Question

Discuss key defining criteria regarding the professional aspects of nursing. Think about why is nursing a profession? 275 Word Min

Answer 1

Professionalization” is an important characteristic of in-service careers.[1] The concept of professionalization is expressed in the terminology of many job groups and has a long history, especially in social context. Dynamic feature and multiple interpretations of professionalization result in numerous definitions with different functions and nature.[2] Over the years, many people spoke about professionalization in nursing and its features. Therefore, there are multiple definitions and characteristics for professionalization in nursing.[3,4,5] Also, researchers used different methods and tools for its assessment and evaluation.

Nursing profession status is an inter-profession and intra-profession challenge. Whether there is nursing professionalism or not is a challenge among the nurses, sociologists, and historians.[6,7,8,9,10] For many years, other scientists considered nursing as a semi-professional career.[3] Until 1970, nursing profession was considered as a female work and women were considered as barriers to professionalization in nursing due to their high workload and part-time work.[11] At that time, some factors such as slow formation of scientific fundamentals of nursing, disagreement in educational requirements for nurses,[10,12,13] lack of academic education at the entry level of nursing courses, and lack of theory and theory-based research[14] were considered as barriers for nursing as a profession.

Gradually, development of education standards and professional certificates led nursing move to professional status.[3] Having stronger powerful basis for theory and practice and professional education in nursing discipline brought about social cognition. Social understanding about nursing made the society consider nurses as cost–benefit health care providers and independent decision makers. Therefore, nursed could receive more funds and governmental financial aids.[15]

Today's rapid changes in value systems in society caused nursing to encounter more ethical and philosophical challenges at providing care to its clients. These changes also created new nursing environments that require professional nursing. Accordingly, nursing professionalization definition and its attributes need to be clarified and adapted with rapid changes. For this purpose, concept analysis is a suitable method.

Concepts are the building blocks of theories.[16] They have important role in theory development. Concept analysis is one of the strategies in concept development. In this strategy, the basic elements of a concept for understanding its structure and function are assessed. During concept analysis process, a researcher, theorist, or clinician becomes familiar with different attributes and definitions of concept and its function.

Evolutionary approach of Rodgers in concept analysis is based on contemporary philosophical thinking on concepts and their roles in knowledge development. In this approach, dynamic features of concepts over time and different social contexts are emphasized.[17] Form evolutionary perspective, instead of emphasis on “what is it?,” more discovery and assessment are mostly focused. Consequently, this process results in a form of cyclical concept development. With this approach, the final results are the starting point for more concept analysis.[17] Purpose of concept analysis in this approach is to explain the concept and its attributes more clearly for its further development.[18]

Accordingly, the purpose of the current study is assessment of “nursing professionalization” concept to understand more about its attributes, antecedents, and consequences. Since the contemporary nursing believed human and other nursing phenomena have constantly a changing and interrelated context, it seems that nursing professionalization is also better understood in the context. This perspective is congruent with evolutionary approach in concept analysis.

Materials and Methods

While there are several methods of concept analysis,[19] an evolutionary approach was selected as the concept of nursing professionalization depends on the context and can be interpreted only when the different parameters appear in a specific context.[17] Although this approach of studying recommends six preliminary activities [Table 1], Rogers believes that many of these activities take place simultaneously during the study. Study process has a non-linear, rotational, and flexible nature. The six stages merely indicate activities that should take place during the study, and it should not be regarded as a continuous process. In this way, Rogers uses inductive approach and detailed analysis and focuses on the collection and analysis of raw data. In this approach, concepts in the specific social and cultural context of a given profession are studied.

Rodgers’ evolutionary concept analysis process

After identifying the concept of interest, the most important step is determining the scope and range of literature.[20] The scientific databases, PubMed, CINAHL, MEDLINE, ProQuest, and EBM REVIEW, were searched. In a preliminary search, the term “professional nurse” was used. Next, to achieve more precise results, the inclusion criteria were identified. The main criterion for inclusion in the final analysis was the literature published in English from 1980 to 2011 in the context of nursing and health sciences. The exclusion criterion was non-English language articles. Preliminary results of the search gave 250 articles meeting the inclusion criteria, and after deleting the duplicated items (14 items), the number decreased to about 236. In the final stage, 213 articles had the term “professional nurse” in their title or abstract, and their full texts, if available and that too in the nursing field, were chosen. In addition, four books were used in the analysis process to cover the subjects. Books and papers were carefully reviewed and studied. For analyzing, thematic analysis and content analysis were used. All articles in the context of nursing were exactly read, and hints and useful features, antecedents, consequences, related concepts, surrogate terms, and definition of concept were extracted. Then, the data were reviewed several times to allow the researcher to be immersed in, and this enabled deriving key tags and notes to provide clear explanations about every aspect of the concept. Overall, inductive analysis of data was done and themes were identified. Information units consisted of the words and sentences related to the information or responses concerning the Papers based on conceptual analysis of studied information were grouped. In order to ensure impartiality, reliability, and bias reduction, the analysis process was checked by two nursing experts in concept analysis.

Results

Identification of the characteristics of the concept is the first stage of the analysis that leads to the actual definition of the concept.[20,21] Characteristics of a concept, including features and specifications of a concept that have been permanently associated with the concept, help identify the clarity, breadth, and depth of that concept.[19] In this study, the conceptual dimensions of nursing professionalization were identified as cognitive, affective, and psychomotor dimensions.

Cognitive dimension of nursing professionalization

Nursing education should be able to develop professional knowledge.[22] All learners should have a basic cognitive framework for understanding the professionalization. It seems that getting all the essential aspects of professional knowledge in all phases of professionalization must be considered and principles of professionalization must be combined at different levels of professional education.[23] Learner development begins from a basic understanding of the underlying principles of professional conduct and the underlying reasons, and ultimately, the learner should be able to prioritize and make decisions.[24]

Walton et al. (2010) assigned five stages of training to professional nurse education as follows: (1) create a practical fake identity of a professional nurse in students, (2) trial and error, (3) the seriousness of the conduct; (4) transfer to the bedside, and 5) professionalization.[25] Some studies suggest that certain training courses such as ethics, research, or professionalization should be included in the professional training program in nursing.[26] Professional training courses can be temporary and occur during periods of formal or informal education. Professional training in formal programs can be provided with specific workshops and courses of training development modules,[27] working in small groups on problem-solving, use of role play, simulated patients,[28] or clinical courses.[29] On the other hand, usually students learn values ​​and norms in informal trainings.[30,31,32,33,34] For this purpose, there must be a professional learning environment.[35,36,37,38] Role modeling and changing the organizational culture can be effective in non-formal education.[39] Every training program should be designed to meet the expectations concerning professionalization.[40]

In the area of professional learning, continuing education is very important. UKCCN (United Kingdom Central Council for Nursing) states that all nurses should provide a certificate of professional updating every 3 years.[41] However, continuing education cannot be considered as the only criterion and antecedent for professionalization, as until mastery of knowledge is not combined with a personal value system and transferred to action, it cannot have a true function.[42] Making this commitment to continuous learning is the primary task of professional education.

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