THE NURSING

PROFESSION
 JOURNEY TO PROFESSIONALISM
• In early twentieth century (20%), nursing leaders realized that nursing must
develop its own knowledge to guide nursing practice,
• The move towards theory-based practice has made contemporary nursing more
meaningful and significant by shifting the focus of nursing from vocation and
occupation to an organized profession.
 OCCUPATION, PROFESSION AND
VOCATION
• Nurses regard nursing in different ways.
• Some considered it merely an occupation while others think more of it as a
profession.
• There are however, subtle differences in the terms occupation, profession and
vocation.
 VOCATION

• Occupation is a mid-14th century word, meaning a person who is employed.

• This refers to work that takes up a person’s time and energies.
• This is also known as a job. This is what a person does to pass the time and
sometimes to make a living; as when a person asks, “what do you do for a
living?”
• For those who are merely pursuing an occupation, monetary compensation and
satisfaction of personal goals is the primary motivator.
 PROFESSION
• Profession is an early 13th century word which referred to people who entered the
religious life who professed to live in poverty, obedience and chastity.
• A person may profess that he has studied everything, there is to know about a
subject matter and has arrived at his conclusions after careful study of the matter.
• University teachers are called professors from the same root, they have “something
to say” to their students. They profess based on their earned study of events and
situations.
• So, in an etymological sense, a professional is someone with something to say on
the subject at hand.
 PROFESSION
• A profession is the group while a professional is the person.
• A professional is differentiated from an amateur who may also know the same
things but does so merely as a hobby. A professional puts his passion, talents,
energy and life for that which he loves to do, his passion, talents, energy and life
for that which he loves to do, and does his work very well as a consequence.
• A profession has an institutionalized goal or social mission. Individuals who
pursue a profession continuously advance its collective body of knowledge
toward improving professional practice.
• A profession contributes to making the world a better place to live in.
 PROFESSION
• It is a profession that requires special knowledge, skills and preparation for the
promotion of health and prevention of illness.
• Nowadays, a ‘profession’ is someone who has acquired formal training and is conferred
a baccalaureate degree and passes a rigorous licensure examination.
• The work of a ‘professional’ requires a person’s mental faculties and ability to work
creatively.
• The motivation to take up a profession transcends monetary benefits. Service rather
than economic benefits is the primary consideration.
• Nursing as a profession is respected. As such, nurses are protected by the law against
servitude and inhumane working conditions and are therefore paid above minimum
wage.
 VOCATION

• Nursing has long been regarded as a vocation and as much as it had been held
such, demands of high degree of sacrifice, commitment and authentic surrender
of one’s self for the alleviation of sufferings of others.
• It is derived from the Latin word vocare “to call or to name.”
• This Latin term translate to “calling.” God’s own choosing of a way of life in
which man will best serve God and neighbour.
• It refers to the talents and gifts God gave man.
• Nursing is a Christ-like vocation since there is a belief that there is a higher being
that directs one’s actions.
 VOCATION
• Nightingale herself believed that God talked to her in her dream and “called” her to
become a nurse
• For some individuals, nursing is merely an occupation that will help put food on the
table while waiting for something better to come along.
• For most, nursing is not only a profession but also a vocation. They believe that
everyone is welcome to choose nursing as a profession, but only those who have the
real calling will be able to stay in the profession to serve those who are in need.
• When Jesus Christ called Peter, the apostle to fulfil a mission. There was nothing
special about Peter. But Peter teaches us that there is nothing special about the
people God calls, they are ordinary people from ordinary backgrounds, but who, with
the help of the Lord, do extraordinary things (Luke, Chapter 5, 1-11)
 VOCATION
• Similarly, there is nothing inherently special or exceptional about the people who
choose to become nurses. Nurses are just ordinary people from ordinary
backgrounds, bur who, with the grace of God, do extraordinary things.
• For example, take the case of the Filipino registered nurse who worked in
Singapore hospital. After her initial two-year contract expired, she decided to stay
in the hospital. She decided to renew her contract even when the life-threatening
viral respiratory illness called SARS (Severe Acute Respiratory Syndrome) broke
out. She strongly felt it was her duty to stay and help the patients afflicted with
SARS. She was dedicated to her job. Indeed she was the epitome of a nurse
who considered nursing not only as a profession but also a vocation
 VOCATION
• Another bible story is the parable of the talents. In this parable, Jesus teaches
that each one is given a specific talent which should be used well. For those
whom much is given, much is also expected. In the same way, of those who
have been given opportunities to study, serve or be blessed with fortune, much
is also expected in terms of how they will use this opportunities that were given
to them.
• In like manner, those who were fortunate to have been called to become nurses
are also expected to treat profession with utmost respect and care towards
themselves and their clients.
 CAREER VERSUS JOB
• Having a career means having life-long work. It is committed, promotes personal
growth, and has increasing levels of responsibility. Nursing is a career that has
moved from traditional cure to one of health promotion and health maintenance.
A nursing career gets nurse off their seat and on their feet. It is an expanded
career that can be practiced anywhere providing personal freedom.
• A career may also involve one or more jobs, engaging in educational
development and professional activities, and gratification comes from the
individual’s accomplishments rather than entirely from payment for hours worked.
The desire for a career is derived from something more than human instinct and
has a higher level of satisfaction. On the other hand, a job is defined as being
 CAREER VERSUS JOB
short-termed with gratification coming from payment for hours worked or
monetary satisfaction only. It is work-oriented, motivated by human instinct
towards survival. Thus, it has a low-level source of satisfaction.
• Even though the main purpose in working in other countries is to better one’s
financial standing , nurses give their best at their work. The Filipino culture
teaches nurses to be patient and resilient making them more adaptable in
working in other countries.
 CRITERIA OF THE NURSING
PROFESSION
• It is evident that nursing is integrally involved in social change. Movement towards
education of nurses in colleges and universities has allowed the formation of the
body in nursing knowledge and the learning of research skills.
• Without a doubt, nursing is a profession. In 1915, Dr. Abraham Flexner, describe
the criteria of a profession in general. The criteria include:
1. A profession involves the use of refined intellectual faculties of man that is
coupled with personal accountability.
- A profession draws on well-defined and well-organized body of specialized
knowledge. It requires thinking and commitment to deliver and be accountable
 CRITERIA OF THE NURSING
PROFESSION
for all their professional actions. They are accountable for the assessment, planning,
implementation and evaluation of standards of care, and for delegating work to
support staff. Professional accountability relates to the additional obligation of the
profession not to abuse the trust of those they care for and to be able to account and
justify their professional actions.
2. A profession is based on knowledge, not routine activities.
- A profession derives its raw materials from science and learning . It uses
the scientific methods and techniques to enlarge that body of knowledge to improve
education and provide quality service . It requires continuous professional
development and organizational applications. A profession educates its practitioners
in institutions of higher learning for extensive training. Members are
 CRITERIA OF THE NURSING
PROFESSION
accountable for continuing education and development of competencies. Nursing
is based on a set of nursing knowledge that continually grows.
3. A professional theories and seeks practical application of theories
learned.
- A profession develops, evaluates and uses theory as basis for practice. A
profession is theory-driven. Theories provide possible explanation to an event
which are translated again into new theories. A profession approaches problems
and issues with a solution in mind. Nursing theories have been developed over
the years that helped contribute to transforming nursing practice into a profession.
 CRITERIA OF THE NURSING
PROFESSION
4. A profession has techniques that can be taught.
- A profession possesses an educationally sound communication
technique. The knowledge generated is passed on and replicated. The techniques
are meant to be shared with other people. Nursing knowledge is not held in a
vacuum but is meant to be shared.
5. A profession is organized internally.
- Self-regulation shows independence of thought. It considers the way a
profession should relate to the clients they serve, their fellow members or like-
minded ‘professors’ , the public and the body that holds them accountable. Among
 CRITERIA OF THE NURSING
PROFESSION
equals, members of an organization set up standards of practice to protect the
public against the risk of poor practices by some of its practitioners. They also
register those who are not registered. It may apply sanctions such as removal and
suspension. Nurses can be removed from the nursing council registry if they are
deemed unfit. The Philippine Nursing Association (PNA) is a profession organized
internally.
6. A profession is motivated by altruism, with members working in some
sense for the good of society.
- It is composed of individuals who consider nursing as their life’s work,
contributing to the good of society through service to others above personal gain.
 CRITERIA OF THE NURSING
PROFESSION
Nursing history teaches that nursing pioneers ere motivated to render service at the
expense of their personal comfort. The professional nurse is involved in community
service to formally and informally share health care information with the
communities they serve.
7. Members of the profession adhere to a code of ethics.
- A code of ethics is the set of written rules that guides and directs how the
members must behave with the other members of the profession, how members
conduct themselves in front of their client, their profession and the organization as
a whole. It is a tools and a necessary mark of a profession and professional self-
regulation.
 CRITERIA OF THE NURSING
PROFESSION
The nursing profession develops and hold members accountable to general ethical
standards. For example, the Philippine Nursing Association Code of Ethics is a guide for
action based on social values and standards. The existence of a code provides a positive
argument that a group self-identifies as “professional,” not just as occupational. A code,
then functions as a reminder of these duties to both the practitioner and the public.
8. Professionals are well-awarded and achieve satisfaction in their chosen
profession.
- In terms of monetary benefits, members of a profession hold a higher status due
to high level of intellectual activity required in their profession. Sometimes, the
psychological rewards far outweigh the financial rewards. A profession is able to
 CRITERIA OF THE NURSING
PROFESSION
Provide its members with the opportunity to achieve their fullest potential and reach
self-actualization. Nursing does the same to nurses. It has done so for many
before not only in terms of financial rewards, as many have been able to generate
wealth because of nursing, but also in terms of psychic rewards. Nursing has
provided a career that just keeps giving.
 CRITERIA OF THE NURSING
PROFESSION
• Ernest Greenwood’s updated characteristics of a profession includes:
- systemic theory
- authority
- community sanction
- ethical codes, and
- culture
 CRITERIA OF THE NURSING
PROFESSION
1. SYSTEMATIC THEORY
• Professionals have knowledge set that is derived from the program of studies
thus, must be gained through an extensive formal education

2. AUTHORITY
• Professionals have significant control over the nature and extent of services they
render, because they serve clients who are generally unable to judge the quality
of those services.
 CRITERIA OF THE NURSING
PROFESSION
3. COMMUNITY SANCTION
• Professionals are subject to licensure or certification by the state that delineates
varying degrees of occupational jurisdiction in accordance with criteria over
which they have considerable influence.

4. ETHICAL CODES
• Professionals adhere to standards of behaviour that are explicit, systematic,
binding, and public service oriented . It has prescribed colleagues relations that
are cooperative, egalitarian, and supportive and are enforced by their
associations
 CRITERIA OF THE NURSING
PROFESSION
5. CULTURE
• Professionals have a career orientation that lead them to high personal
involvement in their work and satisfaction with not only monetary rewards, but
also symbols such as titles and awards.

• Likewise, Bayles’ features of a profession includes extensive train9ng that

involves a significant intellectual component and puts one in a position to provide
a important service to society.
 LEGAL BASIS

• Article 3 Sec. 9 of R.A. 9173 or the “Philippine Nursing Act 2002” provides the
legal basis for the maintenance of the nursing profession in the Philippines>
“The Board of Nursing shall monitor and enforce quality standards of
nursing practice necessary to ensure the maintenance of efficient, ethical and
technical, moral and professional standards in the practice of nursing taking into
account the health needs of the nation.”
 CORE COMPETENCIES UNDER THE ELEVEN
KEY AREAS OF RESPONSIBILITY OF THE
PROFESSIONAL NURSES
• There are basic key areas of responsibility that nurses need to develop the five core
competencies.
1. Provide patient-centered care. The nurse identifies, respects and cares about
patient’s differences, values, preferences, and expressed needs, relieve pain and
suffering. The nurse coordinates and provides continuous care; listen to, clearly
inform, communicate with, and educate patients. The nurse must also share decision
making and management and continuously advocate disease prevention, wellness
and promotion of healthy lifestyle, including focus on population health.
2. Work in interdisciplinary teams. The nurse cooperates, collaborates,
communicates, and integrates care among team members to ensure that care is
continuous and reliable
 CORE COMPETENCIES UNDER THE ELEVEN
KEY AREAS OF RESPONSIBILITY OF THE
PROFESSIONAL NURSES
3. Employ evidence-based practice. The nurse integrates best research
findings with clinical expertise and patient values for optimum care and
participates in learning and research activities to the extent feasible.
4. Apply quality improvement. The nurse must identify errors and hazards in
care, understands and implements basic safety design principles, such as
standardization and simplification. The nurse continually understands and
measures quality of care in terms of structure, process and outcomes in
relation to patient and community needs, and designs and tests interventions to
change processes and systems of care, with the objective of improving nursing
care services.
 CORE COMPETENCIES UNDER THE ELEVEN
KEY AREAS OF RESPONSIBILITY OF THE
PROFESSIONAL NURSES
5. Utilize informatics. The nurse communicates, manages knowledge, mitigates
errors and supports decision making using information technology.
 SIGNIFICANCE OF CORE
COMPETENCY STANDARDS
• Core competency standards are crucial for nursing practice, as they provide a
unifying framework for nursing practice, as they provide unifying framework for
nursing practice, education, regulation and for improving such practices and
training. They also provide framework in developing test syllabi for nursing
profession entrants, a tool for nurses’ performance evaluation, and a means of
public protection from incompetent and or unethical practitioners
 SIGNIFICANCE OF CORE
COMPETENCY STANDARDS
Patient care Empowering Enabling Enhancing
competencies competencies competencies competencies
- Safe & - Legal - Management - Research
quality responsibility of resources & - Quality
nursing care - Ethico-moral environment management
- Health responsibility - Record
education - Personal & management
- Communicati professional
on responsibility
- Collaboration
 ELEVEN KEY AREAS OF
RESPONSIBILITIES
• The core competencies under the eleven key areas of responsibilities which are
very important in nursing practice together with the indicators fro each of the
competencies.
- Patient care competencies refer to:
• Safe and quality nursing care
• Health education
• Communication
• Collaboration
 ELEVEN KEY AREAS OF
RESPONSIBILITIES
• Patient care competencies refer to what nurses have known to be able to take
care of patients.
1. Safe and quality nursing care
- The client depends on the nurse to provide for his well-being while under
their care. Thus, nurses must observe safe and quality nursing care to the clients.
This involves the use of the nurse of concepts and principles derived from
evidence-based research and the use of current trends of nursing practice proven
to be effective and efficient. Nightingale appropriately cautions nurses to do harm.
Clients come to nurses for caring. They entrust their lives to the hands of nurses in
the belief that nurses have their best interests at heart,
 ELEVEN KEY AREAS OF
RESPONSIBILITIES
2. Health Education
- The nurse must also provide health education to enable the clients to take
care of themselves and become self-reliant, particularly after they have left the
hospital. For example, the nurse could brief the client who has just given birth as to
proper hygiene in order to prevent post partum complications or the proper way of
changing infant diapers, swaddling or mixing formula milk. Or, the nurse can teach
the client on proper wound care and change of dressing.
3. Communication
- Good communication skills are basic component of clinical care. The nurse
 ELEVEN KEY AREAS OF
RESPONSIBILITIES
should be able to articulate what she perceives to be the client’s needs and address them
appropriately. She must have self-confidence and be able to project authority as well as
competence. She should be careful about the non-verbal signs that she unconsciously
creates for it also affects the clients emotionally that could create anxiety and fear. Nurses
must be able to use the right words clear and simple when explaining to the client in a
soft voice and manner that best communicates the intended message.
3. Communication
Good communication skills are basic component of clinical care. The nurse
should be able to articulate what she perceives to be the client’s needs and address them
 ELEVEN KEY AREAS OF
RESPONSIBILITIES
appropriately have self-confidence and be able to project authority as well as
competence. She should be careful about the non-verbal signs that she
unconsciously creates for it also affects the clients emotionally that could create
anxiety and fear. Nurses must be able to use the right words clear and simple,
when explaining to the client in a soft voice and manner that best communicates
the intended message.
4. Collaboration
- But above all, a nurse knows that good collaboration between nurses,
health workers and clients is the key ingredient to safe and quality care. A nurse
promotes joint effort with members of the health care team to plan the necessary
 ELEVEN KEY AREAS OF
RESPONSIBILITIES
interventions to ensure patients safety and wellness. A nurse gets the cooperation
of the client to optimize the time spent in healing and recovery at the hospital. The
nurse also collaborates with other health personnel as to patients health status
prognosis and home health plan.
 EMPOWERING COMPETENCIES
- Empowering competencies refer to:
• Legal responsibility
• Ethico-moral responsibilities
• Personal and professional development
- These refer to the authority or power of nurses to do what is best for herself and
the patient.
1. Legal responsibility. With the growing complexity of health care needs in
society, the nurse must also be aware of the legal responsibility attached to the
practice of nursing to avoid malpractice suits. Nurses practice within the confines
 EMPOWERING COMPETENCIES
Of what is legal considering the patient’s rights and privileges as stipulated in the
nursing law and the state law. For example, a nurse must know how to administer a
medication correctly or obtain n informed consent fro a pre=operative patient.
2. Ethico-moral responsibilities. There are accepted norms and ways of how to
live and act in a community. The nurse must be well informed of the ethical and
moral implications of her actions. Beneficence which is to “do good” and non-
malificence which is to “do no harm” to the client must always prevail. IN the issue of
euthanasia, some areas in the United States have found it moral to pull the plug on
the ventilator of a client who requested and ordered a DNR or “Do Not Resuscitate”
under special circumstances. In other parts of the world, euthanasia continues to be
a moral concern.
 EMPOWERING COMPETENCIES
3. Personal and professional development. Nurses are obliged to develop their
personal qualities. To grow in the profession and improve their practice, they need
to continue their professional learning by attending seminars and pursuing further
studies. Nurses must also attend personality development seminars to improve
their attitudes towards themselves, their clients and community They can also
learn how to avoid stress and burn-out in the workplace as well as personal
financial management on how to build their own resources.
 ENHANCING COMPETENCIES

- Enhancing competencies are actions of the nurse that will help improve his/her
personal and professional relationship with her clients.
- This include:
• Research
• Quality improvement
1. Research. It is through research that knowledge is developed. Nursing as a
profession grew through extensive research by nurses themselves offering abstract
and concrete principles arrived at scientific research and logical analysis. Research
findings provides evidence-based data that would make nursing practice
 ENHANCING COMPETENCIES
credible and indispensable. Nursing is not a trade, it is a profession and as such,
can be enriched by further study.
2. Quality improvement. The quality of care done by nurses can be measured by
the response of clients to the care given. It can also be measured by the
effectiveness or outcome of the intervention chosen. It can also be improved by
the quantity of care given. The efficiency of the nurse is also improved by the
systems an resources used to give care.
 ENABLING COMPETENCIES
• Management of resources and environment
• Records management
- There are two things required of a nurse to support her good practice.
These are proper management of resources and environment and record
management. As Nightingale demonstrated, copious note-taking is better than no
notes at all. This will serve the nurse well in times when there is a need to evaluate
the actions taken on a client’s care.
1. Management of resources and environment. A mark of a good nurse is the
ability to identify and make available the resources needed. The nurse must be
 ENABLING COMPETENCIES

able to use these resources efficiently and economize them to save cost to ensure
availability of those resources at all times. The environment affects a client’s
health and to this end, a nurse should be able to ensure that it is sanitary and
noise-free.
2. Records Management. In records management, charts and nursing care plans
must be accomplished, recorded and reported. However, the nurse cannot rely on
good charting alone. The nurse must also be able to get accurate information by
going to the patient or referring to the health care team to enable them to give
accurate and appropriate care to the client.
 CORE VALUES
OF NURSING • A professional nurse must practice RELIC:
respect, excellence, leadership, innovation
PROFESSIONALS and compassion.
• R - espect
• E - xcellence
• L - eadership
• I - nnovation
• C - ompassion
 CORE VALUES OF NURSING
PROFESSIONALS
Respect
• Nurses must consider patients of value, deserving of high regards. The nurse
foremost concern is her patient’s safety and wellness considering patients right
to treatment. Respect is accorded to patients especially when they are most
vulnerable. For example, when a client is delirious and could be saying things
not normally said if lucid, when clients have to wear hospital gowns that
sometimes show their private parts, such as a famous personality undergoing a
sensitive operation, must be treated with respect considering their right to
privacy and confidentiality. However, the nurse must also make sure that she is
accorded due respect by her clients through her words, actions and decisions.
 CORE VALUES OF NURSING
PROFESSIONALS
Excellence
• Nurse must uphold the culture of excellence and shun mediocrity. They must
continuously commit to achieve higher levels of quality. Mediocrity is the
opposite of excellence. Mediocrity is poor service given to the clients an refers
for example, to the negative trait of saying, “pwede na yan.”
Leadership
• Nurses are empowered to become productive and efficient. Nurses influence
their patients to comply with all the health instructions given to them
 CORE VALUES OF NURSING
PROFESSIONALS
• There are different types of leaders and brands of leadership. But the one that
most Filipinos favour is servant leadership. This refers to caring for less able
persons. Nurses must be of service to others. For example, a good head nurse
or unit manager leads and motivates her team of nurses to perform their best in
giving quality care to patients regardless of conditions or situations. Caring is the
bedrock of professional nursing. It is what completely heals the broken spirit
and the wounded bodies of patients
 CORE VALUES OF NURSING
PROFESSIONALS
Innovation
• Nurses are encouraged to tap into their creative and critical thinking as they
practice. Nurses can continuously fulfil service needs of society for caring and
nurturing if they kept abreast with new ideas and research. Progressive
intellectual operations and desire for change enhance nurses capability and
confidence .
Compassion
• Nurses are sensitive to the needs of others. St. Elizabeth of Hungary (1207-
1231), patroness of nursing, served the sick, bathing them, feeding them,
 CORE VALUES OF NURSING
PROFESSIONALS
• Dressing their wounds and ulcers out of compassion. She generously gave alms
to all who were in need, and was especially concerned with the plight of lepers
and orphans. Another saint is St. Martin de Porres (1579-1639), patron saint of
public health and social justice, who showed compassion to the poor and the
lame
• St. Teresa of Calcutta did not tire of embracing the poor and the sick. She said
that she doesn’t need to sleep much as she could do all the sleeping she wants
when she has to join her creator.