Nursing education perspectives headlines

138 Nursing Education Perspectives

Headlines from the NLN

The Formation of Professional Identity in Nursing

E D I T O R ’ S N O T E . This is the fourth in a series of Headlines from the NLN designed to facilitate use of the NLN Education Competencies Model. Previous articles were in 2012 in the May- June, September-October, and November-December issues.

URSING STUDENTS HAVE A V IS ION OF HOW

THEY EXPECT TO BE AS PROFESSIONAL NURSES.

Entering students will often express the desire to take care of peo- ple, helping them get well or, at the least, feel better. The develop- ment of professional identity is a continuous process that begins with admission to the nursing program and evolves throughout one’s professional career in a dynamic and fluid process where interact- ing relationships of education and practice lead to self-reflection, growth, and human flourishing. The process must be consistent with the profession’s history, goals, and codes of ethics while “distin- guish[ing] the practice of nurses from that of other health care providers” (National League for Nursing [NLN], 2010, p. 68).

Professional identity involves the internalization of seven core values integrated throughout the NLN’s Education Competencies Model and applicable to all types of nursing education programs. “These…values become self-evident as the nurse learns, gains experience, and grows in the profession” (NLN, 2010, p. 68). They are reflected in the practice setting in thinking, actions, and behav- iors and how the nurse treats co-workers and patients. The nurse is expected to demonstrate professionalism and a dedication to the values, knowledge, skills, and ethical comportment that is nursing (Sullivan, 2005).

Nursing education involves learning a body of knowledge foun- dational to nursing practice, but knowledge alone is not sufficient. Through educational programs and learning opportunities, nursing students come to know and understand the core values and beliefs of the profession as well as the context of professional practice. Increasingly competent and confident in the mores of the profes- sion, nursing students and graduates must internalize the core val- ues that emphasize a culture of excellence, caring, and integrity with diversity, holism, patient-centeredness, and ethical practice valued and applied in practice. Nurse educators and clinicians in clinical settings serve as critical role models for students as they gradually assimilate the roles of professional nursing practice.

Benner, Sutphen, Leonard, and Day tell us that transformation, the change that occurs between the lay person and a nurse “pre- pared to respond with respect and skill to people who are vulnera- ble or suffering…occurs in every aspect of a nursing student’s edu- cation” (2010, p. 166). “Guided reflection on their clinical experi- ences and how they might improve on their day’s practice” is criti- cal to the nursing student’s learning (Benner et al., p. 167).

The NLN Education Competencies Model encompasses six inte- grating concepts central to nursing practice. In the design of the curriculum, it is important to examine each concept in terms of

knowledge, practice know-how, and ethical comportment (KPE) critical to student learning. Because these integrating concepts and KPEs are essential to the whole of nursing practice, we must consider how and where they are situated in learning experiences that lead to established competencies and course and program out- comes (NLN, 2010).

Sometime in the clinical setting, students will encounter nurses who fail to follow the institution’s written policy. These students may believe the nurse is doing the procedure correctly and what they learned in their educational program is no longer current. Implementing a “guided reflection” (Benner et al., 2010), nurse educators can incorporate the integrating concepts to address the student’s findings. For example, when exploring context and envi- ronment (the setting in which something happens, the circum- stances that lie behind a situation or event), discuss with students the circumstances that may have led to the nurse’s decision to work around written policies and procedures. When discussing quality and safety (emphasis on system effectiveness to provide quality health care and a safe environment), talk about the nurse’s respon- sibility when witnessing a practice that deviates from standards, policies, or procedures.

The opportunity to reflect on clinical learning experiences increases the power of experiential learning (Benner, 2010). It also encourages a just culture, where factors that lead to error are eval- uated for better future outcomes. By encouraging students to reflect on patient care assignments while emphasizing the “courage to con- tinually work to improve the care for patients, families, and commu- nities” (NLN, p. 68), faculty contribute to the formation of profes- sional identity evident in the nurse’s way of being, knowing, and doing (NLN, 2010, p. 35). NLN

Contributed by June Larson, MS, RN, ANEF

Marilyn Brady, PhD, RN Lynn Engelmann, EdD, RN, CNE, ANEF

Bro. Ignatius Perkins, OP, PhD, RN, FAAN, ANEF Cathleen Shultz, PhD, RN, CNE, FAAN, ANEF

References Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010). Educating nurses: A call for radical transformation. San Francisco, CA: Jossey-Bass.

National League for Nursing (NLN). (2010). Outcomes and compe- tencies for graduates of practical/vocational, diploma, associate degree, baccalaureate, master’s, practice doctorate, and research doctorates in nursing. New York, NY: Author.

Sullivan, W. (2005). Work and integrity: The crisis and promise of professionalism in America. San Francisco, CA: Jossey-Bass.

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