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

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