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.
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)

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

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

6. 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.
7. 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
Nursings 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
Thank you