Posts Tagged ‘nursing as a profession’

Is Nursing a Profession?

Posted in Nursing, Nursing Jobs, Uncategorized

Is Nursing a Profession?

There are those who say that nursing will never become a profession until all nurses are required to have at least a BSN. There are others who will argue that the diploma and ADN nurses are better nurses. This debate has gone on for years and will continue for some time to come.

There was a point several years back when progress towards making a BSN mandatory was making headway. Hospitals began only hiring BSN nurses and had even begun to cutback on hiring LP/VNs who then had to look to other venues such as retirement and nursing homes for employment. And then the nursing shortage began to make an impact and it didn’t matter what preparation nurses have as long as they are a licensed nurse.

Not all states have the ability to survey, collect and analyze data from the nursing workforce, so we have to look at figures from 2004. At that time, greater than 51% of the workforce had less than a BSN; 17.5% of RNs were diploma prepared, 33.7% had an ADN, 34.2% had their BSN and 13% had advanced degrees of an MSN or a PhD in nursing.

It is doubtful that a dramatic shift in BSN prepared nurses has occurred since 2004, and with shortages of nurse educators it is not like to happen any time soon. Students are pursuing any avenue open to them including the LP/VN route with an eye to bridge to RN or BSN.

And so the debate over whether nursing is truly a profession will continue. The fact is however, that nurses are the backbone of the health care system. The shortage of nurses has made an impact and brought this point to the forefront. Nurses need to continue to demand respect for our contributions and it is essential to continue to conduct ourselves in a professional manner.

Nursing is a lifelong learning process. No student graduates from nursing school knowing everything they will ever need to know. Health care itself is constantly evolving as technology improves and more is learned about medical science. Techniques, procedures, medications and treatments continue to change.

Nursing roles have evolved over time as well. Nurses have many more responsibilities now than ever before, including the fact that early nurses worked very hard and also swabbed the floors and made bandages, etc.

Continuing education is mandatory in most states. Career advancement requires more formal education. Those who prefer bedside nursing don’t necessarily need more formal education. But clinical specialists and nurse managers do need at least a BSN. Nurse educators are usually at least MSN prepared and professors have a PhD.

To the outside world, nursing may not meet the criteria to be labeled a profession but to those who work the work and talk the talk, nursing is one of the most rewarding of all professions.

By Kathy Quan RN BSN. Kathy is the author of The Everything New Nurse Book and is the author/owner of

©2008 by All Rights Reserved

Is Nursing A Profession?

Posted in Nursing

The question “profession or not” has never been satisfactorily answered, not least because the definition of ‘profession’ is not exactly a fixed item.

However, some aspects of the definition might be considered ‘core items’.

A profession has a unique body of knowledge and values – and a perspective to go with it.
A profession has controlled entry to the group eg registration
A profession demonstrates a high degree of autonomous practice.
A profession has its own disciplinary system.
A profession enjoys the Recognition and Respect of the wider community.

1. Nursing DOES have a unique body of knowledge and values, but all too often adopts the medical perspective over its own; most acadamic nurses these days don’t try very hard to inject new nurses with any values other than the medical model (Yes, there are exceptions!). In that sense, nursing can only ever be a ‘profession allied to medicine’, not a true profession in its own right.

2. Nursing does have controlled entry – most countries have a legally-enforced registration. This is beyond doubt, but of questionnable value, to some degree, it’s a cheat – “Nursing is a profession because the law says it is”.

3. Nursing has a variable degree of autonomy, but for the most part (Yes, there are exceptions!), has very little real freedom; indeed, nursing management, with it’s ‘cost saving’ mentality, does its utmost to strangle any independent thought or action, for fear of expensive litigation; there are ‘protocols’ for everything, these days, and woe betide the nurse who dares to use initiative (Yes, there are exceptions!).

Nurse practitioners (etc.) usually take orders from docs and are accountable to them, because their specialties are branches of medicine. But in many areas, nurses are responsible for *nursing* and in that sense are (still) independent of doctors.

It is a shame – but historically beyond doubt, that nurses tend to give away the areas they are most expert in; physiotherapy and occupational therapy both grew out of a nursing role, respiratory therapy is going the same way. Stoma therapy is an area that utilizes many core nursing skills; how long before it breaks off to become a profession in its own right?

Perversely, wound management was, until recently, a medical responsibility, though nurses applied almost 100% of dressings. Now, specialist nurses are teaching others the principles of wound care.

4. In many countries, Nursing does have its own disciplinary system – but in many of them, this is being eroded in favour of making nurses “accountable to the public” – understandable, but reflecting a view that nurses “cannot be trusted” to deal with there own problems – this is a diminution of professional resect and value.

5. Nurses are recognized as ‘nice’, ‘deserving better’ and ‘sexy’ – the jury is out on whether any of those assist in the definition of ‘professional’.

External recognition is vital, just as the legal side is ‘so what’ – few people would ever argue with doctor and lawyers as ‘true’ professionals; when the ‘Church was one, united, catholic church’, priests were similarly respected – I’m not so sure that’s generally true any more; individual clergymen are respected by individuals, and by their own community; as are individual nurses. But both fall shy of general respect to the level required, sadly. (Though both are streets ahead of journalists, real estate agents and heating engineers!).

To conclude, part of the problem is the poor self respect of nursing; just twenty years ago, the Process of Nursing, care plans and nursing diagnosis looked set to sweep in an era of nursing confidence and a bright, professional future.

Why did it fail? This is not the place to discuss that in detail, but factors include:

Overconfidence and a needless challenge to medicine – little illustrates the power of language better than the blinding stupidity of the term “nursing diagnosis”. Nursing assessment, as a serious, conscious, methodical activity was in its infancy, when ‘nursing diagnosis’ was invented. this simple act guaranteed a fear reaction and backlash from doctors, themselves under attack from the accountants and litigators. From being our allies, doctors become distanced at best, enemies at worst. All that could have been avoided by a few minutes invested in Roget’s thesaurus or a good dictionary .

A too rapid flight to academia – it is hard to argue against developments in Nurse education; God knows, a bit more has to be a ‘good thing’; but talk of a graduate profession form a tiny graduate base in less than twenty years meant that many mediocre people were sucked into senior postions; many good people were seduced away from clinical nursing, and many clinical idiots became academic idiots. Sad; and bad because instead of supporting and defending clinical nursing, academia began to control it, and did not defend it.

Failure to resist the suits – The inexorable rise of the accountant, who knows the price of everything, and the value of nothing, probably could not be stopped; but it was allowed to ride roughshod over nursing, destroying confidence and stopping development dead in its tracks.