NURS 308: Foundations of Professional
Nursing II
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Builds on NURS 301 and NURS 307
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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?
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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
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Last semester, you took your first step
in a “professional transformation”
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The journey continues….
Restructuring process
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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……
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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
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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’
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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)
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What do you think about when you
read the words “create and utilize”
knowledge?
Characteristics of a profession:
Historical perspectives
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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
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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.)
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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?
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a dynamic process whereby many
occupations can be observed to change
certain crucial characteristics (Vollmer
& Mills, 1966)
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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?
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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?
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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
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1970 saw a major increase in the # of
nursing doctoral programs
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Major impact was to reduce the shortage of
nurses in the 1970s and 80s
Expanded the body of nursing knowledge
Code of Ethics (ANA, 1985)
Barriers to full “professionalism’
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Within the profession
 Entry
into practice
 Body of knowledge and the application of
this knowledge in practice
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Outside the profession
 Legal
status of nurses functioning in the
expanded role
 Lack of autonomy
 Entry into practice
Overcoming the barriers
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Research
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Education
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BS as the entry level into professional nursing
practice
Support for advanced education in nursing
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Protect against threats to our privilege to practice
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Develop and expand the body of nursing knowledge
Apply knowledge in practice
Legislation
Distribution of the work force
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Continue to expand into the community to make
nursing more visible
entrepreneurship
Professional Nursing Practice
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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”
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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
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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
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Be familiar with this framework—it provides a foundation for
our practice
Nursing’s Social Policy
Statement
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On p. 3 of the Social Policy Statement, the values and
assumptions undergirding the social contract between nursing
and society are delineated. They include:
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Humans manifest an essential unity of mind, body, and spirit
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Human experience is contextually and culturally defined
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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
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Are communicated through the Code
for Nurses (ANA, 2001, 2008)
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Ethical principles
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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
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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
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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
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The Code of Ethics for Nurses & Nursing’s
Social Policy Statement
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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
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Reflect the values and priorities of the profession
Describe the responsibilities for which practitioners are
accountable
Will be the focus of Unit II