NURS 308: Foundations of Professional Nursing II

Builds on NURS 301 and NURS 307 Application of skills acquired in NURS 301

(information literacy) and NURS 307 (use of research and scholarly writing)

Addresses standards of practice and performance and encourages you to examine your implementation of these standards

Focuses on working in complex organizations in which change is the only certainty

Moves you along in your personal transformation…..

What helped you decide to come back to school?

Making changes are often precipitated by life events that are stressful, pose a conflict, represent a dilemma

Confronting the situation is a deliberate choice

Why did you decide to come back to school ?? Think about this Write down the reasons

These are your personal motivators

Beginning RN-BS education

Last semester, you took your first step in a “professional transformation” The journey continues….

Restructuring process An evolutionary process whereby you

begin to see the world in a new way A consciousness-raising that enhances

your thinking processes A new self-definition….a new “person”

emerges

During the transformation……

Begin to define ourselves differently Views and perspectives change We become more open to sharing

these views and perspectives with others (who may or may not agree with us)

Consequences of the transformation

Feelings of excitement Satisfaction Commitment to the “new self”

while grieving about loss of the “old self”

You will learn that there is no final destination—your vision of the future will constantly change

You will be different when you complete this program—and your personal journey will continue….

PROFESSIONS, PROFESSIONALISM, & PROFESSIONAL NURSING….

How do we measure up?

Definition of a ‘profession’ an occupation whose

incumbents create and explicitly utilize systematically accumulated general knowledge in solution of problems posed by clients, either individuals or groups (Moore, 1970) What do you think about when

you read the words “create and utilize” knowledge?

Characteristics of a profession: Historical perspectives

An intellectual process carrying with it great personal responsibility

It can be learned because it is based on a body of knowledge

Practical; techniques can be taught

Internally strong Motivated by altruism

Flexner, 1915

Characteristics of a profession: Historical perspectives Utilizes in its practice a well-

defined and well-organized body of knowledge which is on the intellectual level of higher learning

Constantly enlarges the body of knowledge it uses and improves its techniques of education and service by use of scientific method

Entrusts the education of its practitioners to institutions of higher education

Bixler & Bixler, 1959

Characteristics of a profession: Historical perspectives (Bixler & Bixler, 1959 contd.)

Applies its body of knowledge in practical services that are vital to human social welfare

Functions autonomously in the formulation of professional policy and the control of professional activity

Attracts individuals of intellectual and personal qualities who value service above personal gain and who recognize their chosen occupation as a life’s work

Strives to compensate its practitioners by providing freedom of action, opportunity for professional growth, and economic security

What is professionalism?

a dynamic process whereby many occupations can be observed to change certain crucial characteristics (Vollmer & Mills, 1966) This change begins with individuals—

that personal transformation you are experiencing—and evolves to encompass all (most) who practice in a given “occupation”

How does nursing measure up? The first ‘training schools’ were

established in the US in the 1860s (proliferated—2300 by 1920)

American Society of Superintendents of Training Schools for Nurses established in 1894—renamed the National League of Nursing Education in 1912

First baccalaureate program established in 1909 at the University of Minnesota

First licensure laws (North Carolina, New Jersey, New York, Virginia) passed in 1903 in order to safeguard the public. By 1910, 27 states had licensure laws

The Nurses’ Associated Alumnae of the US and Canada (est. 1896) became the American Nurses’ Association organized in 1912

How does nursing measure up? First doctoral program in nursing

(EdD) was initiated in 1930 at Columbia Teacher’s College; NYU initiated the first PhD program in 1934; University of Pittsburgh opened the first clinical nursing research program (PhD) in 1954

Associate degree programs initiated in 1952 and flourished Major impact was to reduce the shortage

of nurses in the 1970s and 80s 1970 saw a major increase in the #

of nursing doctoral programs Expanded the body of nursing knowledge

Code of Ethics (ANA, 1985)

Barriers to full “professionalism’

Within the profession Entry into practice Body of knowledge and the

application of this knowledge in practice

Outside the profession Legal status of nurses functioning in

the expanded role Lack of autonomy Entry into practice

Overcoming the barriers Research

Develop and expand the body of nursing knowledge

Apply knowledge in practice Education

BS as the entry level into professional nursing practice

Support for advanced education in nursing Legislation

Protect against threats to our privilege to practice

Distribution of the work force Continue to expand into the community to

make nursing more visible entrepreneurship

Professional Nursing Practice

Nursing’s Social Policy Statement (ANA, 2003; p. 69) identifies 4 essential features of contemporary professional nursing practice in the definition of nursing stating that nursing is “defined as the diagnosis and treatment of human responses to actual or potential health problems” Attention to the full range of human responses to

health & illness without restriction to a problem-focused orientation

Integration of objective data with an understanding of the subjective experiences of the patient

Application of scientific knowledge to the process of diagnosis and treatment

Provision of a caring relationship that facilitates health & healing

Nursing’s Social Policy Statement

Social contract between society and professional nursing

Nursing uses this document as a framework for understanding nursing’s relationship with society and it’s obligation to those who receive professional nursing care

Includes a definition of professional nursing, descriptions of nursing and it’s knowledge base, scope of professional nursing practice, and the methods by which the profession is regulated Be familiar with this framework—it provides a foundation

for our practice

Nursing’s Social Policy Statement

On p. 3 of the Social Policy Statement, the values and assumptions undergirding the social contract between nursing and society are delineated. They include: Humans manifest an essential unity of mind, body, and spirit Human experience is contextually and culturally defined Health & illness are human experiences. The presence of illness does

not preclude health not does optimal health preclude illness The relationship between nurse and patient involves participation of

both in processes of care The interaction between nurse and patient occurs within the context of

the values and beliefs of the patient and nurse Public policy and the healthcare delivery system influence the health

and well-being of society & professional nursing

Think about how your values as a professional are (or are not) influenced by these values. Think about how your behaviors are influences by them.

Nursing’s core values

Are communicated through the Code for Nurses (ANA, 2001, 2008) Ethical principles

Distributive justice Truth-telling (Veracity) Autonomy (patients & professionals) Privacy, Confidentiality, Informed Consent Fidelity (loyalty) Beneficence Non-maleficence

Concepts of interpersonal relationships

Code of Ethics for Nurses Naturally evolved and developed in

accordance with the changing social context of nursing, and with the progress and aspirations of the profession Central ethical values, duties, and

commitments of nursing have remained stable

The Code of Ethics is the public expression of those values, duties and commitments

Our first Code of Ethics

The first Code of Ethics for Nurses was the Nightingale Pledge (Grettner, 1910)

On p. xiii of the Guide to the Code for Nurses: Interpretation and Application read the pledge. Think about how it defines our practice today—or does it??

The COMPASSES that direct our profession

The Code of Ethics for Nurses & Nursing’s Social Policy Statement The focus of Unit I Define nursing and nursing’s social contract with

recipients of professional nursing care and the public Built on our values as a profession

Standards of Professional Practice and Performance Reflect the values and priorities of the profession Describe the responsibilities for which practitioners are

accountable Will be the focus of Unit II