SAAII COLLEGE OF MEDICAL SCIENCE

AND TECHNOLOGY KANPUR

SUBJECT : ADVANCE NURSING PRACTICE

TOPIC : NURSING AS A PROFESSION

SUBMITTED TO SUBMITTED BY

SHIVANI TIWARI
F.Y M.Sc.Nursing
Saaii College Of Medical Science
And Technology- Kanpur
SUBMITTED ON: 23/09/2021
 NURSING AS A PROFESSION

Introduction

● Nursing has been called the oldest of the arts and the youngest of the professions.
The term Nurse evolved from the Latin word “nutrix”, which means to nourish or to
cherish.
● Today nursing emerged as a learned profession, that is both a science and an art.
● It is a body of knowledge. Knowledge is an awareness or perception of reality, which
is acquired through learning or investigation.
● Science is defined as both a unified body of knowledge concerned with specific
subject matter, the skills and methodology necessary to provide such knowledge.
● Nursing as an art is the application of knowledge and skill to bring about desired
results. It is an individual action. Nursing art is carried out by the nurse in an one-to-
one relationship with the patient and constitutes the nurse's conscious responses to a
specific and a specific and patient's immediate situation.

DEFINITION

● Profession : a type of occupation that meets certain criteria that raise it to a level
above that of an occupation.
● Profession : is a calling that requires special knowledge, skill and preparation.
● An occupation that requires advanced knowledge and skills and that it grows out of
society's needs for special services.
● Professional : a person who belongs to and practices a profession Professionalism :
demonstration of high level of personal, ethical and high level of skill characteristics
for a member of a profession.
● Difference between Occupation & Profession.
According to Webster : - Occupation : is defined as what occupies or engages,
one's time, business and employment .
 Profession : is defined as a vocation requiring advanced training and usually
involving mental rather than manual work, as teaching, engineering, especially
medicine, law etc.

CRITERIA OF PROFESSION

High Intellectual Level Of Functioning : Modern nurses use assessment skill and
knowledge, have the ability to reason and make routine judgment depending on the patient's
condition. Professional nurses function at a high intellectual level. Florence Nightingale
raised the bar for education and graduates of her school were considered to be highly
educated.

High Level Of Individual Responsibility And Accountability : Nurses must be

accountable and demonstrate a high level of individual responsibility for the care and
services they provide. The concept of accountability has legal, ethical and professional
implications that include accepting responsibility for action taken to provide client care as
well as accepting responsibility for the consequences of action that are not performed.

Specialized Body Of Knowledge : Nursing has developed into an identifiable separate

discipline, a specialized body of knowledge called nursing science. It was compiled through
the research effort of nurses with advanced educational degrees. Although this body of
specialized knowledge is relatively small, it forms a theoretical basis for the practice of
nursing today. As more nurses obtain advanced degrees, conduct research and develop
philosophies, and theories about nursing, this body of knowledge will increase in scope.

Evidence Based Practice : Almost all the currently used nursing theories address this issue
in some way. Evidence based practice is the practice of nursing in which interventions are
based on data obtained from research that demonstrate that the findings are appropriate and
successful. It involves a systematic process of uncovering, evaluating and using information
from research as the basis for making decisions about providing client care.

Public Service And Altruistic Activities : Individuality is the focal point of all
nursing models and nursing practice. Nursing has been viewed universally as being
an altruistic profession composed of selfless individuals who place the lives and well
being of their clients above their personal safety. Dedicated nurses provide care for
victims of deadly diseases with little regard for their own welfare.

Well Organised And Strong Representation : Professional organizations represent

the members of the profession and control the quality of professional practice. In
India TNAI & SNA are the two organizations that represent nursing in today's health
care system. Many do belong to specialty organizations that represent a specific area
of practice.

Code Of Ethics : A code of ethics document may outline the mission and values of
the business or organization, how professionals are supposed to approach problems,
the ethical principles based on the organization's values and the standards to which
the professional is held. Some of the ethical principles are autonomy, justice, non-
maleficence

Competencies And Professional License : Nurses must pass a national licensure

examination to demonstrate that they are qualified to practice nursing. Only after
passing the examination the nurses are allowed to practice. The granting of a nursing
license is a legal legal activity conducted by the individual state under the regulations
contained in the state's nursing practice act.

Autonomy And Independence Of Practice : In reality nursing is both an

independent and interdependent discipline. Nurses in all health care settings must
work with physicians, hospital administrators, pharmacists and other groups in the
provision of care. In some cases nurses in advanced practice role eg. Nurse
practitioners can establish their independent practices. To be considered a true
profession, nursing will need to be recognised by other disciplines as having
practitioners who practice nursing independently.

Professional Identity And Development : Until nurses are fully committed to the
profession of nursing, identify with it as a profession and are dedicated to its future
 development, nursing will probably not achieve professional status.

CHARACTERISTICS OF A PROFESSION

A basic profession requires an extended education of its members, as well as a basic liberal
foundation. A profession has a theoretical body of knowledge leading to defined skills,
abilities and norms. A profession provides a specific service. Members of a profession have
autonomy in decision-making and practice. The profession has a code of ethics for practice.

Definitions of Nursing

The unique function of nurses in caring for individuals, sick or well, is to assess their
responses to their health status and to assist them in the performance of those
activities contributing to health or recovery or to dignified death that they would
perform unaided if they had the necessary strength, will, or knowledge and to do this
in such a way as to help them gain full or partial independence as rapidly as possible

(Virginia Henderson, 1977)

Nursing encompasses autonomous and collaborative care of individuals of all ages,

families, groups, and communities, sick or well, and in all settings. Nursing includes
the promotion of health, prevention of illness, and the care of ill, disabled, and dying
people. (Short Version definition by ICN)

Nightingale defined nursing over 100 years ago as “the act of utilizing the
environment of the patient to assist him in his recovery". (Florence Nightingale,
1860)

“Nursing is 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)
 Concepts of Nursing

The art and science of modern nursing encompasses fundamental nursing concepts
that include health, illness, stress and health promotion. Nurses work with physicians
and other medical staff in a wide variety of medical and community settings.

They provide preventive, primary, acute and chronic care for sick and injured
patients with health information, restorative care, medication administration and
emergency care. Nursing care focuses on protecting and promoting physical and
mental health for patients and for the community.

Health

Health is the absence of illness, injury and disease. Health as a fundamental nursing
concept involves both mental and physiological well being, and it changes over a
patient's lifetime. Nurses work in health care to promote and protect health by
instructing patients about self-care, and about how lifestyle and behavior affects their
health. They help people to recover from physical and mental illness, and they tend
to sick and injured patients to restore health.

Illness

Illness is a fundamental nursing concept that defines a deviation from health with
three stages: the onset of illness, the acceptance of the state of illness and the
convalescence or recovery stage. A nurse's role in illness includes monitoring and
interpreting symptoms, administering medication and self-care information, and
caring for patients who are incapacitated by illness, such as administering
intravenous fluids to a patient dehydrated from fever and vomiting.

Stress

Nurses work to make patients more comfortable, and a big part of nursing care
includes reducing patient stress. Nurses care for patients who experience stress from
 being weakened due to illness or injury, being removed from a familiar environment
etc. Nurses explain procedures to patients, listen to patient concerns and answer
questions, protect patients' privacy and ask how patients are feeling. The goal is to
calm them and make them feel more physically and emotionally comfortable.

Health Promotion

It's the responsibility of every nurse to promote better health by informing patients of things
such as illness prevention methods, safe health practices and healthy lifestyle choices.
Nurses promote health by discussing weight and exercise issues, nutrition, the risks of
drinking, smoking and drug use, and other self-care that increases their quality and length
of life.

PHILOSOPHY OF NURSING

A philosophy of nursing is a statement, sometimes written, that declares a nurse's

beliefs, values, and ethics regarding their care and treatment of patients while they
are in the nursing profession. Although the philosophy may seem solely academic
and too cerebral to be of any use, it is vital to approaching your profession in an
appropriate manner. When you develop a personal philosophy of nursing, it benefits
your career and the lives of the people you provide care to their families.

Respect is another quality that builds rapport with the patient. Patients want to be
treated with dignity and involved with their treatment. Being respectful to patients
encompasses getting to know them, their culture, and beliefs; it helps to distinguish a
treatment plan that the patient will be cooperative with.

These qualities are crucial in nursing because each person should be treated as an
individual and not a diagnosis. Health includes a person's social and mental
wellbeing as well as their physical wellbeing, so developing relationships with
patients is critical in delivering the best quality of care. With compassion, honesty,
and respect, nurses will be able to create an environment that optimizes the health of
their patients.
 OBJECTIVES OF NURSING

● Maintain and promote wellness, prevent illness, care for and rehabilitate the
sick of disabled through the human science of nursing.
● Reduce stress
● Provide comfort to client
● Develop interaction between nurse and client.
● Focus on a man a living unity and man's qualitative participation with
experience

CHARACTERISTICS OF NURSING

● Nursing is caring.

● Nursing involves close personal contact with the recipient of care.

● Nursing is concerned with services that take humans into account as

physiological, psychological, and sociological organisms.

● Nursing is committed to promoting individual, family, community, and

national health goals in its best manner possible.

● Nursing is committed to personalized services for all persons without regard

to color, creed, social or economic status.

● Nursing is committed to involvement in ethical, legal, and political issues in

the delivery of healthcare.

Nature And Scope Of Nursing Practice

● Nurses contribute to health care within a multidisciplinary team. They are

individually accountable for their actions and practise within a statutory
 regulatory framework established to protect the public and assure the quality
of nursing services.

● The role of the nurse is constantly changing and developing. This means that
nurses may add new functions to their work. When deciding to do so, nurses
must be sure that patients will benefit and that they are competent for the new
role.

● Nursing is a service which helps individuals, families and communities to

achieve and maintain good health.

● Supports, assists and cares for people during illness or when their health is
threatened

● Enhances people's ability to cope with the effects of illness and disability

● Ensures, as far as possible, that death is dignified and free from pain
goals by knowledge and skills gained through education and training, updated
and tested by research. It is the combination of professional knowledge and
skills, with the desire to care for others, which provides the base of nursing.

● The broad scope of nursing practice reflects all of the roles and activities
undertaken by registered nurses to address the full range of human
experiences and responses to health and illness. This includes: health
promotion, health protection, health maintenance, health restoration,
rehabilitation, and palliation

● The actual scope of practice of individual nurses is always narrower than that
of the scope of the nursing profession as a whole. The scope of practice of the
individual nurse is influenced by the nurses' knowledge, practice setting,
employer requirements, and client needs (CNA, 2002c). It is often described
in job descriptions and/or illustrated in practice settings as competencies.
They can work in settings like
❖ Hospital
❖ Nursing homes.
❖ Clinics and Health Department
❖ Orphanages and old age homes
❖ Military (Army, Navy, Air Force and Marines)
❖ Community settings i.e. school nurse, health visitor.
❖ Industrial houses and factories.
❖ Railways and public sector medical departments.
❖ Training Institutes as educators.
❖ Home care , Palliative care, hospice care
❖ Public health agencies.
❖ Ambulatory care centres ,extended care centers.
❖ Offices ,corporations ,health-related industries.
❖ Mental health services
❖ Private health care providers e.g. Practitioners • Prison nurse/ Correctional , de-
addiction.
❖ Researcher promoting advances in health care and health promotion practice

-operating room, critical care and emergency departments.

QUALITIES OF NURSE

1.Communication Skills:

Solid communication skills are a basic foundation for any career. But for nurses, it's
one of the most important aspects of the job. A great nurse has excellent
communication skills, especially when it comes to speaking and listening. Based on
team and patient feedback, they are able to problem-solve and effectively
communicate with patients and families. Nurses always need to be on

2. Emotional Stability:

Nursing is a stressful job where traumatic situations are common. The ability to
accept suffering and death without letting it get personal is crucial. Some days can
seem like non-stop gloom and doom.
That's not to say that there aren't heart-warming moments in nursing. Helping a
patient recover, reuniting families, or bonding with fellow nurses are special benefits
of the job. A great nurse is able to manage the stress of sad situations, but also draws
strength from the wonderful outcomes that can and do happen.

3. Empathy

Great nurses have empathy for the pain and suffering of patients. They are able to
feel compassion and provide comfort. But be prepared for the occasional bout of
compassion fatigue; it happens to the greatest of nurses. Learn how to recognize the
symptoms and deal with them efficiently.

Patients look to nurses as their advocates of the softer side of hospital bureaucracy.
Being sympathetic to the patient's hospital experience can go a long way in terms of
improving patient care. Sometimes, an empathetic nurse is all patients have to look
forward to.

4. Flexibility:

Being flexible and rolling with the punches is a staple of any career, but it's
especially important for nurses. A great nurse is flexible with regards to working
hours and responsibilities. Nurses, like doctors, are often required to work long
periods of overtime, late or overnight shifts, and weekend.

5.Interpersonal Skills
Nurses are the link between doctors and patients. A great nurse has excellent
interpersonal skills and works well in a variety of situations with different people.
They work well with other nurses, doctors, and other members of the staff.
 Nurses are the glue that holds the hospital together. Patients see nurses as a friendly
face and doctors depend on nurses to keep them on their toes. A great nurse balances
the needs of patient and doctor as seamlessly as nocc

6.Quick Response: Nurses need to be ready to respond quickly to emergencies and

other situations that arise. Quite often, health care work is simply the response to
sudden incidences, and nurses must always be prepared for the unexpected.

7. Respect: Respect goes a long way. Great nurses respect people and rules. They
remain impartial at all times and are mindful of confidentiality requirements and
different cultures and traditions. Above all, they respect the wishes of the patient
him- or herself.

QUALITIES OF NURSE

➔ Must have a Bachelor of Science degree in nursing

➔ Must be physically and mentally fit.
➔ Must have a license to practice nursing in the country.

Mnemonics of NURSE
N - Noble/ Nurturing
U - Understanding/Usefulness
R - Reliable/Respectfulness
S - Selfless/Smart
E - Empathy/Efficiency

ROLE & FUNCTIONS OF NURSE

Caregiver
 The caregiver role has traditionally included those activities that assist the client
physically and psychologically while preserving the client's dignity. Caregiving
encompasses the physical,psychosocial, developmental, cultural and spiritual levels.
Communicator

Communication is an integral to all nursing roles. Nurses communicate with the

client, support persons, other health professionals, and people in the community. In
the role of communicator, nurses identify client problems and then communicate
these verbally or in writing to other members of the health team. The quality of a
nurse's communication is an important factor in nursing care

Teacher
As a teacher, the nurse helps clients learn about their health and the health care
procedures they need to perform to restore or maintain their health. The nurse
assesses the client's learning needs and readiness to learn, sets specific learning goals
in conjunction with the client, enacts teaching strategies and measures learning.

Client advocate

Client advocates act to protect the client. In this role the nurse may represent the
client's needs and wishes to other health professionals, such as relaying the client's
wishes for information to the physician. They also assist clients in exercising their
rights and help them speak up for themselves
Clinical & Ethical Decision Maker
Here the nurse uses critical thinking skills throughout the nursing process and makes
decisions in collaboration with clients and family members.As a decision maker she
collaborates and consults with other health care team members.

Counsellor

Counseling is a process of helping a client to recognize and cope with stressful

psychological social problems, to develop improved interpersonal relationships, and
to promote personal growth. It involves providing emotional, intellectual, and
psychological support.

Change agent

The nurse acts as a change agent when assisting others, that is, clients, to make
modifications in their own behaviour. Nurses also often act to make changes in a
system such as clinical care, if it is not helping a client return to health.

Leader

A leader influences others to work together to accomplish a specific goal. The leader
role can be employed at different levels; individual client, family, groups of clients,
colleagues, or the community. Effective leadership is a learned process requiring an
understanding of the needs and goals that motivate people, the knowledge to apply
the leadership skills, and the interpersonal skills to influence other.

Manager
The nurse manages the nursing care of individuals, families, and communities. The
nurse-manager also delegates nursing activities to ancillary workers and other nurses,
and supervises and evaluates their performance.

Case Manager

Nurse case case managers work with the multidisciplinary health team to measure
the effectiveness of the management plan and to monitor outcomes. care case.

Research consumer

Nurses often use research to improve client care. In a clinical area nurses need to:
 ● Have some awareness of the process and language of research

● Be sensitive to issues related to protecting the rights of human subjects

● Participate in identification of significant researchable problems

● Be a discriminating consumer of research findings

BIBLIOGRAPHY

# BOOKS
1.NAVDEEP KAUR BRAR “TEXTBOOK OF ADVANCED NURSING
PRACTICE”JAYPEE BROTHERS PUBLICATIONS,FIRST EDITION 2015

2.LAKHWINDER KAUR “TEXTBOOK OF NURSING FOUNDATIONS”

PEEVEE,2021 EDITION

#NET REFERENCE
1.https://www.rnpedia.com/.../nursing-profession
2.https://www.slideshare.net/babithadevu/note-nursing-as-a-profession-1