Criteria for a Profession

Fadia Hasna, PhD, RN

Course General Objective

Utilise leadership/management skills in the delivery of caring, competent, legal and ethical nursing care to individuals and groups in a variety of settings

Why is Nursing Leadership Important

1. Professionalisation of Nursing 2. It can be learnt 3. Patients have shorter hospital stays & their needs must be met more quickly 4. Maintaining quality of care despite cost effectiveness measures 5. It is a multi-dimensional process: nurse-leader and the group, the setting in which interaction occurs and the theory of leadership chosen by the nurse-leader

Strategies to enhance the nurse leaders effectiveness

Organising Teaching-learning Decision-making Changing Managing conflict Evaluating

The Professionalisation of Nursing

1. 2. 3.
4. 5. 6.

Definition of Profession: The six criteria of Flexner (1915) for a work group to acquire professional status The activities must be intellectual The activities can be learnt (based on knowledge) Activities must be practical (vs. academic or theoretical) Profession to have teachable techniques (professional education) Strong internal organisation of members of the work group Altruism (a desire to provide for the good of society) be the motivating force of group members

Updating Felxners criteria

The existence of a body of knowledge unique to that work group (nurses) established through research and scientific analysis A nurse to acquire that body of knowledge through a long period of study taught by existing members of the work group Presence of a committed group who enforce a code of ethics

Nursing as a Profession: Status Today

Theory: More nursing- researchers with doctoral qualifications are doing research focused on clinical practice of nursing. Scientific bases (evidence-based) for nursing best practices are being established Nursing Research Journal (1952) followed by the establishment of the Annual Review of Nursing Research (1982) to critically review extant nursing research Journal of Knowledge Synthesis for Nurses only the second on-line journal for health sciences

Nursing as a Profession: Status Today (contd.)

Relevance to Basic Social Values: Nursing like medicine is concerned with the well-being of individuals Challenge is that society does not always recognise that nursing performs a necessary and unique service. Society values cure (physicians) rather than care (nurses) Gunning 1983.

Nursing as a Profession: Status Today (contd.)

Training or Education Period Amount (length of education) Degree of specialisation involved Use of symbolic and ideational processes in content (manipulation of ideas and symbols) Professional education includes values, norms roles (specific to the profession)

Nursing as a Profession: Status Today (contd.)

Motivation: Service to public rather than to individuals. Degree of motivation is difficult to assess. Degree of altruism decreasing in nursing today. The me generation (Angel &Petronko 1983)

Nursing as a Profession: Status Today (contd.)

Autonomy: Freedom to regulate and control its own work behaviour Professional work groups have self-regulation (internal control) established by consensus. Autonomy of nursing increasing (state nurse practice acts). In Jordan Nursing Council established. Professional practice group is recommended. Standards of Nursing Practice (1973), in 1991 Standards of Clinical Nursing Practice in USA helped regulate practice. Barriers to autonomy: Nurses employed in institutions were they have little or no control over their terms of work Many nurses still believe in the authority of the physicians over their work, feel less important than the physicians rather than their colleagues. Certified nurse midwives have established independent practices Peer review guidelines established since 1988 Nurses in critical areas have more colleagueship with physicians than in other areas of practice

Nursing as a Profession: Status Today (contd.)

Sense of commitment (lifetime or long-term commitment). Traditionally has been poor. Nurses move in and out of the profession. Marriage and leave the profession to raise families. No longer the case. Today in USA 80% of nurses are employed (Aiken and Mullinix 1987) Job (income) rather than career (commitment to people and continuing education); based on the degree of congruence among personal, professional and organisational goals and purposes.

Nursing as a Profession: Status Today (contd.)

Sense of Community: Common identity & destiny and share a subculture The professional nurses associations in the USA and Jordan are considered labor unions because of their collective bargaining history and capacity. Then, many administrative and supervisory nurses consider membership as a conflict of interest (member of management and labor union) Barriers to joining: costs, perceived lack of time, feelings of no personal benefits, general apathy

Nursing as a Profession: Status Today (contd.)

Code of Ethics Formalised as the group moves towards professionalisation Complexity, number of behaviours and relationships described, enforceability of the code.

Nursing as a Profession: Status Today (contd.)

1. 2. 3. 4. 5. 6. 7. 8. Theory Social Values Education Motivation Autonomy Commitment Community Code of Ethics