Nursing as a Profession

A. Profession

1. Definitions
- an occupation that requires extensive education or a calling that
requires special knowledge, skill and preparation (Kozier et. al.,
2008)
- an occupation or calling requiring advance training and experience
in some specific or specialized body of knowledge which provides
service to society in that special field (Webster’s Dictionary)

Terms related to Profession:

1) Professionalism- refers to professional character, spirit or methods.
It is a set of attributes, a way of life that implies responsibility and
commitment.
2) Professionalization- the process of becoming professional, that is,
of acquiring characteristics considered to be professional.

2. Criteria
Generally distinguished from other kinds of occupations by:
- a) its requirement of prolonged, specialized training to acquire a
body of knowledge pertinent to the role to be performed
- b) an orientation of the individual toward service, either to a
community or to an organization
- c) ongoing research
- d) a code of ethics
- e) autonomy
- f) a professional organization

Is Nursing a Profession?

Based on the following, nursing is a profession:

Specialized Education
Specialized education is an important aspect of professional status. In
modern times, the trend in education for the professions has shifted toward
programs in colleges and universities. Means of entry into registered nursing
include baccalaureate degree, master’s degree and doctoral degree.

Body of Knowledge
As a profession, nursing is establishing a well defined body of knowledge
and expertise. A number of nursing conceptual frameworks contribute to the
knowledge base of nursing and give direction to nursing practice, education and
ongoing research.

Service Orientation
A service orientation differentiates nursing from an occupation pursued
primarily for profit. Many consider altruism (selfless concern for others) the
hallmark of a profession. Nursing has a tradition of service to others. This service,
however, must be guided by certain rules, policies, or codes of ethics. Today,
nursing is also an important component of the health care delivery system.

Ongoing Research
Increasing research in nursing is contributing to nursing practice.

Code of Ethics
Nurses have traditionally placed a high value on the worth and dignity of
others. The nursing profession requires integrity of its members; that is, a
member is expected to do what is considered right regardless of the personal
cost. Nursing has developed its own codes of ethics and in most instances has
set up means to monitor the professional behavior of its members.
Autonomy
A profession is autonomous if it regulates itself and sets standards for its
members. Providing autonomy is one of the purposes of a professional
association. If nursing is to have professional status, it must function
autonomously in the formation of policy and in the control of its activity. To be
autonomous, a professional group must be granted legal authority to define the
scope of its practice, describe its particular functions and roles and determine its
goals and responsibilities in delivery of its services.
To practitioners of nursing, autonomy means independence at work,
responsibility and accountability for one’s actions.

Professional Organization
Operation under the umbrella of a professional organization differentiates
a profession from an occupation. Governance is the establishment and
maintenance of social, political and economic arrangements by which
practitioners control their practice, their self-discipline, their working conditions
and their professional affairs. Nurses, therefore need to work within their
professional organizations.

Examples of Nursing Organizations in the Philippines

- Philippine Nurses’ Association, Inc. (PNA)
- Critical Care Nurses Association of the Philippines, Inc. (CCNAPI)
- Philippine Oncology Nurses' Association, Inc. (PONA)
- Maternal and Child Nurses Association of the Philippines (MCNAP)

B. Nursing

1. Definitions
- The act of utilizing the environment of the patient to assist him in his
recovery (Nightingale, 1860-1969)

- Assisting the individual, sick or well, in the performance of those

activities contributing to health or its recovery that he would perform
unaided if he had the necessary strength, will or knowledge and to do
this in such a way as to help him gain independence as rapidly as
possible (Henderson, 1966)

- The protection , promotion and optimization of health and abilities,

preventions of illness and injury, alleviation of suffering through the
diagnosis and treatment of human response, and advocacy in the care
of individuals, families, communities and populations (American
Nurses Association, 2003)

- Encompasses autonomous and collaborative care of individuals of all

ages, families, groups and communities, sick or well and in all settings.
Nursing includes the promotion of health, prevention of illness and the
care of ill, disabled and dying people. Advocacy, promotion of a safe
environment, research, participation in shaping health policy and in
patient and health systems management and education are also key
nursing roles (International Council of Nurses, 2002)

2. Characteristics based on the many definitions:

- Nursing is caring.
- Nursing is an art.
- Nursing is a science.
- Nursing is client centered.
- Nursing is holistic.
- Nursing is adaptive.
- Nursing is concerned with health promotion, health maintenance
and health restoration.
- Nursing is a helping profession.
3. Focus: Human Responses

Nursing involves concepts of health and person. A holistic approach is

used when assessing selected basic human responses. Culturally sensitive
interventions are designed to meet client needs. Nursing comes in infinite forms
with factors such as situation, culture, age, medical condition, and need for
assistance.

Well-Being and More-Being: That nursing is tied to the health-illness quality of

man is obvious. How it is related is not so easily determined. The term "health" is
an essential component of the equation from the broadest definition of well-
health to the narrowest such as dying. Nursing is integral to this continuum.
"Nursing, then, as a human response, implies the valuing of some human
potential beyond the narrow concept of health taken as absence of disease.
Nursing's concern is not merely with a person's well-being but with his more-
being, with helping him become more as humanly possible in his particular life
situation." Nursing then assists the person to be greater than the total sum of all
parts.

Human Potential: Humaneness is essential for nurses. When nurses are

thanked for this quality in what they do, a large part of them are surprised. Those
nurses not displaying humaneness are usually criticized. To view that all nursing
acts are "overflowing of the milk of human kindness" is in error, as nursing acts
and nursing deeds contain all the human potential of anger, pain, meanness,
frustration, as well as, joy, happiness, and caring. Thus, nursing acts can contain
all responses that all humans experience.

Intersubjective Transaction: The nursing act occurs between at least two

persons. The nurse does and the receiver receives and responds to the nursing
or nurturance. The acts of both create an intersubjective transaction, a
relationship if only for a moment. This is the "between" that has meaning to both.
This is an essential dimension beyond science. "It is a quality of being that is
expressed in the doing."

Being and Doing: Nursing involves both being and doing and these are so
interrelated that one does not exist without the other. Much of the description of
nursing is focused on the doing half. The "doing" half can be examined, held up
for example and talked about. The "being" half of the equation is much more
ephemeral and less apparent for scrutiny, but the mere "presence" of the nurse is
just as valuable. It is "just being there," to be an active presence. An example
may be that of sitting by the bedside during the dying process.

Authentic Commitment: Nursing that is directed toward the human potential, "that
is, an active presence with the whole of the nurse's being. This involved
presence is personal and professional." The personal commitment in each nurse
is unique. The nurse brings to the interaction his or her unique presence with the
professional commitment that the interaction is goal directed. This goal directed
act is held to industry standards. While the perfect goal is to have a positive
interactive transaction, in actual practice, this may not be the case. Humanistic
nursing occurs along a continuum with degrees of genuine presence (Paterson &
Zderad in www.humanisticnursingtheory.com).

Aims of Nursing
- To promote health
- To prevent illness
- To restore health
- To facilitate coping with disability or death

Promoting Health and Wellness

Wellness is a process that engages in activities and behaviors that
enhance quality of life and maximize personal potential (Anspaugh, Hamrick &
Rosata, 2003 in Kozier, et.al, 2008). Nurses promote wellness in clients who are
both healthy and ill. This may involve individual and community activities to
enhance healthy lifestyles such as improving nutrition and physical fitness,
preventing drug and alcohol misuse, restricting smoking and preventing
accidents and injury in the home and workplace.
Nurses promote health by maximizing the patient’s own individual
strengths. Health promotion is the framework for nursing activities. Nurse
considers the patient’s self-awareness, health awareness and use of resources
while providing care. Through knowledge and skill, the nurse accomplishes the
following: 1) facilitates decisions about lifestyle that enhance quality of life and
encourage acceptance of responsibility for one’s own health 2) increases health
awareness by assisting in the understanding that health is more than just not
being ill and by teaching that certain behaviors and factors can contribute to or
diminish health 3) teaches self-care activities to maximize achievement of goals
that are realistic and attainable; serves as a role model 4) encourages health
promotion by providing information and referrals.

Preventing Illness
The objectives of illness-prevention activities are to reduce the risk for
illness, to promote good health habits and to maintain optimal functioning.
Nurses prevent illness primarily by teaching and by personal example. Such
activities include the following: 1) educational programs in areas such as prenatal
care for pregnant women, smoking-cessation programs and stress-reduction
seminars 2) community programs and resources that encourage healthy
lifestyles, such as aerobic exercise classes, “swimnastics,” and physical fitness
programs 3) literature, television, radio or Internet information on diet, exercise
and the importance of good health habits 4) health assessments in institutions,
clinics and community settings that identify areas of strengths and risks for illness.
Additional nursing activities that prevent illness include immunizations, infant
care and prevention of sexually transmitted diseases.

Restoring Health
Activities to restore health focus on the individual with an illness and range
from early detection of a disease to rehabilitation and teaching during recovery.
Such activities include the following: 1) performing diagnostic measurements and
assessments that detect an illness (e.g. taking BP, measuring blood sugars,
examining feces for occult blood) 2) referring questions and abnormal findings to
other healthcare providers as appropriate 3) providing direct care of the person
who is ill by such measures as giving physical care, administering medications
and carrying out procedures and treatments 4) collaborating with other
healthcare providers in providing care 5) planning, teaching and carrying out
rehabilitation for illnesses such as heart attacks, arthritis and strokes 6) working
in mental health and chemical –dependency programs.

Facilitating Coping with Disability and Death

Nurses also facilitate patient and family coping with altered function, life
crisis and death. Nurses can facilitate an optimal level of function through
maximizing the person’s strengths and potentials, through teaching, and referral
to community support systems. Nurses provide care to both patients and families
during end of life care, and they do so in hospitals, long-term-care- facilities and
homes. Nurses are active in hospice programs, which assist patients and their
families in preparing for death and in living as comfortably as possible until death
occurs.

4. Personal and Professional Qualities of a Nurse

A. Professional Preparation
1. A nurse must have a Bachelor of Science degree in Nursing.
2. A nurse must have a license to practice nursing in the country.
3. A nurse must be physically and mentally fit.
B. Personal Qualities and Professional Proficiencies

A nurse should have the following:

1. Interest and willingness to work and learn with individuals or groups in variety
of settings;
2. Concern for people;
3. Resourcefulness and creativity as well as well-balanced emotional condition;
4. Capacity and ability to work cooperatively with others;
5. Initiative to improve self and service;
6. Competence in performing work through the use of nursing process;
7. Skill in decision-making, communicating, and relating with others and being
research oriented;
8. Active participation in issues confronting nurses and nursing; and
9. Warm/pleasing personality reflective of the following:
a) Poise
- Knowledge of etiquette, a gracious manner and a complete
mastery of social usages are also important. Social usage is based
on consideration for the comfort and happiness of others.
- As a nurse, one constantly meets new people and finds
himself/herself trusts into unfamiliar and unexpected situation. A
nurse must be prepared to meet any situation with ease. For
instance, it is necessary to be calm and collected in an emergency
where life and death are involved.
- A nurse must have the qualities of courtesy, unselfishness
and self-control.
- Other qualities affecting poise are:
1. Self-acceptance
2. Acceptance of others
3. Right kind of pride

b) Good complexion
- This is also an index of health. The purpose of use of
makeup is to enhance and beautify the natural appearance
however; this should be use with discretion.

c) Hair
- The hair should be washed and brushed as often and
necessary to keep it lustrous and attractive and should be arranged
always in a becoming coiffure that suits one’s uniform or apparel.

d) Good posture
- With the body carried in proper alignment, the organs are
enabled to function naturally.

e) Nurse’s uniform
- The nurse should wear the uniform only when engaged in
the performance of professional duties. The nurse must maintain its
neatness and cleanliness.

f) Art of conversation
- In nursing, one’s relationship with his/her professional and
social associates needs to be pleasant ones, thus, he/she will use
conversation constantly to convey his/her ideas and thoughts.

g) Spiritual Health
- The nurse who is truly religious will understand the need of
doing what he/she can to help cure spiritual illness as well as to
maintain his/her own state of spiritual health.