Nursing is gaining recognition as a profession. The nurse in all professional relationships, practices with compassion and respect for the inherent dignity, worth and, uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems. Professionalism refers to professional character, spirit, or methods. It is a set of attributes, a way of life that implies responsibility and commitment. Each healthcare institution has specific standards and policies which are within the nursing educational program. Specific professional nursing values are stated in nursing code of ethics, in standards of nursing care practice and in the legal system itself. The professional nurse frequently assumes the roles of a leader who influences others to work together to accomplish a specific goal. Professionalism in Nursing
A profession is generally distinguished from other kinds of occupations by its requirement of prolonged, specialized training to acquire a body of knowledge pertinent to the role to be performed, an orientation of the individual toward service, either to a community or to an organization, ongoing research, and code of ethics, autonomy, and professional organization.
Nursing is an art of practice, based on theory driven, and scientifically based profession. The process of care, which occurs through partnership between the practitioners and patient, enables nurses to nurture human potential, enhance quality of life and assists to achieve optimal health. Nursing draws its knowledge and theory from nursing, basic, behavioral, and biological sciences (Mission, 2007).
Leadership is a shared responsibility in which nurses form strong relationships that will result to excellent nursing practice. In order to support excellence in professional practice, humanism must be in the work environment to help nurses feel safe, respected and valued.
The purpose of nursing leadership varies according to the level of application and includes (a) improving the health status of individuals or families, (b) increasing the effectiveness and level of satisfaction among professional colleagues, and (c) improving the attitudes of citizens and legislators toward the nursing profession and their expectations of it. Leadership has been characterized with different styles; one of the styles is autocratic. Also called an authoritarian leader. An authoritarian leader makes decision for the group. Their driving force is extrinsic, they desire rewards from others and are incapable of independent decision making. Autocratic style is effective and productivity is high. When urgent decisions are necessary, one must assume the responsibility for making decisions without being challenged. When we do not wish to participate in making decisions, the authoritarian style solves the problem and enables the individual or group to move on.
“Authority is one of the most important approaches towards influence as it monitors the behavior of any individuals of any organizations from the outside environment” Simon, H.A. (1976). Authority is defined as the power to make decisions, which guides the actions of another, in other words, a typical relationship between superiors and subordinates. The superior constructs and communicates the orders to the subordinate with the expectations of its fulfillment. Simon discusses the four types of sanctions. Firstly, he informs us about the social sanctions, which is apparently the most essential of the sanctions. In a society an individual has certain social situational rules and if those rules are broken he or she suffers the embarrassment of insubordination. Secondly, are the psychological differences that play a crucial role in a relationship? Though the study of leadership is in a very primitive stage, there are some indications that there are certain personality types that lead and others follow. Third is sympathy, several conditions imply that this is an effective sanction. Formal sanctions follow which is based on the economic security and status. Therefore obedience would result in a higher position and higher salary. And finally, it is unwillingness, where the assigned task may displease the subordinates and they would prefer to be told what to do rather than do it on their own. In this the psychological aspects lies way beyond the consequences of an incorrect decision.
Nurses deal with intimate and fundamental human events such as birth, death, and suffering. With this, they are responsible with the morality of their own actions when they face the many ethical issues. Nurses’ professional values are acquired during socialization into nursing from codes of ethics, nursing experiences, teachers and peers.
As Professionals, codes of ethics were implemented to govern all professionals in their practice. It is a formal statement of a group’s ideals and values. And a set of ethical principles that is shared by members of the group, it reflects their moral judgments over time, and serves as a standard and guidelines for their professional actions and informs the public of its commitment. This has higher requirements than legal standards and never lowers the legal standards of the profession. The nurse’s primary commitment is to the patient, whether an individual, family, group or community.
Health is a fundamental right of every individual. Therefore, the nurses’ primary responsibility is to preserve health at all cost. Basic to nursing is knowledge and understanding of man. Standards of practice vary in different settings. Society is ever-changing and the nurse responds to changes. Respect for the rights and dignity of individuals is basic to the practice of the profession. Milton’s (2007) study the following:
For any discipline with a practice component, value priorities are reflection of choices on what it means to be a member of the discipline. For the recipients of professional nursing services, values reflect owning individual priorities for what is most important in living health and quality of life. In the context of healthcare, priority has been afforded to disciplinary practices whose values are consistent with those at normative, empirical sciences.
Advocacy is needed for the nursing profession as well as for the public. Nurses who function responsibly as professional and public advocates are in an enviable position to effect change. Nurses are the advocates for their patients. They take appropriate steps to safeguard the patient’s rights and privileges. Advocacy role functions to inform, to support, and mediate.
Nurses help to determine and implement desirable standards of nursing practice and nursing education. They participate actively in the development and growth of the nursing profession. They strive to secure equitable socio-economic and work conditions in nursing through appropriate legislation and other means.
Nursing students also have legal responsibilities for their own actions and are liable for their own acts of negligence committed during the course of clinical experience. When performing duties within the levels of professional nursing, such as administering injections, they are legally held to the same standard of skill and competence as a registered professional nurse.
In an influential article Charlotte Nath, B.S.N., Ed.D.; Rebecca Schmidt, D.O., F.A.C.P.; Erdogan Gunel, Ph.D. (2006) write about a study of medical schools and the role of professionalism being taught at each school. The study was conducted through a two-stage survey. The schools first were questioned about general activities related to the teaching of four essential elements of professionalism--subordinating one's self-interest to the interest of patients; adhering to high ethical and moral standards; responding to societal needs; and show clearly core humanistic values, such as empathy, integrity, altruism, and trustworthiness. The second survey instrument gathered more specific information about the format through which professionalism was taught and the goals of the curriculum. Today’s health care arena poses complex ethical and moral dilemmas for both faculty and students of the health professions. The socialization process within various training programs contributes to the molding of and internalization of both personal and professional values specific to a particular discipline. Are those values standard across disciplines? Is professionalism a characteristic that a student brings to the field, or does he or she learns it in the socialization process inherent to the particular discipline? Is professionalism inherent to cultural and socioeconomic background? Is it the responsibility of health care educators to teach aspects of professionalism as part of the basic curriculum? Can professionalism be defined, taught, and measured? (p.825-834).
According to UTHSCSA (2007), “Faculty and preceptors, as role models for students, personify the qualities for professionalism.
The objective of all nursing activities is to provide quality nursing care in the amount needed. Emphasis is placed not only in improving basic nursing education, but increasingly on comprehensive nursing education, post-basic or advanced education, and overall planning for nursing service at state or national levels.
Nurse’s acceptance of a leadership role in nursing affairs shows consideration of the cultural and social factors affecting the care of patients, the variety of clinical settings in which nurses serve. Each institutions foster high standards of nursing practice and to promote welfare and the professional advancement of nurses for better nursing care.
The student will begin to realize that to practice nursing they should understand what is meant by professional nursing and how one may qualify to practice. The nursing student typically visualizes the various fields of nursing they want to enter into once they qualify to practice.
Nurses are accountable for their own nursing practice. They are responsible for their personal and professional growth and development. They maintain or modify standards of practice within the reality of any given situation. Quality care is their goal. Respect for the rights and dignity of individuals is basic to the practice of profession. Recognizing the need for change and initiates, participates and supports activities to meet the health and social needs of the people. Nurses are aware that their nursing actions have professional, ethical, moral and legal dimensions. They strive to perform their work in the best interest of all concerned.
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