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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….
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