Nursing as a profession

Nursing as a Profession

Ram Sharan Mehta, Ph.D.
Medical-Surgical Nursing
Department
B.P. Koirala Institute of Health Sciences

• One of my favorite quotes:
Nursing is an art;
and if it is to be made an art,
it requires as exclusive a devotion,
as hard a preparation,
as any painter's or sculptor's work;
for what is the having to do with
dead canvas or cold marble,
compared with having to do with the
living body - the temple of God's spirit?
It is one of the Fine Arts;
I had almost said
the finest of the Fine Arts
- Florence Nightingale

• Profession is defined as "a vocation
requiring advanced training and usually
involving mental rather than manual work,
as teaching, engineering, especially
medicine, law“
-Webster1989.

Profession
• Professions are those occupations possessing a
particular combination of characteristics
generally considered to be the expertise,
autonomy, commitment, and responsibility.
• A profession is an occupation based on
specialized intellectual study and training, the
purpose of which is to supply skilled services
with ethical components and others.

Occupation

• Training may be on job and duration varies.
• The values, beliefs, and ethics are not
prominent features.
• The commitment and identification: varies.
• In occupation people often change Job.
• Accountability rest on employer.

Profession
• Is basically intellectual
• Is based on a body of knowledge that can be
learned.
• Is practical rather than theoretical.
• Can be taught through a process of professional
education.
• Has a strong internal organization of members.
• Has practitioners who are motivated by altruism
(desire to help others)

Professions vs Occupations
Professions Occupations
• College or University • On the job training
• Prolonged education • Length varies
• Mental creativity • Largely manual work
• Decisions based on science or • Guided decision making
theoretical constructs • Values, beliefs & ethics not
• Values, beliefs & ethics integral part of preparation
part of preparation • Commitment may vary
• Strong commitment • Supervised
• Autonomous • Often change jobs
• Unlikely to change professions • Motivated by $ reward
• Commitment > $ reward • Employer is primarily
• Individual accountability accountable

• Genevieve and Roy Bixler, a husband and
wife team of non-Nurses who were
nevertheless advocates and supporters of
nursing, first wrote about the status of
nursing as a profession in 1945

• They appraised nursing according to
theire original seven criteria, noting the
progress made in nursing, as a
profession.

• Abraham Flexner (1910), conducted study of
medical education and went on to study
other disciplines and latter, in a paper about
social work published a list of criteria that
he felt were characteristics of all true
professions. Flexner's believed in
professional work

Criteria of profession:
Abraham Flexner (1916)
• Intellectual (opposite of physical).
• Based on body of knowledge, that can be learned.
• Practical rather than theoretical.
• Can be taught through a process of professional
education.
• Has a string internal organization of members.
• Has practioner

William shepherd (1948):
• Based on scientific principles.
• Demands: adequate pre-professional and cultural
training.
• Demand: specialized and systematized knowledge.
• Must give: evidence of needed
• Scientific technique: tested experiences.
• Time judgment / duty Performance.
• Beneficial work.
• Group consciousness: scientific knowledge.
• Sufficient self impelling power.
• Obligation to society: code of ethics.

Kelly: - 1981
• Service provided is vital to humanity and
welfare of society.
• Special body of knowledge: continually.
• Intellectual activity: accountability.
• Educated in institutions.
• Relatively independent: autonomy.
• Motivated by job / service.
• Code of ethics: to guide decisions.
• Organization (association): to encourage and
support practice.

Collegiality
Standard of ANA – Scope and Standards of Practice, 2004

According to Bruhn - 2001
• Be civil
•Be collaborative
• Be ethical
•Be forgiving
• Be honest
• Be the best •Be current
• Be consistent •Be involved
• Be a communicator •Be a model
• Be accountable

Nursing is gaining recognition as a profession based on the criteria
that a profession must have: -

• A well defined body of knowledge.
• A strong service orientation.
• Recognized authority by a professional group.
• A code of ethics: ICN.
• A professional organization that sets standards: NNC /
NAN.
• On going research.
• Autonomy.
Hence, nursing is a Nobel profession, Recognized
internationally.

1. A profession utilizes in its practice a wel-
defined and wel-organised body of specialized
knowledge.
2. A profession constantly enlarges the body of
knowledge it uses and improves its techniques
of education and service by the nurses of the
scientific method.
3. A profession entrusts the education of its
practitioners to institutions of higher
education.

1. A profession applies its body of
knowledge in practical services which are
vital to human and social welfare.
2. A profession functions autonomously in
the formation of professional policy and
control of professional activity thereby.

1. A profession attracts individuals of
intellectual and personal qualities who
exalt service above personal gain and
who recognize their chosen occupation
as a life work.
2. A profession strives to compensate its
practitioners by providing freedom of
action, opportunity for continuous
professional growth and economic
security

Image Makers of Nurses
• Nurses of America Campaign
– convey to public that RNs are expert
clinicians
– raising consciousness of invisibility of
nursing in the news media

Public Concern with Nursing

• What is the image of nursing being created
today?
• Saint vs. Sinner image
• “Can I trust my life to this RN?
• Public want to believe that knowledgeable,
caring, committed and dedicated RNs will be
available for them.

What the Public Believes About Nursing

• RNs ranked highest among all professions for
the highest professional standards of honesty
and ethics
• Public seek advice in 4 areas:
– self-care or immediate post op care
– health care products
– administration and SE of prescription drugs
– interpreting physician-provided information

Business Model of Health Care
• Shift from altruistic to business model
– Mismatch: nursing care marketed and nursing
care provided
• Competitive Marketplace
– scarce resources
– unlimited wants

Nursing’s View

• Female dominated by persons socialized to be
anti-intellectuals
• Focus on skills rather than critical thinking
• Knowledge is power

Communicating with Physicians

• Factually document medical problems in
patient care terms
• Stay on the issue, not personality
• Appropriate communication
– do not allow inappropriate interruptions

Creating a New Image
• Nurses value nursing and image it daily
• Nurses take themselves seriously and dress the
part
• Nurses recognize the value of caring, health
promotion, health teaching, and illness care
• Nurses believe in themselves and their
colleagues

Barriers to Professionalism
• Variability in educational preparation
• Gender issues
• Historical influences
• External conflicts
• Internal conflicts

Nursing as a profession

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