Frederick William V. Flores, RN

Nursing as a Profession

Characteristics of a ProfessionA Model of ProfessionalismStandard of a Profession

Foundation of Nursing Education

Occupation – a job or a career

Profession – learned vocation or occupation that has superiority and precedence within a division of work

A profession is generally distinguished from other kinds of occupation by:A. prolonged specialized training to acquire a body of knowlegde

B. Orientation of the individual toward service

Professionals are valued by society because their services are beneficial for the members of the society.

Educational Routes to become an RN:1. Diploma – earliest type of nursing education

2. Baccalaureate Degree Programs (DGP) - (1909) provides a broader background of knowledge on sciences and liberal education

3. Associate Degree in Nursing(AND) - response to nursing shortage - bedside nurses

ASSOCIATE DEGREE NURSING

DIPLOMA BACCALAUREATE

LOCATION Junior/community colleges, senior colleges/university

Hospital Senior colleges or universities

LENGTH OF STUDY

2 Academic/Calendar years

24-30 mos or 3 years

4 academic yrs

REQUIREMENTS FOR ADMISSION

entrance requirements as well as programs

high school graduate or equivalent / completion of prerequisite courses

entrance requirements as well as programs

PROGRAM OF TRAINING

Basic natural and social science with general education and humanities

Theory courses and practice of nursing, biologic physical and behavioral sciences. May require certain in physical and social science courses be taken at a college or university

Frequently concentrates on theory courses and practice of nursing in junior and senior years. Provides theory and practice of nursing education

Courses in Liberal arts and behavioral physical sciences

CLINICAL COMPONE

significant program supervised instruction in hospitals or other community agencies

provides early and substantial clinical learning experiences in hosp. and community agencies; focused on understanding of hosp environment and interrelationship of other disciplines

provides clinical laboratory courses in a variety of settings where health and nursing care are given.

OPPORTUNITY FOR EDUCATIONAL ADVANCEMENT

some credits may appplied to baccalaureate

little or no transferability unless affiliated with college or university

provides basicacademical preparation for advancement to higher positions in nsg and in master’s degree

Characterisics of a Profession1. a defined base power2. power and authority over

training and education3. registration4. altruistic service5. code of ethicslengthy socialization7. autonomy

A Profession must also have an institutionalized goal or social mission as well as a group of scholars, investigators or researchers who works to continually advance the knowledge of the profession with the goal of improving its performance.

Professionals are responsible and accountable to the public for their work.

Nursing has a social mandate to provide healthcare for clients and there is a growing knowledge base, authority over education, altruistic service, a code of ethics and registration of requirements for practice.

…. It can successfully be argue that nursing is an aspiring, evolving profession.

Standards of a Profession- establishing and implementing standards of practice are major functions of a professional organization.

- serves as yardstick for the measurements used in licensure, certification, accreditation, quality assurance, peer review and public policy.

Standards of Clinical Practice Developed by ANA in 1991. Generic in nature and provide for the practice of nursing regardless of area of specialization

Describes the responsibilities for which nurses are accountable

1. reflect the value and priorities of nursing profession2. provide direction for professional nursing practice

3. provide a framework for the evaluation of nursing practice.

4. define the profession’s accountability to the public and the client outcomes for which nurses are responsible.

The profession’s responsibilities inherent in establishing and implementing standards of practice includes:

1. to establish, maintain and improve standards,

2. to hold members accountable for using the standards

3. to educate the public to appreciate the standards

› 4. to protect the public from individuals who have not attained the standards or willfully do not follow them.

› 5. to protect the individual members of the profession from each other.

ANA Standards of Professional Performance1. Quality of the Care2. Performance Appraisal3. Education4. Collegiality5. Ethics6. Collaboration7. Research8. Utilization

A Model for Professionalism

Professional Socialization – the means of developing professional identity.

I. Initial Socialization – prepares the student for the work setting.1. Simpson Model (1967)2. Hinshaw Model (1986)3. Davis Doctrinal Conversion Model (1966)

Simpson Model Hinshaw Model Davis Doctrinal Conversion Model

Stage 1- proficiency in specific work task

Stage 2 – attachment to significant others in the work environment

Stage 3 – internalization of the professional group and adoption of the behavior it prescribes

Phase 1 – Transition of anticipated role of expectations to the role expectations of societal groups

Phase 2 – attachment to significant others/ labelling incongruencies

Phase 3 – Internalization of role values/ behaviors

Stage 1- initial innocence

Stage 2 – labelled recognition of incongruity

Stage 3 – “psyching out” and role simulation

Stage 4 – increasing role simulation

Stage 5 – provisional internalization

Stage 6 – stable internalization

Kelman’s 3 Level of Value Orientation1. Compliance2. Identification3. Internalization

II. Ongoing Professional Socialization and ResocializationThree Models of Career Stages Development:1. Kramer’s Post Graduate Resocialization Model

- model for the transition of graduates of educational setting to work setting

- Kramer introduced the concept of “reality shock”

Stage 1. Skill and routine mastery

Stage 2. Social integration

Stage 3. Moral outrage

Stage 4. Conflict resolution

2. Dalton’s Career Stages Model- by Dalton, Thompson and Price

that emphasizes the development of competence derived from experience

Stages CentralActivity Primary Relationship

Major Psychological Issue

1 Helping and learning; performs fairly routine duties under the direction of a mentor

Apprentice; subordinate

Dependence

2 Works independently as a competent peer

Colleague Independence

3 Influences, guides, directs and helps others to develop

Informal mentor, role model

Assuming responsibility for others

4 Influences the direction of the organization or a segment of it; has one of 3 roles: manager, internal entrepreneur or idea innovator

Sponsor Exercising power

III. Benner’s Stages of Nursing Expertise

- describes 5 level of proficiency based on Dreyfus model of skill acquisition.

- Benner believes that experience is essential for the development of professional expertise

Stages1 Novice – no experience2 Advance beginner – demonstrate marginally accepted

behavior3 Competent – has 2-3 yrs experience.

- demonstrates organizational planning abilities - differentiates important

from less important aspects of care - coordinates multiple

complex care of demands4 Proficient – has 3-5 yrs of experience.

- perceives situation as a whole than parts - uses maxims as guides for situation - has holistic understanding of

the client, which improves decision making - focuses on long term goals

5 Expert – fluid, flexible and highly proficient performance - no longer requires rules, guidelines or maxims - demonstrates highly skilled

intuitive and analytic ability in new situations

- Is inclined to take a certain action because it felt right

Thank you