Professionalism

Professionalism carries different meanings for different people. The primary concept of professionalism as cited by Shepard (2014) refers to the ability to maintain good work ethics, accountability for one’s self, engage and work with difficult people, maintain self-control and self-direct in the face of adversity.

Professional preparation requires a higher level of education or a specialized body of knowledge and skills but as well requires orientation to the beliefs, values and attitudes expected of the members of the profession, as well as the standards of practice and ethical considerations as stated by Black (2014).

As nursing has evolved it has moved from an occupation to a profession with the creation of formal training and the development of education standards, professional certificates (Ghadirian, Salsali & Cheraghi, 2014), as well as professional practice standards defined by several professional nursing organizations such as the College of Nurses of Ontario (Shepard, 2014). Embedded in nursing professionalization is professional conduct, priority decision making or critical thinking, continuing education, acquisition of professional values and professional identity and knowing the ‘professional self’ (Ghadirian et al, 2014).

Dr. Lucie Kelly compiled eight characteristics of a profession in 1981 and these characteristics remain prevalent and relevant in nursing today:

1. The services provided are vital to humanity and the welfare of society

2. There is a special body of knowledge that is continually enlarged through research

3. The services involve intellectual activities; individual responsibility is a strong feature

4. Practitioners are educated in institutions of higher learning

5. Practitioners are relatively independent and control their own policies and activities

6. Practitioners are motivated by service and consider their work an important component of their lives

7. There is a code of ethics to guide the decision and conduct of practitioners

8. There is an organization that encourages and supports high standards of practice.

In my role as a nurse leader today I am challenged on some levels with professionalism and have questioned whether it is in jeopardy or there has been a natural evolution based on rapid health care change. The first challenge I have identified is the variability of education in the practitioners in our organization. Within our nursing teams we currently have different levels including BScN or BN prepared, RN’s from a diploma program (no longer offered), Registered Practical Nurses (RPN) and Personal Support Workers (PSW) unregulated, which leads to varying degrees of commitment and professional development but a more apparent gap in standardized formal education and application of knowledge and self-reflection (Black, 2014).

Secondly, professionalism is a skill that is to be acquired and practiced in classrooms and clinical settings yet it is a skill that is difficult to develop (Shepard, 2014). As stated by Shepard (2014) adult learners present to nursing programs with great diversity in backgrounds, life experiences and ages which impact their personal values and beliefs as well as shape their professional identity. These may or may not align with professional standards or organizational standards. As leaders we have to address and acknowledge when there is conflict or in congruencies with professional standards despite these vast differences (Shepard, 2014) and foster the concept of professionalism at a local level; yet literature shows that we are ill prepared to deal with the complexities of unprofessional behaviors (Shepard, 2014).

Lastly, as we practice Interprofessionality and team based care there needs to be competencies integrated around collaboration, teamwork and effective communication (Shepard, 2014) as these are not intuitive skills and could negatively impact nursing professionalism (Shepard, 2014).

In my own practice I feel that my professionalism is related to my work experiences, my continuing education and my strong core values of integrity, honesty and accountability. At times when I am faced with making some difficult decisions based on funding for example my values are tested but there is strength in adhering to a code of conduct, putting patients at the center and remaining self-aware and non-judgmental.

Ghadirian et al state (2014) state that nursing professionalism is an inevitable, complex, varied, and dynamic process. Ongoing changes in healthcare and society will present challenges to maintaining the boundaries of nursing professionalism. I believe as leaders we will have to continually evaluate and evolve nursing education, policy and standards to address the core aspects of the profession such as human dignity, integrity, autonomy, altruism and social justice and embed these in our organizational practices and values (Ghadirian et al, 2014).

References:

Black, B. P. Professional Nursing Concepts and Challenges, ed 7. Elsevier 2014.

Ghadirian, F., Salsali, M., & Cheraghi, M.A. (2014). Nursing professionalism: an evolutionary concept analysis. Iranian Journal of Nursing and Midwifery Research, 19 (1), 1-10.

Kelly, L. Dimensions of Professional Nursing, ed 4, New York, 1981, MacMillan.

Shepard, L. H. (2014). It Takes A Village To Assure Nurse Professionalism. I-manager’s Journal on Nursing, 3 (4), 1-5.