Professional Identity

1. A profession has specific characteristics. In regard to how nursing meets these characteristics, which criteria are consistent and standardized processes? (Select all that apply.) a. Code of ethics b. Licensing c. Body of knowledge d. Educational preparation e. Altruism

1. Answer: a, b, c, e Nursing as a profession has a code of ethics, licensing, a body of knowledge, and altruism. Because there are multiple paths of education for nursing and not a standard entry into practice, this is one criterion of a profession that varies in nursing.

The protection, promotion, and optimization of health and abilities, prevention 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 (ANA))

Nursing

A minimum set of criteria of practice to provide quality care.

Nursing Standards

Treating the patient's physical, mental, emotional, spiritual, and social self

Nursing is seen as a holistic profession:

Care Provider Educator Advocate Leader Change Agent Manager Researcher Collaborator Delegator

Primary Roles and Functions of the Nurse

A sense of oneself that is influenced by characteristics, norms, and values of the nursing discipline, resulting in an individual thinking, acting, and feeling like a nurse.

Professional Identity

Deep and meaningful understanding of the professional identity of the nurse. Incorporates health and illness concepts along with norms and values that characterize the nurse as a member of a profession.

Clinical Judgement

Promotion of Personal Health, Safety and Well-Being with Interpretive Statements

Code of Ethics for Nurses 5.2

Doing, Being, Acting Ethically, Flourishing, Changing Identities

Common attributes of Professional Identity

Fundamental to the nursing discipline, and as such, constitutes a substantial part of what actually happens in moment-to-moment nursing practice.

Communication

Feeling what another is feeling and responding to it with the intent of doing something to help. (Taking time to talk with a troubled family member, Responding to a patient's call light with genuine interest, Comforting a colleague, Using eye contact to apologize for a misstep)

Compassion

8. Which factors affect the nursing shortage? (Select all that apply.) a. Aging faculty b. Increasing elderly population c. Job satisfaction due to adequate number of nurses d. Aging nursing workforce e. Greater autonomy for nurses

8. Answer: a, b, d The nursing workforce and nursing faculty are aging. The entire population is aging, which increases the need for more nurses. The insufficient number of nurses leads to job dissatisfaction and burnout. Greater autonomy for nurses does not affect the nursing shortage.

9. The nurse has performed a physical examination of the patient and reviewed the laboratory results and diagnostics on the patient's chart. The nurse is performing which specific nursing function? a. Diagnosis b. Assessment c. Education d. Advocacy

9. Answer: b The nurse is performing the first step in the nursing process -- assessment.

Nurse does what she says she'll do and acts with consistency and purpose. Basis for trust. (Following through with pain medication, Calling the physician when the patient asks you to, Checking the Code Chart by the prescribed time, Giving medications within the 30 minute window)

Integrity

Clinical Judgement, Leadership and Ethics, Communication

Interrelated Concepts of Professional Identity

10. The nurse supports a patient's decision to decline more cancer treatment and to be cared for by a hospice team, even though the nurse personally thinks the patient should seek more treatment. The nurse is practicing which nursing role? a. Advocacy b. Change agent c. Leader d. Collaborator

10. Answer: a The nurse has many roles. In this circumstance, however, the nurse is acting as the patient's advocate. Nurses advocate for the patient and support the patient's decision even when the nurse does not agree with the decision.

2. What specific aspect of a profession does the development of theories provide? a. Altruism b. Body of knowledge c. Autonomy d. Accountability

2. Answer: b Theories establish a specific nursing body of knowledge that is unique to the discipline, which is one criterion of a profession.

3. Heath care workers are discussing a diverse group of patients respectfully and are being responsive to the health benefits and practices of these patients. What important aspect of nursing professional practice are they exhibiting? a. Autonomy b. Accountability c. Cultural competence d. Autocratic leadership

3. Answer: c The nurse and other health care workers are exhibiting cultural competence by being responsive to patients' health beliefs and practices that are influenced by each patient's culture. Autonomy is being independent and self-motivated. Accountability is accepting responsibility for one's own actions and omissions. An autocratic leader exercises strong control over subordinates.

4. A nurse makes a medication error, immediately assesses the patient, and reports the error to the nurse manager and the primary care provider (PCP). Which characteristic of a profession is the nurse demonstrating? a. Autonomy b. Collaboration c. Accountability d. Altruism

4. Answer: c The nurse is demonstrating accountability by taking responsibility for the error and reporting it after an initial assessment of the patient. Criteria of a profession include altruism (public service over personal gain), autonomy (independence), accountability, and diversity; however, in this case, the nurse is demonstrating accountability. Although collaboration is important for the health care team, it is not a criterion for a profession.

5. Which are included in the ANA standards? (Select all that apply.) a. Standards of professional performance b. Code of ethics c. Standards of practice d. Legal scope of practice e. Licensure requirements

5. Answer: a, c ANA standards have two parts: One is standards of professional performance and the other is standards of practice. ANA has a separate document that is a code of ethics. Nurse practice acts are a legal scope of practice. Licensure requirements include graduation from an accredited school of nursing and passing a licensure exam.

6. Which core competency of advanced practice registered nurse (APRN) is the nurse educator exhibiting when counseling a student nurse on the unit in therapeutic communication techniques? a. Leadership b. Ethical decision making c. Direct clinical practice d. Expert coaching

6. Answer: d A nurse educator who is teaching and counseling students is practicing expert coaching and guidance. A nurse educator with a master's degree practices the other competencies of leadership and ethical decision making in other situations. Although a nurse educator may also work as a nurse involved in direct patient care, this is not part of the educator role.

7. Which statements describe a component discussed in nursing theories? (Select all that apply.) a. Optimal functioning of the patient b. Interaction with components of the environment c. The conceptual makeup of the administration of the hospital d. The illness and health concept e. Safety aspect of medication administration

7. Answer: a, b, d There are four components that a nursing theory discusses: (1) the patient, (2) health, (3) environment, and (4) nursing. Hospital administration and safe medication administration, while important to nursing, are not part of nursing theories.

Assessment Diagnosis - Outcomes identification (patient goals) Planning Implementation - Nursing interventions Evaluation - Of the patient outcomes/goals

ADPIE

Doing the right thing or acting ethically

Acting Ethically

"Last line of defense" on behalf of the patient. (Listening carefully, Communicating)

Advocacy

What it means to do the right thing even when no one is looking.

Being

Novice Advanced Beginner Competent Proficient Expert

Benner's Novice to Expert Model

Evolving (nursing always changing)

Changing Identities

To affect change and "to stand in opposition for moral rightness". Can be categorized as physical or moral. (Speaking up when a colleague did something wrong, Conveying the details of a conversation a dying patient had with you to other members of the healthcare team, Taking practice issues to the practice council to positively change practice on your nursing unit)

Courage

- Altruism - Body of Knowledge and Research - Accountability - Higher Education - Autonomy - Code of Ethics - Professional Organization - Licensure - Diversity

Criteria for a Profession

Incorporates the societal and professional codes and standards that are part of nursing discipline. It also includes a skill orientation, or a "doing component".

Doing

Integrity, Compassion, Courage, Humility, Advocacy, Human Flourishing

Exemplars of Professional Identity

Positive and transformational growth. An important component of both forming and fostering identity

Flourishing

The purpose of being human is to flourish. We have a duty to do what is possible to foster outcomes that lead to human flourishing. (Encouraging patients in their difficult times, Seeing additional resources for patients, Encouraging coworkers to see employee assistance, Creating a positive, encouraging environment)

Human Flourishing

Taking neither an overstated amount of credit nor blame for a particular situation. (Realistically viewing family members' ability to cope with a crisis, Being nonjudgmental as staff deal with a unit-based crisis, Clearly identifying your part in an error and not accepting more blame than is yours)

Humility

Hearing expectations clearly, Value debriefing and feedback from role models, Engage in reflection, Actively adopt a professional identity, Understand your own responsibilities for learning and be accountable for them, Build relationships with those around you, Develop personal self care habits, Embrace any opportunity or experiences with patients

Interventions for building a Professional Identity

Govern the nurse's social contract with patient and families within his or her care. Advocacy for the patient and family is a primary consideration for all decisions made within the healthcare environment.

Leadership and Ethics

Practice to the full extent Achieve higher levels of education and training Be full partners with physicians and other health care professionals in redesigning health care Workforce planning, better data collection and an improved information infrastructure

National Academy of Medicine - Goals for Nursing

The concept of professional identity is developed in many ways, through real and simulated experiences and reflection and role-modeling by professional colleagues.

The scope of Professional Identity

Defines or identifies the features of a profession. It helps keep us self regulated as professionals, it helps to keep us accountable, it also helps describe an obligation that we have between our clients (patients), our profession, and our colleagues. Serves as a mean for us to analyze, decide, and take action.

What is an Ethical Code for Nursing?