OBJ 2
What is
A Profession?
Let’s start with definitions
Position-group of tasks assigned to one individual
Job-a group of positions similar in nature and level of skill
Occupation-a group of jobs similar in type of work
Profession-a type of occupation that requires prolonged preparation and formal qualifications and meets higher level criteria that raise it above that of an occupation
Process Approach
All occupations are at different points of development from position to profession
Position ----------------------------- Profession
Based on public perception of where each fit on the continuum
Lacks objective criteria
Do you think the public views nursing as a profession?
Power Approach
Two criteria
How much independence of practice does this occupation have?
How much power does this occupation control?
Political power
Earning power
Medicine, law, and politics clearly considered professions according to these criteria
What about nursing? Does nursing have the political power and earning potential to meet the criteria?
Salaries
Membership in professional organizations
Political power
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Trait Approach
Common characteristics
High intellectual level
High level of individual responsibility & accountability
Specialized body of knowledge
Knowledge learned in institutions of higher education
Public service and altruism
Traits continued
Public service over financial gain
Relatively high degree of autonomy & independent practice
Well-organized and strong organization to control quality of practice
Code of ethics
Strong professional identity
Demonstration of professional competency & legally recognized license
Where does nursing stand?
High intellectual level
In today’s high tech environment, nurses must function at high intellectual level
High level of individual responsibility & accountability
Unlike the past, nurses now held accountable for errors
Can no longer state, “Did what doctor ordered”
Nursing Traits
Specialized body of knowledge
Theory, research, nursing science to direct practice in place of “tradition”
Evidence-based practice instead of “we have always done it this way.”
Use of research-supported nursing practice
Public service & altruism
Continue to be seen as selfless, placing others above own safety
Today-on call, 12 hour shifts
Is this still universal? What are “refrigerator nurses?”
More traits to consider?
Well-organized and strong representation
ANA, NLN, specialty organizations
What is the degree of nursing membership in comparison to other “professional organizations?”
Code of ethics
Competency and professional licensure
NCLEX
Individual state nurse practice acts
Any negatives?
Education is still quite diverse
What are current recommendations?
What interferes?
Autonomy & individual practice
Despite advances, nursing remains interdependent and independent
States regulate the amount of independent practice-who else cares?
Handmaiden image-how is this impacted by amount of education?
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Health Care Teams
Nurses must work with a diverse group of providers-each bringing special skills to healthcare
Nurses have a wide range of opportunities
Require varied backgrounds, experiences, credentials
Move from acute to chronic care settings
Advanced practice nurses
Nurse practitioners
Clinical nurse specialist
Case managers
Lack of acute care jobs, but increasing need for chronic care and community
NP-diagnose and treat; some states allow 3rd party reimbursement
CNS-work with acute and chronic-educators and physician collaborators,
Case managers can have a wide variety of education-SW, physicians, nurses, laypeople-are nurses the best to fill this role?
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Nursing Power
Despite much responsibility-little control
Do “helpers” feel comfortable wielding power?
How can nurses move from subservient to using their influence?
What is empowerment?
Referent power-what is gained with nurse-patient, nurse-co-worker relationships?
Expert power-helps build respect with other health care team members
Power of rewards-behavior modification
Coercive power-not considered therapeutic
Legitimate power-legal power related to licensure
Collective power-power in numbers
Referent power-based in relationship
Often do something for someone that you would not do otherwise because you have a relationship with the person
Tolerate long hours, do difficult tasks, patients take meds or get out of bed because of the nurse-patient relationship; doctor return your call promptly; CNA help you without asking, etc
Expert power-increased knowledge and understanding commands more respect
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Increasing Power
Professional unity-encourage membership and involvement in professional organizations
Political activity-need to be involved with those who have effect on our power & practice
Accountability & professionalism-govern ourselves with high standards
Networking-present united front
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What’s ahead?
Although called a “nursing profession,” it is probably more appropriate to say nursing is moving from occupation to true profession
Stand firm in the process
Avoid quick fixes
Addressing pending nursing shortage
Lifelong commitment to nursing