Professionalism - 12 Flashcards Preview

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Flashcards in Professionalism - 12 Deck (41):

Characteristics of a Professional

•It demands possession of a body of specialized knowledge and extended practical training.
•It renders an essential social service.
•It demands continuous education of its members.
•Its individuals performances are measured in relation to standards determined by his or her colleague group.
•It expects its members to adhere to a code of ethics
•It sets up its own professional organization.


Just the facts.... [2016]

•3.4 million RNs
•40% of health care workforce
•Todays nurse:
46.8 years old
94.3% female
10.6% minorities
34.2% BSN
33.7% ASN
17% diploma
13% masters or doctorate


Professional Nurse

•“A specially trained professional that addresses the humanistic and holistic needs and response patterns of patients, families, and community to actual and potential health problems. The professional nurse has many roles, such as care provider, client advocate, educator, care coordinator and change agent” (Katz et al, 2009).


Graduates of Associate Degree Programs
(ANA scope)

•Prepared to engage in technical aspects of clinical practice of nursing
•Should have graduated from a program that provided them with knowledge base needed to apply a circumscribed body of established nursing principles and skills
•Should be able to understand patient problems from a biological, social and psychological perspective
•Use problem solving approach to the health care of individuals and their families in a variety of organized nursing service settings


Competency Measures of Graduates

•NLN: Core values include caring, diversity, ethics, excellence, holism, integrity & patient centeredness
•NLN emphasizes the expectation that nurses will increase their personal & professional knowledge, provide safe quality care, perform in a team work manner & provide relationship-centered care.

•QSEN: emphasizes patient centered care, teamwork & collaboration, EBP, QI, & Informatics


Public Beliefs & EBP

•Gallop poll
•Research by Linda Aiken and colleagues
•Institute of Medicine report


Institute of Medicine report

The Future of Nursing: Leading Change, Advancing Health: Recommendations

•Remove scope-of-practice barriers
•Expand leadership opportunities for improvement efforts at all levels
•Implement nurse residency programs•Increase number of RN with BSN degrees
•Double number of nurses with a doctorate degree
•Ensure nurses engage in lifelong learning
•Prepare nurses to lead change to advance health
•Collect and analyze inter-professional healthcare workforce data


What can you do?

•What can the profession implement that would enhance the image of nursing?

•What actions can you take that will impact the image of nursing?


Get Smart!!!

•Commit to life-long learning
•Become an expert in your specialty
•Get certified
•Pursue higher nursing degrees
•Attend a nursing conference


Be Involved!!!

•Join ANA, FNA
•Get involved in projects on your unit
•Reflect on what interests you
•Find your passion!!


Professional Nursing Organizations

Professional organizations:
oProvide opportunities to network with other nurses
oMay serve as political voice for nurses
oMay fund political initiatives
oMay disseminate research and provide other sources of education relevant to current practice
oMay provide a service to the community


Be Committed

•Have courage to be a patient advocate
•Demonstrate positive work ethic
•Be loyal to organization
•Possess a spirit of collaboration
•Improve communication & conflict resolution skills
•Understand your scope of practice


Nurse Practice Act

•Developed by each state
•It’s the law!!
•Purpose of Act
•Definition of Nursing
•Scope of Practice
•Licensure/CE requirements
•Role of Board of Nursing


Nurse Practice Act

•(3)(a) "Practice of professional nursing" means the performance of those acts requiring substantial specialized knowledge, judgment, and nursing skill based upon applied principles of psychological, biological, physical, and social sciences which shall include, but not be limited to:
•1. The observation, assessment, nursing diagnosis, planning, intervention, and evaluation of care; health teaching and counseling of the ill, injured, or infirm; and the promotion of wellness, maintenance of health, and prevention of illness of others.
•2. The administration of medications and treatments as prescribed or authorized by a duly licensed practitioner authorized by the laws of this state to prescribe such medications and treatments.
•3. The supervision and teaching of other personnel in the theory and performance of any of the above acts.



•1940s: Mandatory licensure
•1950: Written examination “The Boards”
•1982: NCLEX
•1994: Computerized adaptive testing (CAT) for NCLEX began


[pt 1]

•Once a nurse takes the licensure exam, passes & then receives a license, he or she can re-new their license as long as they complete the required CE units.

•They if a nurse moves to another state, that nurse can receive a new nursing license for that state by paying a fee & by getting Endorsement from the previous state in which they were licensed. A Law enforcement background check may again be performed.

•Single State model of nursing regulation

•Mutual Recognition model of nursing regulation

Renewed every 2 years
CE's required - posted through


[pt 2]

•Can get a license by exam or by endorsement

•Currently, FL has a Single State model of nursing regulation

•FL is moving to a Mutual Recognition model of nursing regulation

•Nurse Licensure Compact (NLC)

•Effective date is December 31, 2018 OR upon enactment of the NLC into law by 26 states, whichever occurs first

•Allows nurses to practice under in multiple states under one license.


Continuing Education

•First renewal cycle need:
-2 hrs Prevention of Medical errors:
-2 hrs Florida Laws, Rules & the Nurse Practice Act Review
-1 hr HIV/AIDS (one time only)

•Second & subsequent renewal cycles
-need 20 hrs CE PLUS 2 hrs Prevention of Medical Errors
-2 hrs Florida Laws, Rules & the Nurse Practice Act Review

•Domestic Violence every 3rd renewal cycle


Continuing Education

•There will be a new CE requirement for Renewals beginning in 2017: Recognizing Impairment in the Workplace.

•Effective August 1, 2017, then every other biennium thereafter (every 4 years).



•Recognizes excellence in practice
•Voluntary or required
•American Nurses Credentialing Center (ANCC)


Career Ladder

PH.D. , DNSc, and DNP
Research, education, practice

Educator, clinical specialist

case management, care coordination

hospital care provision, direct care supervision




The Stresses of the Profession

•What stressors do nurses face daily in the profession?

•What will be your biggest challenges as a new nurse?

•Increased education requirements
•Keeping up with advanced medical treatments, medications, and technology
•Legal & ethical boundaries
•Staff shortage
•Mandatory overtime
•Management personnel
•Organizational politics
•Physician relationships
•Dealing with demanding patients & family


First Day as a RN


Reality Shock in Nursing

•Occurs when a person prepares for a profession, enters the profession, and then finds that he/she is not prepared (Cherry & Jacob, 2014, p. 424).
•Grad nurse realizes there are variances between the school environment and work environment

•4 Phases of Reality Shock:
o1) Honeymoon phase
o2) Shock/rejection phase
o3) Recovery phase
o4) Resolution phase

o*Degree of phases will be different for each graduate nurse


Honeymoon Phase

•The “fun” and “happy” phase
•Grad nurse is excited about passing the NCLEX, being done with school, getting a nursing job and getting paid for accomplishing their nursing tasks
•“I survived nursing school”
•Novice nurse is eager to learn and care for others as an actual nurse


Shock (Rejection) Phase

•Orientation is over, GN begins to receive his/her own assignments
•The nurse comes into contact with conflicting views and different ways of performing skills (Cherry, Jacob, 2014, p. 426)
•GN lacks the safety net of an instructor or preceptor to assist them when placed into uncertain situations
•May feel discomfort, discouraged, uneasy, lack of self-confidence


Recovery and Resolution Phases

•Phases of adjustment and adaptation to new work place
•Assignments are more easily met and doable
•Nurse’s uneasy and discouraged feelings diminish
•GN regains self-confidence and can positively get through their work shift
•Be the nurse YOU want to be; don’t let other nurses define you


Reality Shock Amongst Newly Graduate Nurses Study

Based on 347 nurses with a minimum of 2 months experience and a maximum of 2 years experience:
•78.2% perceive the early transition period of their career very difficult
•72.9% stated their job expectations were not met
•42.4% thought of quitting their job after the first 2 months
•49.3% found clinical practice insufficient compared to actually working as an RN(Caliskan & Ergun, 2012)


The Early Studies of Reality Shock

●1974 Marlene Kramer coined the phrase “Reality Shock” in her book Reality Shock: Why Nurses Leave Nursing
●1984 Patricia Benner created the nursing theory of “Novice to Expert” based on the Dreyfus Skill Acquisition Model (Petiprin, n.d.)


"Novice to Expert"

Expert - No longer needs rules; works intuitively
Proficient - Sees big picture; can begin addressing problems for the organization, not just the team
Competent (2-3 years each speciality) - Has experience with real problems; no longer struggles with basic rules
Advanced Beginner - Can start using advice in context
Novice - Needs step-by-step instructions


Reality Shock Clip




•A condition where nurses experience exhaustion from continuous mental and physical stress

Symptoms include:
•Extreme fatigue
•Mood swings
•GI problems
•Poor work quality
•Drug use


Compassion Fatigue

•Becomes an issue when the nurse cannot disengage from the stressors and they are taken on as a “burden”
•Prolonged compassion stress without relief leads to fatigue


Traps & Pitfalls

•Having no boundaries
•Allowing work to become all encompassing
•Feeling like a victim
•Participating in negative talk
•Allowing poverty of the spirit
•Having insufficient courage

•“We are taught to understand, correctly, that courage is not the absence of fear, but the capacity for action despite our fears”.


Prevention Strategies for Burnout & Fatigue

•Role models and mentor
•Professional organizations
•Recognize self-defeating behavior
•Increase personal resiliency
•Commit to self-care


Workplace Violence

•Horizontal (lateral) Violence: incivility, intimidation or humiliation

•Involves an abuse or misuse of power

•The subtle art of emotional devastation

•Recognize bullying


Bullying in Nursing

•Those most likely to participate in lateral violence:
-senior nurses
-charge nurses
-nurse managers
•Creates a toxic work environment
•Interferes with team work & communication
•Need to look out for each other
•Zero-tolerance policy
•Document incidences
•Intervene quickly
•Report it to your supervisor whether you are the victim or witnessed it
•Don’t participate in gossiping





Answer These Questions

•What can the profession implement that would enhance the image of nursing?

•What actions can you take that will impact the image of nursing?

•What stressors do nurses face daily in the profession

•What will be your biggest challenges as a new nurse?

•How do you replenish your energy?

•What, how & how often do you celebrate?

•Do you see nursing as a journey or an event?

•Where do you see yourself in 5 years in nursing?

No book can teach you how to cry with a patient. No class can teach you how to tell a family that their parents have died or dying. No professor can teach you how to find dignity in giving someone a bed bath. Nursing is not about the pills or the charting. It's about being able to love and care for people when they are at their weakest moments.



foundation belief that patients can grow in their healing and creativity



treats the whole person: mind, soul, spirit