition, nursing is a profession. This statement by the family speaks of clinical knowledge, collaboration, and patient advocacy. I look back at my time in this unit with great admiration for the expertise and clinical experience I gained. There is no other hospital that I have worked in since that can compare to all the nurses, patient care technicians, and doctors that make UVA great. One must not forget that all healthcare professionals daily have and make Daisy moments; it doesn’t take sculptures to be a professional.

How we sculpt our practice daily makes us professionals.  

Tell The World Project WC edit.edited.docx

References

Buresh, B., & Gordon, S. (2013). From silence to voice: What nurses know and must communicate to the public. New York: Cornell University Press.
What is the DAISY Foundation? (n.d.). Retrieved November 11, 2019, from https://daisyfoundation.org/.
Allee, J. G. (1997). Webster's dictionary. Owings Mills, MD: Ottenheimer.

Tim is a previous flight paramedic and current ASN RN working in the ICU as a two-year traveler. Currently enrolled in James Madison University’s BSN program with future plans to earn my AGACNP.

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Asystole RN is a BSN, RN and specializes in Vascular Access, Infusion Therapy.

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A profession is somewhat more complicated and formal than this. At best, nursing is recognized as a semi-profession or developing-profession. 

The main problem is that formal higher-educational requirements as a bar to entry into the profession is somewhat of a core characteristic of a profession and nursing does not have that yet. 

What are the educational requirements to be a nurse? It varies of course based on the state in which you seek licensure. Diploma, ADN, ASN, BSN, MSN, and even PhD can all be entry level nurses. We see the debates on this site often, ASN v. BSN

Now there are some exceptions such as law which is long considered to be a profession. Most lawyers have a JD but there are some states that allow anyone to take the Bar exam. This however is a notable exception considering the vast, VAST majority of the profession has a sort of standard level of higher-education as a bar to entry. 

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RosesrReder has 15 years experience.

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This has the potential to hurt people's feelings so I opt on in my opinions; however, I will say that management treats us like little children and far from professionals.

 

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Sour Lemon has 9 years experience.

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I think it's a skilled trade. I clock in. I clock out. I have to ask permission to take time off. I don't think of that as "professional" in the most traditional sense of the word.

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RosesrReder has 15 years experience.

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15 minutes ago, Sour Lemon said:

I think it's a skilled trade. I clock in. I clock out. I have to ask permission to take time off. I don't think of that as "professional" in the most traditional sense of the word.

That's the terminology. Skilled trade!

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Of course Nursing is a profession.

We have a specialized body of knowledge, we assess our patients plan care, deliver it, evaluate it, etc.

What good is a doctor without nurses to carry out orders, observe patients, relay observations to doctors?  How many times has a student or resident been gently led/corrected by a tactful, more experienced, more knowledgeable nurse?  How many times has calamity been avoided because of nurses?

Just because we do physical labor, have managers who make our schedules, and have to say please and thank you to less-than-enthusiastic aides doesn't mean we are not professionals.

Skilled labor is some of what we do.  It is informed by our education and experience.

I cringe to think that some nurses think so little of themselves that they are reluctant to call themselves "doctor" if they have a doctorate and that some think of themselves only as worker bees.

Even those we might more readily be taught to see as pros - such as physicians, dentists, psychologists, engineers, and attorneys have to be reasonably nice to others and are dependent, for example, upon clerical workers, managers, and HR personnel -  especially since many of these pros are now employees instead of employers.

Respect yourself, behave like a professional.  Then others will be more inclined to see you as a professional.

Think about this - people we see as laborers are also skilled and expert in a particular body of knowledge.  Do you want someone who doesn't know how to work on your garden?  Plumbing?  Roof?  Car?  Etc.

Do you want your mortgage handled by a non-expert?  Do you want your child taught by someone who hasn't been taught how to do it and might not know Piaget's theory or the subject matter (like English, Math, etc.)?

Every job is important, everyone deserves respect and appreciation.

The Queen of England has someone to break in her new shoes.  That person is also the Royal Dressmaker.  Just sayin'.  🤩

Edited by Kooky Korky

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6 hours ago, RosesrReder said:

This has the potential to hurt people's feelings so I opt on in my opinions; however, I will say that management treats us like little children and far from professionals.

 

Your managers report to someone, too.  And they have to ask for time off, too.

Even Presidents and CEO's report to someone - a Board of Directors, stockholders, etc.  Congress reports to voters. 

I guess Supreme Court justices are an exception.  

What do your bosses do that makes you feel you are treated like a little child?

Nurses who were in Vietnam c/o they had to ask permission to get pts OOB once they came back to work in the US.  Over there, they practically did surgery.  I understand why they felt the way they did, but it was 2 very different settings.  Look at the whole picture.

 

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This is the type of over-thinking that I dread with BSN completion. 🤣

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Semantics.

I work with techs I consider professional.

If you are an olympic athlete, you are an amateur, but if you get paid to sit on the bench because you are too drunk to play, you are a professional.

So, it depends on which definition of professional you use.

But, using your choice of definitions, I disagree:

"A calling requiring specialized knowledge and often long and intensive academic preparation.

The whole body of persons engaged in a calling.

From this definition, I am all that, right?"

I did not have long and intensive academic training.  I did a 2 year associated degree.  While it was time consuming, and annoying, it was not rigorous.

Since then I have earned ACLS, PALS, BLS, TNCC,  ENPC, CCRN, CEN.  I don't think I am less professional than a nurse with a masters and no clinical experience, I don't think I am more professionals than some of my peers who re great nurses without all my alphabet soup.

There is a difference between being a professional and being professional.  My chimney sweep is extremely professional- Punctual, efficient, knowledgeable, etc..  But you would be hard pressed to call bing a chimney sweep a profession.  OTOH, Lawyering is considered a profession.  Have you seen Rudy Giuliani?

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mmc51264 has 7 years experience as a ADN, BSN, MSN, RN and specializes in orthopedic; Informatics, diabetes.

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I feel that I am a professional. I am constantly trying to be better at what I do, educate others, I work hard and care relentlessly for my pts.  I work with some that it is -clock in, pass meds, do am assessment, check the boxes and clock out. They are the semi-skilled trade people that frustrate me. 

I have advanced degrees that I value, I didn't get them for anyone else. I have a masters and am still quite happy working at the bedside. I think each person's perspective decides whether they are professional or not. 

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Asystole RN is a BSN, RN and specializes in Vascular Access, Infusion Therapy.

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15 hours ago, hherrn said:

Semantics.

I work with techs I consider professional.

If you are an olympic athlete, you are an amateur, but if you get paid to sit on the bench because you are too drunk to play, you are a professional.

So, it depends on which definition of professional you use.

But, using your choice of definitions, I disagree:

"A calling requiring specialized knowledge and often long and intensive academic preparation.

The whole body of persons engaged in a calling.

From this definition, I am all that, right?"

I did not have long and intensive academic training.  I did a 2 year associated degree.  While it was time consuming, and annoying, it was not rigorous.

Since then I have earned ACLS, PALS, BLS, TNCC,  ENPC, CCRN, CEN.  I don't think I am less professional than a nurse with a masters and no clinical experience, I don't think I am more professionals than some of my peers who re great nurses without all my alphabet soup.

There is a difference between being a professional and being professional.  My chimney sweep is extremely professional- Punctual, efficient, knowledgeable, etc..  But you would be hard pressed to call bing a chimney sweep a profession.  OTOH, Lawyering is considered a profession.  Have you seen Rudy Giuliani?

I think you are confusing the act of being professional and the semi-formal institution of a profession. You can act and feel you are a professional in any occupation or act. I buttered my toast in a most professional manner this morning. 

Nursing itself is not a recognized profession as it is defined but a semi-professional to developing-profession at best.

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Asystole RN is a BSN, RN and specializes in Vascular Access, Infusion Therapy.

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11 hours ago, mmc51264 said:

I feel that I am a professional. I am constantly trying to be better at what I do, educate others, I work hard and care relentlessly for my pts.  I work with some that it is -clock in, pass meds, do am assessment, check the boxes and clock out. They are the semi-skilled trade people that frustrate me. 

I have advanced degrees that I value, I didn't get them for anyone else. I have a masters and am still quite happy working at the bedside. I think each person's perspective decides whether they are professional or not. 

An individual can act and feel professional...that is a very different concept from defining whether nursing as an institution is a profession. 

It is the difference between me feeling like a professional race car driver in the morning as I navigate traffic and actually being a professional race car driver. 

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