Gina's Nursing 316 Experience, online.....

1
My Professional Identity
Gina McKim, RN
Nursing 316
UNCW School of Nursing
10/10/2009

Working as a professional nurse for over twenty years has provided many opportunities for career development and self-evaluation. Exposure to multiple disciplines within an interdisciplinary team, patients representing all aspects of our society and humanity, and varied areas in the nursing field have shaped and molded my career. Developing our own professional identity and promoting professionalism in nursing care are core requirements for safe and effective practice (Miller, Adams, & Beck, 1993). The evaluation of my own professional identity will help me grow and develop as a nurse.
Using the nine characteristics of professional nursing and following the American Nurses Association code of ethics (ANA, 2001) ensures high standards of care. They are used to evaluate and shape our profession, and offer great resources for the promotion of nursing standards and self-reflection. Knowing our strengths and weaknesses allows us to reshape our identities, and build on our strengths.
Self-evaluation and reflection are valuable in all areas of our lives. Using these tools to promote excellent patient care and the advancement of our own careers will encourage the growth of our profession.
One of the best definitions for the philosophy of nursing was presented by Virginia Henderson, considered an outstanding leader in nursing. She saw the profession as unique, and her philosophy of nursing included the care, support, and assisting of the patient with their health needs (Henderson, 1966). We all have our own philosophy of nursing based on our personal belief system and view of the world. This paradigm is one that changes and shifts with research and knowledge. Overall, there is a metaparadigm of nursing which incorporates an overall concern of nursing that is found in all nursing models (Kearney-Nunnery, 2008).
There are four essential requirements needed for the nursing metaparadigm. They are identity (distinctly different from others), inclusiveness (all phenomena of interest, manageable and understandable), neutrality (inclusive of all), and internationality (representative of all national, social, cultural, and ethnic boundaries) (Fawcett, 2005). Professional nursing uses the following to incorporate these four requirements: human beings, the environment, health, and nursing. Our philosophies determine how we use these concepts in practice. How we respond to human needs, use our knowledge to provide care, and observe our patients objectively and subjectively are all part of our philosophy. Our ethics, standards of practice, and our own personal expectations are our values and beliefs (ANA, 1980). Continuing our education and promoting the nursing profession are also included in our professional identity and philosophy of nursing. All of these components are important in providing the best care possible and maintaining our personal standard.
After completing Chapter 1 interactive exercise 6 (Kearney-Nunnery, 2008), my own philosophy of nursing was found to correlate with the ANA’s, as outlined in the preceding paragraph. Humans represent the spectrum of humanity from birth to death, and humanity isn’t based on gender, race, age, disability, or learning ability. The environment is varied, from a healthy environment promoting wellness to a harmful one promoting an unhealthy lifestyle. Our homes, society, work environments, and health facilities are all part of our environment. Each and every one has the potential to be a good or bad influence. Maintaining health is the best goal of our environment, health is the optimal state of wellness. As nurses, we strive to promote healthy lifestyles and to help our patients have a good quality of life. This is done with acute and chronic illnesses, and care is adapted based on our patients needs.
Personally, we as nurses should strive to promote our own health and maintain wellness. Being healthy helps us provide for others, and enhances our ability to further our knowledge and promote healing. Nursing includes advocacy for our patients, protecting them from harm, and providing compassionate care. In general, all people represent humanity, and all deserve the best care we can provide. Having a philosophy of nursing that incorporates all areas of concern and leads to providing consistent, evidence-based care is important for our profession and personal career goals.
We each must analyze our own value systems and beliefs, and evaluate how they influence our practice of nursing. There isn’t room for bigotry or prejudice, as all humans are worth having the highest standards of nursing. Maintaining the health and wellness of our patients and ourselves is a major goal of our philosophy.
Miller et al. (1993) provide a great system for evaluation of one’s professional nursing status. They include evaluation of our educational background, knowledge of the ANA code of ethics (ANA, 2001), participation in professional organizations, continuing education and continued competence, communication and publication, autonomy and self-regulation, community service activities, nursing theory and knowledge, and research involvement.
Completing the interactive exercise for our textbook chapter one, exercise 7, gave me a good outline for evaluating my own definition of professional nursing. My definition includes using nursing skills to promote the health and welfare of patients to their optimal level. This includes the advocacy of patients and their rights, alleviation of suffering, diagnosis and treatment based on individual response, and promoting healthy lifestyles. Using the professional nursing evaluation tool helped me to define my personal professional status, and identified my strengths and weaknesses relative to the listed characteristics. These will be discussed in detail in the next section.
Literature Review
In evaluating literature explaining the professional role and definition of nurses, I researched five articles that addressed the issue. They included:
1) The Future of Professionalism in Nursing ( Pinkerton, S., 2001)
2) What contributes to professionalism? (LaSalla & Nelson, 2005)
3) Professionalism in Nursing (Ahmad, N., 2009)
4) Professionalism and Nursing: One and the Same (Underwood, P., 2000)
5) Philosophical and Theoretical Perspectives for Advanced Practice (Cody, W., 2006)
All of the articles expressed the importance of knowledge and autonomy, and using safe practices in providing nursing care. The importance of our physical appearance and the first impression we make on patients was stressed in the second article. The fifth article emphasized using valid research for the advancement of our practice, and continuously advancing our knowledge. The third article called professional nursing an area of specialized knowledge that requires skilled preparation. The fourth article explained the importance of nurses participating in organizations that further their knowledge and advocacy as a group, and the first article also discussed autonomy and how it varies with organizations. The overall theme was that nursing is a profession that requires ongoing education, ethics, and participation in organizations promoting the profession.
It is essential that nurses have criteria and standards for practice, and using tools and assessing one’s goals are critical in ongoing education and best standards of practice. Having guidelines that outline and detail our professional standards helps us to evaluate ourselves and comply with the values that separate us as a unique profession. There are many models available for assessment, but the essential themes are service and altruism, obtaining advanced knowledge, and autonomy and ethical standards (Chitty, 2005).

My Definition of Professionalism

Using the nine characteristics of nursing helped to define my proposed definition of professional nursing. Using several resources from our textbook and literature signified the importance of having professional standards in place. The American Nurses Association Social Policy Statement (2003) defines nursing as:
a caring relationship to promote health and healing, attention to our patients physical responses to health and illness in their environment, using scientific knowledge to diagnose and treat patients using critical thinking skills, using objective data with an appreciation of the subjective experience of the patient, advancement of nursing knowledge, and doing our part to influence public policy to promote social justice (p.6).
These clearly define nursing as a unique discipline that utilizes all areas of a patient’s life to promote their best quality of life while maintaining high standards for the profession. Using evidence-based care (Greiner and Knebel, 2003) has improved the practice of nursing, and using data collection and assessing patient outcomes has lead to better standards and core competencies. As stated in our textbook, professionalism is an attribute in constant refinement and nurses must have the resources and self-regulation to pursue and become competent in all areas of change (Kearney-Nunnery, 2008).
Characteristics of Professional Nursing
Education
This area assessed my educational background. Completion of a Licensed Practical Nursing program at Tom P. Haney Vocational School was my first endeavor. Located in Panama City, FL, this is an excellent program that emphasizes clinical skills and is accredited by the state of Florida. Upon completion of this program in 1982, I passed the licensure examination and began working in the area of obstetrics and gynecology, followed by oral surgery. Wanting to further my career and increase my salary, I attended Gulf Coast Community College in Panama City and completed the LPN to RN articulation program in 1989. This was an accredited program which was also clinically oriented, and focused on patient advocacy and critical thinking before its time. I received an Associate’s Degree in Nursing, passed the state boards, and began my new career. My nursing jobs have been varied and numerous, including the areas of home health, endoscopy, and surgical services. Presently, I am attending the UNCW RN to BSN program, with hopes of obtaining a BSN. This program is very research oriented and encourages nurses to continue furthering their careers. There is a high success rate of graduates and licensure exam passing rates, and UNCW has an excellent reputation, as well as state accreditation. Another area of interest is Forensic Nursing, which I studied via an online course with Kaplan University. I found this information fascinating, and attended a seminar presented by our local District Attorney and a dinner program at UNCW on this topic in the last few years. . “Self-initiated education” is a hallmark for professional nurses, according to the American Association of Colleges of Nursing (2002). We must take action to ensure that we pursue these standards as part of our professional standard.
Code of Ethics
This is a very important part of professional nursing. The ANA’s code of ethics provides guidelines for both formal and informal standards of ethical practice. This code focuses on the fact that we, as nurses, are to treat all patients with respect and dignity. We are to strive to increase our knowledge base and provide the best care possible, and it is important to maintain our own health and self-care. We are to promote a positive work environment that utilizes our capabilities and is encouraging to others, advocate for our patients, and maintain high standards of practice to prevent harm to those we care for. Our standards and preservation of this code will help influence our profession in the future.
My personal practice of nursing is based on maintaining these standards. Providing the best care possible and furthering my education are a constant process, and nonnegotiable standards. My failure in this area is the maintenance of my own health and self-care, living a healthier lifestyle will be emphasized in the future.
Participation in Professional Organizations
My participation in professional organizations is lacking, less than ten percent of Registered Nurses belong to the American Nurses Association. This is a sad statistic, as they are the only full-service professional organization representing RN’s. They promote the standards of nursing and lobby Congress for nursing issues, as well as fostering the growth of nursing. This will be one area that I will improve by joining the ANA.
Continuing Education and Continued Competence
Working at New Hanover Regional Medical Center meets most of the continuing education and continued competence requirements to maintain my RN licensure. The policies and procedures at NHRMC have classes and competencies that are completed yearly or as needed. Online courses, seminars, and college courses have helped complete and surpass the minimum requirements for licensure. Reading nursing and scientific literature helps provide safe, effective, and ethical care for my patients. The American Journal of Nursing is one resource that has been very educational and is an ongoing source of relevant and valid information. It is important to check validity of all of your learning sources, as the internet isn’t the best place for finding this kind of information. Greiner et al. (2003) have found that patients like to “educate” themselves on the web, nurses must stay up-to-date and knowledgeable to inform them of the scientific and medical fact.
Communication and Publication
This is another area that needs improvement in my nursing career. Participating on the Nursing Congress Practice and Finance Committees allowed me to have input on final publications at NHRMC related to these areas, but I have never done my own publication for nursing. Online groups for classes and personal use, coursework for college, and participating in Magnet certification at the hospital required communication. This is viewed as a very important characteristic for nursing. Communication is important to me, but publishing my own work has never held any significance in my career.
Autonomy and Self-Regulation
This characteristic is a personal responsibility that holds us accountable to self and others. With state licensing, we are given the great task of providing high-quality care and maintaining excellent standards in our work and personal environments. The peer review process, Nursing Congress, and compliance with set policies and procedures help in meeting this characteristic. Having our own set of values and morals provides a compass for our conscience, and helps us regulate our own contributions to humanity.”Self-initiated education” is a hallmark for professional nurses, according to the American Association of Colleges of Nursing (2002). We must take action to ensure that we pursue these standards as part of our professional standard.
Community Service Activities
These activities are personally one of the most important. Being involved in the community and promoting self-awareness are standard practices in my life. Serving as a board member of the Children’s Museum of Wilmington and Coastal Horizons Center have been very fulfilling, and an honor. Participating in Relay for Life, Leukemia and Lymphoma Society’s Team in Training, Pink Ribbon fundraising, the NHRMC foundation, and teaching friends and family about how to do Self Breast Exams are high priorities. Funding a scholarship for the University of North Carolina at Wilmington Cameron School of Business and a program to promote healthier lifestyles in women cancer survivors at the University of NC Hospital give me great personal satisfaction. This characteristic is valuable in that it helps promote the good for all of us, and we can give of ourselves with our time or financially.
Nursing Theory and Knowledge
This characteristic is related to the trends in patient outcomes. The critical analysis of patient care is a core competency of evidence-based care (Greiner and Knebel, 2003). Collecting data on patient outcomes helps to promote better standards of care by comparing what works with what doesn’t, or improving upon proven standards. This is a constant, changing characteristic that is required for best care practices.
Research
My involvement with research has been on a personal level. This includes being involved in a study through UNC Hospital for breast cancer and genetics, and another one at Memorial Sloan-Kettering Cancer Center for papillary thyroid cancer. Supporting the development of research and knowledge is invaluable for the growth of health care, and diagnosis and treatment of diseases. Using the information gleaned from research makes our profession more valuable and makes us more competent as nurses.
In evaluating all nine characteristics, there are areas of weakness that need to be developed. These include participation in professional organizations, communication and publication, and further participation in research. My strengths lie in maintaining the code of ethics, community service, continuing education and competencies, nursing theory and knowledge, autonomy and self-regulation. This evaluation has been very productive in making me take a good look at how I practice and what my personal beliefs are. It is a great tool for an evaluation of our professional status as nurses.
Using the information I have obtained with this assignment will improve my professional practice and enhance my personal philosophy of nursing. The importance of the nine characteristics was well-documented. The code of ethics for nursing must be followed, and this isn’t an issue that can be challenged if we are to promote the best care for patients. As outlined in my presentation, research and joining professional organizations are areas in which I plan to improve. The ANA will prove to be a valuable resource for my professional development. Better eating habits and exercise are goals for my own health and self-care.
Having a grasp of what shapes us as nurses, and knowing our own values and belief systems can only enhance the care we provide. Being non-judgmental and compassionate towards all human beings and obtaining knowledge to provide excellent care are necessary components of nursing. Performing a self-evaluation of our roles as nurses will advance our skills and further our career goals. As stated by the Ohio Board of Nursing (2001):
Nursing practice is dynamic and responsive to societal health needs; therefore, it is generally impractical for the law and rules to list all the specific duties or tasks that
licensed nurses may or may not perform. Attempts to delineate all the specific activities
of licensed nurses would needlessly impede the growth of the discipline of nursing. It is
critical to note that the law and rules require that the licensee provide nursing care only in
circumstances which are consistent with one’s preparation, education, experience,
knowledge and demonstrated competency (p. 1).

References:
American Association of Colleges of Nursing (AACN). (2002). Hallmarks of the Professional
Nursing Practice Setting: What Every Nursing School Graduate Should Consider When Seeking
Employment. Retrieved September 12, 2009, from
http://www.aacn.nche.edu/Publications/positions/hallmarks.htm

American Nurses Association (ANA). (2001, June 30). Code of Ethics for Nurses. Retrieved
September 12, 2009, from
http://nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthics

American Nurses Association (ANA). (2003). Nursing's Social Policy Statement. (2nd ed.)
Retrieved September 21, 2009, from
http://www.nursingworld.org/EspeciallyForYou/StudentNurses.aspx

Chitty, K. (2005). Professional Nursing: Concepts and Challenges. (4th ed.). St. Louis, MI: Elsevier,
Inc.

Fawcett, J. (2005). Criteria for evaluation of theory. Nursing Science Quarterly, 18(2), 131-135.

Greiner, A. & Knebel, E. (2003). Health Professions Education: A Bridge to Quality.
Washington, DC: The National Academies Press.

Henderson, V. (1966). The Nature of Nursing: a definition and its implications for Practice,
Research, and Education. New York, NY: MacMillan.

Kearney-Nunnery, R. (2008). Advancing Your Career: Concepts of Professional Nursing.
Philadelphia, PA: F.A. Davis Co.

Miller, B. K., Adams, D., & Beck, L. (1993). A behavioral inventory for professionalism in
nursing. Journal of Professional Nursing. 9(5). 290-295.

Ohio Board of Nursing, (2001). Decision-making model. Columbus, OH: Scope of Practice
Decision Making Model. Retrieved September 21, 2009, from http://www.nursing.ohio.gov