The gravitas behind this phrase was not immediately obvious. At that point, “professionalism in nursing” sounded just like many other buzzwords that would remain ethereal and useless beyond a work interview. Are we talking about the knowledge, the drive to care for others, the spirit that drives us forward with an atropine shot right when needed? Is it a combination of all these things?
Now that graduation is finally within reach, I know more about what becoming a nursing professional entails. I haven’t mastered all the skills involved, but at least I know what I’m missing (mostly). Today, we’ll be shedding some light on the abilities needed to be a professional and how you can begin developing them while you’re still in school.
What is Professionalism in Nursing?
When asked to define professionalism in nursing practice, we are talking about the values, skills, and attitudes that we expect nurses to uphold while taking care of patients.
Stop for a second and think of the ideal nurse you would like to see caring for your loved ones.
He or she would have a set of qualities – some more realistic than others – that we all agree would give your relative the best chance at recovery.
What comes to mind?
- A calm demeanor that makes you feel in competent hands?
- Thorough knowledge of the ailment at hand?
- Sharpness and attention to detail to notice if everything is evolving as it should?
- An efficient and well-rehearsed technique when performing procedures?
All these skills are part of professionalism in nursing, and no nurse ever truly finishes developing them. Nursing school will provide us with some basics, but we will have to reflect on our performance and choose to work on various aspects ourselves.
What Skills Are Included Here?
Many nursing programs now include a course called “Professional development,” which is supposed to introduce the soft skills and attitudes required of a nurse. However, if you haven’t had any clinical experience yet, it may be hard to connect the theory to real-life, everyday nursing tasks.
This is largely because professionalism in nursing involves three separate skill sets, and only some of them can be taught in a classroom: the theoretical knowledge, the practical skills, and the attitude used when applying the first two.
One of the most-quoted studies on professionalism is a report published in the Iranian Journal of Nursing and Midwifery Research. They classified professionalism into three interconnected categories: cognitive, attitudinal, and psychomotor professionalism.
The knowledge: cognitive professionalism
This section is likely the easiest one to “study” in the traditional sense, as it encompasses all the theoretical knowledge needed to care for patients. However, it should go one step further: the values and facts you learn in the classroom need to be used to prioritize certain aspects of care or make decisions that offer the most benefit or the least amount of discomfort.
The values: attitudinal professionalism
These ideals should guide your everyday practice as you perform the day’s duties or implement any of your knowledge-based decisions. It also includes the ethical principles you should adhere to when interacting with patients, especially when facing a “gray” or ambiguous situation.
Finally, it will also include the way you communicate with the rest of your team, whether they are nurses, doctors, or other health professionals.
The practical skills: psychomotor professionalism
These are the clinical competencies and procedures that you’ve rehearsed and mastered. This side of the equation combines the physical dexterity behind each skill and the rationale behind each specific action.
Putting the Professionalism Puzzle Together
During each course and rotation in your nursing career, you will be bombarded with the knowledge that touches upon these three spheres of professionalism. They will often merge and impact each other.
The key to developing professionalism in nursing students is to spot how these principles will affect how you perform even the most straightforward nursing task.
For example, let’s take a relatively common procedure, such as a Foley catheter insertion. You likely first practiced this on a dummy at school, then helped do it on a real patient with progressively less supervision. By the time you become an RN, you should be able to insert a catheter without help, in one smooth movement, and without rechecking your notes. Before the procedure, you will check that the patient knows what you are about to do and why she needs it before asking for her consent – even if it’s a patient who has been catheterized before. You should ensure minimal pain during the procedure and arrange your utensils and the patient’s bed to maintain sterility. While you do all this, you will move around the patient steadily, inspiring confidence and showing you know what you’re about.
4 Examples of Professionalism in Nursing You Can Start Working On Right Away
Now, compare the idealized scenario above with the first time you helped a nurse place a Foley catheter. You probably had to double-check your tray twice before getting started – and maybe the patient even gave you the side-eye, hesitant at allowing a student to “practice” on them.
Did it feel like you still had miles to go? While you are still a student, it’s easy to feel a bit like an imposter or struggle to see yourself as the confident nurses you’re shadowing. I feel like this often enough, and so do many recent-graduate nurses when they compare themselves to their seniors.
This professionalism should never stop being a work in progress – but that doesn’t mean you should postpone nurturing it until after your NCLEX. Here are four ways in which you can start to cultivate all spheres of professionalism from the first day of clinicals.
Approach people from other disciplines
Hospital work is teamwork – if we were to rely on one profession alone, absolutely nothing would get done. And yet, many hospitals still perpetuate some silent differences in rank between doctors, nurses, CNAs, dietitians, and so on. This can often feel like a social minefield – especially if you don’t know yet what each role brings to the table.
During clinicals, your main task will be to shadow a staff nurse or a clinical instructor. However, you should also seek out other professionals, talk to them about their work, and ask them what they like to see in a nurse they are working with.
Put the patient first
One of the core ethical principles for nurses worldwide is the preservation of the patient’s wellbeing and dignity. This includes taking the patient’s rights into consideration whenever interacting with them, defending those rights when threatened, and acknowledging how patients feel about their treatment.
We are tasked with acting in the patient’s best interests at all times. While we likely know more about physiology and health than most patients, we don’t necessarily know their priorities and concerns. Ask them and ensure they feel like you are listening.
Perform everything as if it were an exam
When time is limited and helping hands are scarce, it can be challenging to keep track of every single checkpoint and security measure we are supposed to do. We’ve all heard the old trope that “classroom nursing” is vastly different from “real nursing,” – but this should not be a reason to toss the rules out the window the second your instructor is not looking.
Even if they send you to prepare a bed, do it to the best of your ability, respecting every step in your manual as if it were part of your practical exam.
Remain accountable and ethical
As both a student nurse and an RN, you are bound to make mistakes at some point. It could be a symptom you missed, an unforeseen consequence, or simply a patient who is not improving as expected. When this happens, own up to your mistake and offer a way to correct it.
If you are asked to do something that you are not ready to do or haven’t practiced in a while, ask for help. There’s no shame in knowing your limits.
Pursuing professionalism is impossible unless we understand what it entails. Most of the time, we are much quicker to spot “unprofessional behavior” than to define the correct course of action. Nurse professionalism requires you to be knowledgeable, dexterous, and display a positive attitude with patients and other healthcare team members.
So how do we go about this? Stay true to your principles, keep the patient’s wellbeing at heart, and never stop learning!