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Dr R.RAJALAKSHMI,
M . S C ( P S Y. N U R S I N G ) . , M B A - ( H R ) . , M A - S O C I O L O G Y, P h . D
C O L L E G E O F N U R S I N G ,
N AT I O N A L I N S T I T U T E O F M E N TA L H E A L T H & N E U R O S C I E N C E S ,
B A N G A L O R E - 5 6 0 0 2 9
Nursing as a profession
Objective of the session
To learn about
 Nursing as a profession
 Philosophy, nursing practice
 Aims and objectives
 Characteristics of a professional nurse
 Current trends and issues in Nursing.
 Regulatory bodies; INC,SNC acts:
constitution, functions
• INTRODUCTION
 Nursing, besides being a honorable profession, is
one of the oldest arts and an essential modern
occupation.
 Nursing is one of the greatest of humanitarian
services and all people whether ill or well, rich or
poor, literate or illiterate, young or old are in some
way or other, directly or indirectly closely
associated with it.
 Nursing has its own body of knowledge scientifically
based and humanitarianism that promises expanded
benefits to people and society.
 It assists the individual or family to achieve their
potential for self-direction for health.
 Nursing is not only an applied science, it is also an art,
which provides skillful care for the sick in appropriate
relationship with the patient, family, physician and with
others who have related
responsibilities.
It is concerned equally with the prevention of illness and
the conservation of health.
Skillful nursing care embraces the whole person, body,
mind and soul, his physical, mental, social and spiritual
well-being (holistic approach).
 NURSING is a discipline involved in the
delivery of health care to the society.
 is a helping profession
 is service-oriented to maintain health and
well-being of people.
 is an art and a science.
 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.
Characteristics of Nursing
 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 health care.
 NURSE - originated from a Latin word NUTRIX,
means to nourish, to cherish, to protect, to sustain.
 N= nobility
 U= usefulness
 R=responsibility
 S= simplicity
 E=efficiency
Florence nightingale defined nursing 100 yrs ago as
“the act of utilizing the environment of the patient to
assist him in his recovery” (Nightingale 1860).
Nursing
 Virginia Henderson was one of the first modern
nurses to define nursing.
 According to her “the unique function of the
nurse to assist the individual, sick or well, in the
performance of those activities contributing to
health or its recovery (or to peaceful death) that
he would perform unaided if he had the
necessary strength, will or knowledge and to do
this in such a way as to help him gain
independence as rapidly as possible” Henderson
1966.
Nursing
 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 (ANA, 2003).
 This definition asserts the prominence and
importance nursing holds in providing health care
to people of our global community.
NURSING DEFINED
“Nursing is the unique function of the nurse, that is to
assist the individual (sick or well) in the performance of
those activities contributing to health or its recovery (or
to a peaceful death) that he would perform unaided if he
had the necessary strength, will or knowledge.”
- ICN
 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.
Advocacy, promotion of a safe environment,
research, participation in shaping health policy and
in patient and health systems management, and
education are also key nursing roles.
Last Updated on 23 June 2014
Definition of Nursing
 Person
 Environment
 Health
 nursing
Concept of nursing
Philosophy of Nursing
 Nursing philosophy is described as a statement of
fundamental and universal assumptions, beliefs and
principles about the nature of knowledge and
thought(epistemology) and about the nature of the
entities represented in the meta paradigm(ie,
nursing practice and human health processes
(ontology)
 Leddy and Pepper (2003) defined philosophy of
nursing is the intellectual and effective outcomes of the
professional nurses' efforts to understand the ultimate
relationship among humans, environment, and health;
 to approach nursing as a scientific discipline;
 to integrate a sense of values into practice;
 to appreciate esthetic (study of sensory or emotional
values), elements that contribute to health and well-
being; and
 to articulate a personal belief system about human
beings, environment, health and nursing.
Philosophy
 Nursing philosophy refers to the belief system
of the profession and provides perspectives
for practice, scholarship, and research.
 Intellectual
 Moral
 Spiritual
 Emotional
 Physical
 social
Current perspectives in philosophy
 Integrative philosophy of nursing is the current
movement.
 This perspective links the art and science of nursing
and closes gap between practice and science.
 It is a philosophy that recognizes nursing as a basic
discipline with a unique focus.
Philosophy of nursing
 Principle of excellence in service
 Principle of excellence in Practice
 Principle of excellence in Leadership
 Principle of excellence in administration
 Interrelatedness
 Factual evidence
 Delegation of responsibility
 Individual and organizational goal
 Effective communication
 Flexibility
 To prepare nurses who will give expert bedside
nursing care in the hospital and home.
 To provide integration of health and social aspects
theory and practice in generalized public health
nursing
 To provide an adequate, sound scientific foundation
to understand the functioning of the body and mind
in health and disease.
Aims and Objectives of Nursing
Aims and Objectives of Nursing
 To prepare nurses who will be able to work co-
operatively with team members.
 To provide opportunities through curricular and
extra-curricular activities for full development of
personality of each individual student
 To ensure opportunities for initiative and
resourcefulness, sense of responsibility for one self.
 To provide a needed service to the society.
 To advance knowledge in its field.
 To protect its members and make it possible to
practice effectively.
Conti…….
Profession
Meaning
 Profession has been defined as an occupation that
requires extensive education, that requires special
knowledge, skill and preparation
 Professionalism
 Professionalization
 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.
 It utilizes in its practice of well defined & well organized
body of specialized knowledge which is on the intellectual
level of higher learning
Characteristics of a profession
 It constantly enlarges the body of knowledge
 It applies its body of knowledge in practical
services which are vital to human and social
welfare.
 It entrusts the education of its practitioners, to
institutes of higher education.
 It attracts individuals of intellectual & personal
qualities
Conti……
 Members of profession adhere to a code of ethics
 Members of profession participate in professional
organization
 Members of the profession are autonomous and self
regulatory, operation under the professional
organization
 Profession develops, evaluates and uses theory as a
basis for practice
 Members of profession involved in research.
Differences
Occupation Profession
Training may occur in the
job and length of training
varies
Values ethics belief are not
important
Commitment and personal
identification vary or poor
Workers are supervised
People often change the job
Accountability rest with
employer
Education take place at
college or university, based on
the curriculum
Values ethics belief are
integral part
Commitments and personal
identification is strong and
necessary
Workers are autonomous
People unlikely to change the
job
Accountability rest with
individual
Nursing As A Profession
 Genevieve and Roy Bixler first wrote about the status of
nursing as a profession in 1945. These criteria include the
following.
1. The services provided are vital to humanity and
the welfare of the society. Nursing is the service that
is essential to the wellbeing of the people and to the
society. Nursing promotes, maintains and restores the
health of individuals, groups and communities.
2. Assisting others to attain the highest level of
wellness is the goal of nursing. Caring, meaning
nurturing and helping others are the basic components
of professional nursing.
3.There is a special body of knowledge that is
continually enlarged through research.
In the past, nursing was based on principles borrowed from
the physical and social sciences and other disciplines. Today
there is a unique body of knowledge to nursing.
4. The services involve intellectual activities.
Individual responsibilities (accountability) are a strong
feature. Nursing has developed and refined its own unique
approach to practice. Nursing process is a cognitive activity
that requires both critical and creative thinking and serves
as the basis of providing nursing care.
5. Individual accountability in nursing has become the
hallmark of practice. Accountability is ‘ is being answerable
to some one for something one has done’ Through legal
opinion and court cases, society has demonstrated that
nurses are individually responsible for their actions as well as
for those of personnel under their supervision.
6. Practitioners are educated in institution of higher
learning.
There are basic nursing program, baccalaureate program,
masters and Doctoral program in nursing.
7. Practitioners are relatively independent and control
their own policies and activities. (Autonomy).
Autonomy or control over one’s practice is another
controversial area for nursing. Although many nursing actions
are independent, most nurses are employed in hospitals where
authority resides in one’s position.
 8. Practitioners are motivated by service (altruism)
and considered their work an important component of
their lives. Nurses are dedicated to the ideal of service to
others, which is known as altruism.( Selflessness)
9.There is a Code of Ethics to guide the decisions and
conduct of practitioners.
The International Council of Nurses (ICN) has established Code of
Nursing Ethics through which standards of practice are established,
promoted and refined.
10. There is an organization (Association) that encourages
and supports high standards of practice.
Nursing has a number of professional associations that were formed
to promote the improvement of the profession. Foremost among
these, is the TNAI (The Trained Nurses Association of India). The
purposes of TNAI are to foster high standards of nursing practice,
promote professional and educational advancement of nurses and
promote the welfare of the nurses.
Characteristics of a Professional Nurse
 For an efficient discharging of her/his duties and for a
satisfactory fulfillment of all the aims and aspirations that
her/his profession stands for, the following qualities in a
nurse are inevitable.
1. Love: with all its other attendant qualities like mercy,
kindness, gentleness, patience and understanding are a
must in a successful nurse. All her service for the sick and
disabled are sponsored by these qualities. Without these
essential characteristics the nurse becomes only a
mechanical aid.
 Willingness and self-sacrifice: These two qualities are
complimentary to each another. Because she is willing to
serve under any trying situation, a nurse sacrifices her
time, comfort
and even material benefits. Eg. Florence Nightingale at
Scutari.
 Reliability: A nurse is one who can be depended upon
for a faithful discharging of her duties, the patients under
her care, their families, doctors and members of the
"health team" depend on her, for she is trust worthy and
competent.
 Resourcefulness: In critical circumstances she
uses her wisdom and knowledge and performs her
duties to the best of her ability with whatever means
that are at her disposal. She tackles situations with
clarity.
 Courage: In times of confusion, calamity or
catastrophe, the nurse manages her work with
compassion and is ready to meet any problem with
courage. She is cool and levelheaded and does not get
agitated easily.
 Loyalty and honesty: Her relationship with the
patient, the doctor and her associates are marked by
utmost loyalty and honesty.
 Observant : A good nurse is always vigilant. She
keeps a close and constant watch on the patients,
their progress, their changes and reactions to
treatment etc. and gives the doctor timely
reports, A nurse should anticipate and meet the
patients' needs.
 Willingness to learn: A nurse must keep in
touch with the latest discoveries and developments
in medicine and treatment and must "maintain her
knowledge and skill at a consistently high level".
 Co-operative and considerate: A nurse learns
to live in harmony with patients, doctors and other
members of the health team and tries to help them
in times of need.
 Cleanliness: A nurse is always clean and neat
personally and in her work. She must be tidy and
demand high standards of cleanliness from those
whom she is associated within her profession.
 Spirituality: A nurse must learn to create a
spiritual atmosphere for the patient and must try
and help the patients to put their confidence and
trust in a "Power" that is higher than any other
power in the world.
QUALITIES OF A NURSE
 Love for fellow beings, honest, courteous, dignified & loyal
 Disciplined, obedient, alert & intelligent
 Technically competent, resourceful & economic
 Dependable & adjustable
 Able to inspire confidence
 Sympathetic, empathetic, tactful & poised
 Patient & with a sense of humour
 Physically and mentally healthy
 Generous
 Gentle & quiet
Conti….
 Self confident
 Loyal
 Cooperative
 Good listener
 Observer
 Administrator
 Impartial
 Capable
 Responsible
 Competent
 Decision making
FUNCTIONS OF A PROFESSIONAL NURSE
 Provide basic care to clients
 Administer treatments as advised
 Observe patients response and adaptation to illness
 Observe patients response and adaptation to
treatments
 Teach self care and counsel on health matters
Conti….
 Supervise/ guide in rehabilitative activities related to
daily living
 Participate in research work related to health care
 Plan care with the patient (trust & self worth)
 Coordinate all services for client care
 Teach & supervise nursing students, auxiliary
personnel and clients
 Maintain own physical and mental health
Roles of a Professional nurse
Caregiver/ Care provider
 The traditional and most essential role
 Functions as nurturer, comforter, provider
 “mothering actions” of the nurse
 Provides direct care and promotes comfort of client
 Activities involves knowledge and sensitivity to what
matters and what is important to clients
 Show concern for client welfare and acceptance of
the client as a person
Teacher
 Provides information and helps the client to learn or
acquire new knowledge and technical skills
 Encourages compliance with prescribed therapy.
 Promotes healthy lifestyles
 Interprets information to the client
Counselor
 Helps client to recognize and cope with stressful
psychological or social problems; to develop an improve
interpersonal relationships and to promote personal growth.
 Provides emotional, intellectual to and psychological
support.
 Focuses on helping a client to develop new attitudes, feelings
and behaviors rather than promoting intellectual growth.
 Encourages the client to look at alternative behaviors
recognize the choices and develop a sense of control.
Change agent
 Initiate changes or assist clients to make
modifications in themselves or in the system of care.
Client advocate
 Involves concern for and actions in behalf of the
client to bring about a change.
 Promotes what is best for the client, ensuring that
the client’s needs are met and protecting the client’s
right.
 Provides explanation in clients language and support
clients decisions.
Manager
 Makes decisions, coordinates activities of others,
allocate resource
 Evaluate care and personnel
 Plans, give direction, develop staff, monitors
operations, give the rewards fairly and represents
both staff and administrations as needed.
Researcher
 participates in identifying significant researchable
problems
 participates in scientific investigation and must be a
consumer of research findings
 must be aware of the research process, language of
research, a sensitive to issues related to protecting
the rights of human subjects.
Extended roles of nurse
 Communicator
 Teacher
 Client Advocate
 Counselor
 Change agent
 Leader
 Manager
 Decision maker
 Rehabilitator
 Comforter
 Nurse practitioner
 Nurse clinician
 Nurse midwives
 Nurse anesthetist
 Nurse researcher
 Nurse entrepreneur
 Nurse advisors
Expanded roles of nurse
• Flight Nurse
• Aerospace Nurse
• Industrial Nurse
• School Nurse
• Hotel Nurse
• Nurse informaticist
Trends and issues in nursing
 Trends denote general direction and
tendencies especially of events.
 so the nursing trends refer to the general
direction towards which the different
nursing events have moved and are moving
as well as opinions in and around nursing
and tendencies that we find in and about our
profession.
Changes in society
For the past five decades, five social factors have greatly
influenced present trends in nursing.
 These are,
 Intensive efforts of government to meet the health
needs of people.
 Gradual improved literacy level of the people with the
growing awareness of health needs.
 Advanced scientific technology
 The changing role of women and the continuing
growth of population.
Changes in other professions
 Trends in the nursing profession have always been
closely related to those in the medical profession.
 Growing specialization in medical field is resulting in a
trend towards increased specialization in nursing.
 The development of new diagnostic procedure and
equipments make specialization even more necessary.
 Patients Bill of Rights, patients care and
legal responsibilities for the patient.
 Developments in other discipline
 Developments in other discipline other than
medicine also influence trends in nursing profession.
 Nursing is moving towards more specific nursing
functions as other members of health team like
dieticians, social workers and physiotherapists are
more available and more highly specialized.
Leadership within the profession
 Leadership within the profession also influences the
trends in nursing.
 Nursing is moving towards professionalism due to the
untiring efforts of nurses who have been dedicated to
achieve the aim.
Working and studying in abroad
 Working and studying in abroad is influenced by many
factors within India and in other countries. Shortage of
nurses in other countries, higher salary paid in abroad is
the main causes for the working of Indian nurses in
abroad.
Greater specialization in nursing education and
practice.
 Greater specialization in nursing education and practice
is a trend related to that in the medical profession and
the growing amount of scientific knowledge available.
Working conditions
 Working conditions for nurses are also changing. There is
a gradual change towards shorter and more convenient
hours of duty, better accommodations and higher salaries.
Trends in other countries
 Trends in other country also influence the trends in
nursing profession in India. The rapid development of the
degree programme has promoted the same emphasis and
development here for professional nursing.
Changing roles and functions of the nurse
as perceived in the globe.
 The nurses in India are also prepared and more
privileged to face the changes and ready to accept
the challenging roles and functions of the nurse as
perceived in the globe because of the development
in the education and training system.
The following roles and positions perceived as in the
globe are given below.
 a. Nurse educator works in schools of nursing, staff
development departments. They provide the educational
programme for student’s nurses and nurses, teach
clients about the self-care and home care.
 b. Clinical nurse specialist specializes in managing
specific diseases and they function as clinicians,
educators, managers, consultants and researchers.
 c. Nurse practitioners are certified to provide health
care to clients in out-patient or community settings.
 Certified nurse-midwife are certified by the American College of Nurse-
Midwives to provide independent care for women during normal pregnancy,
labour and delivery.
 Nurse anesthetist, having advance training in anesthesiology, provides
surgical anesthesia to the client under the supervision of an anesthesiologist
during minor surgery with baccalaureate degrees or master’s degree.
 Nurse administrators manage client care within the healthcare agencies in
a middle level or upper level management position.
 Nurse researcher with Doctoral degree investigate nursing problem to
improve care and to define and expand the scope of nursing practice.
Advancements in science increase health needs of the society and thereby
expect changes in the role of nurses and thus increases the scope for nurses.
Issues in nursing
 It refers to items for consideration or
questions for discussion. Issues grouped in to
three broad areas.
 Issues related to the profession of nursing.
 Issues related to the areas of nursing education and
nursing practice.
 Issues related to the nurses themselves.
Issues related to profession of nursing
 Status of nursing in society in the health care
delivery system.
 Values reflected in our nursing performances.
 Attitude, humane approach and concern shown in
our behavioral pattern.
 Quality in nursing education and practice.
 Is nursing within the mainstream of health? How
does nursing relate itself to the country’s health
policy programmes and goals.
Issues…
 Has nursing leadership in India formulated its own
strategies in the perspective of changing health
scenarios and demands.
 Has nursing leadership disseminated the essential
information in this regard to the nurses.
 Has nursing developed a nursing information
network.
 Has leadership been able to create its rightful place
in the health administration.
 Have today’s nursing educational programmes in the
country taken into consideration of national health policy
goals and programmes.
 Have it Shifted the emphasis from traditional to
community health oriented approach and reoriented
nursing curriculum accordingly.
 whether sincere efforts are put to prepare nurses for the
jobs, where they are expected to perform in their work
fields in terms of appropriate skills, knowledge and right
attitude and desired behavior pattern.
Issues related to nursing education and
nursing practice.
Related to nursing education…
 Did country had been preparing nurses by
keeping the states and country’s health needs
in mind.
 Did country had Been making efforts for
leadership building, management and skill
training.
 Made efforts in organizing higher education
in nursing including post diploma etc.
 Giving the due emphasis on nursing research.
Issues related to area of nursing practice
 The nurses have to work under tremendous
constraints and pressure both in community
settings and institutional setting.
 Are nurses as a matter of policy consulted in all
matters related to decision areas for nursing
practice?
 Have nursing man hour studies been conducted in
relation to various nursing practice areas?
 Do they have the necessary backup support from
the system for performing the way they are
required to perform.
Issues related to area of nursing practice…
 Do the practicing nurses feel confident and
secure in independently performing the
different nursing tasks required of them at
the community and institutional settings?
 Is there a hospital nursing management
information system available where the
nursing records play a vital role?
Issues related to nurses themselves
 Long hours of duty with very little time for recreation.
 Working against the presence of:
 Overcrowding
 Shortage of staff
 Dearth of essential supplies and equipment
 Attending to many bosses
 Non availability of guidance and counseling services
when ever necessary
 irregular staff development including in-service
education and continuing education.
Issues related to nurses themselves
 Non availability of regular health care programmes
for nurses
 Non availability of crèches for the children of
married nurses coming from outside.
 Non availability of residential accommodation for
nurses working in emergency services.
 Pressure from influential people.
 Inadequate dietary provisions for on duty nurses.
 Non- involvement of nurses in nursing matters
 Poor pay structure.
 Lack of promotional opportunities leading to job
dissatisfaction, stagnation and frustration.
 Work environment-not always congenial or friendly.
 Lack of security and safety.
 Non availability of basic amenities like toilet facilities
in the residential accommodation of community
nurses.
 Non availability of transport facilities for community
nursing services.
Categories of nursing professional
 Director / superintendent
 Deputy superintendent
 Asst nsg. Superintendent
 Ward inchrges/Tuter
 Senior nurse
 Junior nurse/staff nurses
 Principal
 Professor
 Associate professor
 Assistant professor
 Lecturer
 Asst. Lecturer
 Tutor
 Organizations provide a means through which united
efforts are made to elevate standards of nursing education
and practice. It also offers a means of voicing and
opinions, developing our abilities and keeping informed of
new trends.
a) The Indian Nursing Council (INC)
 The Indian Nursing Council was authorized by the Indian
Nursing Council Act of 1947. It was established in 1949 to
provide uniform standards in nursing education and
reciprocity in nursing registration throughout the country.
Professional Organizations
Indian Nursing Council
 The Indian Nursing Council is an Autonomous Body
under the Government of India, Ministry of Health &
Family Welfare was constituted by the Central
Government under section 3(1) of the Indian Nursing
Council Act, 1947 of parliament.
 The basic Aims, Objectives and functions of Indian
Nursing Council are as follows:
Indian Nursing Council
 To establish and monitor a uniform standard of
nursing education for nurses midwife, Auxiliary
Nurse-Midwives and health visitors by doing inspection
of the institutions.
 To recognize the qualifications under section 10(2)(4)
of the Indian Nursing Council Act, 1947 for the purpose
of registration and employment in India and abroad.
 To give approval for registration of Indian and
Foreign Nurses possessing foreign qualification
under section 11(2)(a) of the Indian Nursing Council Act,
1947.
lieu
Indian Nursing Council
 To prescribe the syllabus & regulations for Nursing programs.
 Power to withdraw the recognition of qualification under
section 14 of the Act in case the institution fails to maintain
its standards under Section 14 (1)(b) that an institution
recognized by a State Council for the training of nurses, midwives,
auxiliary nurse midwives or health visitors does not satisfy the
requirements of the Council.
 To advise the State Nursing Councils, Examining Boards,
State Governments and Central Government in various
important items regarding Nursing Education in the Country.
Functions
1. It provides uniform standards in nursing education and
reciprocity in nursing registration.
2. It has authority to prescribe curriculum for nursing
education in all states.
3. It has authority to recognize programme of nursing
education or to refuse recognition of a programme if it did
not meet the standards required by the council.
4. It is registering the foreign nurses.
5. It also maintains the Indian Nurses Register.
6. The INC authorizes State Nurses Registration Council
and examining boards to issue qualifying certificates.
Organizational Structure of Indian
Nursing Council
 President
 Vice President
 Secretary
 Joint Secretary
 Deputy Secretary
 Assistant Secretary
 Office Staff
Committees
Executive Committee of the Council to deliberate on the
issues related to maintenance of standards of nursing
programs
The Nursing Education Committee, The committee is
constituted to deliberate on the issues concerned mainly with
nursing education and policy matters concerning the nursing
education.
Equivalence Committee – to deliberate on the issues of
recognition of foreign qualifications which is essential for the
purpose of registration under section 11(2)(a) or (b) of the
Indian Nursing Council Act, 1947, as amended.
 Regulation of training programme of the diploma,
Graduate and Post Graduate Courses.
 Supervision of the practice of the profession by its
Member.
 Granting recognition to the training institutions and
periodical Inspection there on, as the Council is
governing authority of physical and clinical facilities in
almost all the nursing courses conducted in the
institution.
FUNCTION OF STATE NURSING COUNCIL
FUNCTION OF STATE NURSING
COUNCIL…
 Proscribing syllabus and curriculum for various
nursing courses and conducting qualifying
examination there for.
 Registration and granting certificate to qualified
persons to practice their profession and to watch and
take action against practice of profession by quacks
and check mal-practice as well and to take action.
Thankyou

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Nursing as a profession.pptx

  • 1. Dr R.RAJALAKSHMI, M . S C ( P S Y. N U R S I N G ) . , M B A - ( H R ) . , M A - S O C I O L O G Y, P h . D C O L L E G E O F N U R S I N G , N AT I O N A L I N S T I T U T E O F M E N TA L H E A L T H & N E U R O S C I E N C E S , B A N G A L O R E - 5 6 0 0 2 9 Nursing as a profession
  • 2. Objective of the session To learn about  Nursing as a profession  Philosophy, nursing practice  Aims and objectives  Characteristics of a professional nurse  Current trends and issues in Nursing.  Regulatory bodies; INC,SNC acts: constitution, functions
  • 3. • INTRODUCTION  Nursing, besides being a honorable profession, is one of the oldest arts and an essential modern occupation.  Nursing is one of the greatest of humanitarian services and all people whether ill or well, rich or poor, literate or illiterate, young or old are in some way or other, directly or indirectly closely associated with it.
  • 4.  Nursing has its own body of knowledge scientifically based and humanitarianism that promises expanded benefits to people and society.  It assists the individual or family to achieve their potential for self-direction for health.
  • 5.  Nursing is not only an applied science, it is also an art, which provides skillful care for the sick in appropriate relationship with the patient, family, physician and with others who have related responsibilities. It is concerned equally with the prevention of illness and the conservation of health. Skillful nursing care embraces the whole person, body, mind and soul, his physical, mental, social and spiritual well-being (holistic approach).
  • 6.  NURSING is a discipline involved in the delivery of health care to the society.  is a helping profession  is service-oriented to maintain health and well-being of people.  is an art and a science.
  • 7.  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.
  • 8. Characteristics of Nursing  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 health care.
  • 9.  NURSE - originated from a Latin word NUTRIX, means to nourish, to cherish, to protect, to sustain.  N= nobility  U= usefulness  R=responsibility  S= simplicity  E=efficiency Florence nightingale defined nursing 100 yrs ago as “the act of utilizing the environment of the patient to assist him in his recovery” (Nightingale 1860).
  • 10. Nursing  Virginia Henderson was one of the first modern nurses to define nursing.  According to her “the unique function of the nurse to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge and to do this in such a way as to help him gain independence as rapidly as possible” Henderson 1966.
  • 11. Nursing  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 (ANA, 2003).  This definition asserts the prominence and importance nursing holds in providing health care to people of our global community.
  • 12. NURSING DEFINED “Nursing is the unique function of the nurse, that is to assist the individual (sick or well) in the performance of those activities contributing to health or its recovery (or to a peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge.” - ICN
  • 13.  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. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles. Last Updated on 23 June 2014 Definition of Nursing
  • 14.  Person  Environment  Health  nursing Concept of nursing
  • 15. Philosophy of Nursing  Nursing philosophy is described as a statement of fundamental and universal assumptions, beliefs and principles about the nature of knowledge and thought(epistemology) and about the nature of the entities represented in the meta paradigm(ie, nursing practice and human health processes (ontology)
  • 16.  Leddy and Pepper (2003) defined philosophy of nursing is the intellectual and effective outcomes of the professional nurses' efforts to understand the ultimate relationship among humans, environment, and health;  to approach nursing as a scientific discipline;  to integrate a sense of values into practice;  to appreciate esthetic (study of sensory or emotional values), elements that contribute to health and well- being; and  to articulate a personal belief system about human beings, environment, health and nursing.
  • 17. Philosophy  Nursing philosophy refers to the belief system of the profession and provides perspectives for practice, scholarship, and research.  Intellectual  Moral  Spiritual  Emotional  Physical  social
  • 18. Current perspectives in philosophy  Integrative philosophy of nursing is the current movement.  This perspective links the art and science of nursing and closes gap between practice and science.  It is a philosophy that recognizes nursing as a basic discipline with a unique focus.
  • 19. Philosophy of nursing  Principle of excellence in service  Principle of excellence in Practice  Principle of excellence in Leadership  Principle of excellence in administration  Interrelatedness  Factual evidence  Delegation of responsibility  Individual and organizational goal  Effective communication  Flexibility
  • 20.  To prepare nurses who will give expert bedside nursing care in the hospital and home.  To provide integration of health and social aspects theory and practice in generalized public health nursing  To provide an adequate, sound scientific foundation to understand the functioning of the body and mind in health and disease. Aims and Objectives of Nursing
  • 21. Aims and Objectives of Nursing  To prepare nurses who will be able to work co- operatively with team members.  To provide opportunities through curricular and extra-curricular activities for full development of personality of each individual student  To ensure opportunities for initiative and resourcefulness, sense of responsibility for one self.
  • 22.  To provide a needed service to the society.  To advance knowledge in its field.  To protect its members and make it possible to practice effectively. Conti…….
  • 23. Profession Meaning  Profession has been defined as an occupation that requires extensive education, that requires special knowledge, skill and preparation  Professionalism  Professionalization
  • 24.  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.  It utilizes in its practice of well defined & well organized body of specialized knowledge which is on the intellectual level of higher learning Characteristics of a profession
  • 25.  It constantly enlarges the body of knowledge  It applies its body of knowledge in practical services which are vital to human and social welfare.  It entrusts the education of its practitioners, to institutes of higher education.  It attracts individuals of intellectual & personal qualities
  • 26. Conti……  Members of profession adhere to a code of ethics  Members of profession participate in professional organization  Members of the profession are autonomous and self regulatory, operation under the professional organization  Profession develops, evaluates and uses theory as a basis for practice  Members of profession involved in research.
  • 27. Differences Occupation Profession Training may occur in the job and length of training varies Values ethics belief are not important Commitment and personal identification vary or poor Workers are supervised People often change the job Accountability rest with employer Education take place at college or university, based on the curriculum Values ethics belief are integral part Commitments and personal identification is strong and necessary Workers are autonomous People unlikely to change the job Accountability rest with individual
  • 28. Nursing As A Profession
  • 29.  Genevieve and Roy Bixler first wrote about the status of nursing as a profession in 1945. These criteria include the following. 1. The services provided are vital to humanity and the welfare of the society. Nursing is the service that is essential to the wellbeing of the people and to the society. Nursing promotes, maintains and restores the health of individuals, groups and communities. 2. Assisting others to attain the highest level of wellness is the goal of nursing. Caring, meaning nurturing and helping others are the basic components of professional nursing.
  • 30. 3.There is a special body of knowledge that is continually enlarged through research. In the past, nursing was based on principles borrowed from the physical and social sciences and other disciplines. Today there is a unique body of knowledge to nursing. 4. The services involve intellectual activities. Individual responsibilities (accountability) are a strong feature. Nursing has developed and refined its own unique approach to practice. Nursing process is a cognitive activity that requires both critical and creative thinking and serves as the basis of providing nursing care.
  • 31. 5. Individual accountability in nursing has become the hallmark of practice. Accountability is ‘ is being answerable to some one for something one has done’ Through legal opinion and court cases, society has demonstrated that nurses are individually responsible for their actions as well as for those of personnel under their supervision. 6. Practitioners are educated in institution of higher learning. There are basic nursing program, baccalaureate program, masters and Doctoral program in nursing.
  • 32. 7. Practitioners are relatively independent and control their own policies and activities. (Autonomy). Autonomy or control over one’s practice is another controversial area for nursing. Although many nursing actions are independent, most nurses are employed in hospitals where authority resides in one’s position.  8. Practitioners are motivated by service (altruism) and considered their work an important component of their lives. Nurses are dedicated to the ideal of service to others, which is known as altruism.( Selflessness)
  • 33. 9.There is a Code of Ethics to guide the decisions and conduct of practitioners. The International Council of Nurses (ICN) has established Code of Nursing Ethics through which standards of practice are established, promoted and refined. 10. There is an organization (Association) that encourages and supports high standards of practice. Nursing has a number of professional associations that were formed to promote the improvement of the profession. Foremost among these, is the TNAI (The Trained Nurses Association of India). The purposes of TNAI are to foster high standards of nursing practice, promote professional and educational advancement of nurses and promote the welfare of the nurses.
  • 34. Characteristics of a Professional Nurse  For an efficient discharging of her/his duties and for a satisfactory fulfillment of all the aims and aspirations that her/his profession stands for, the following qualities in a nurse are inevitable. 1. Love: with all its other attendant qualities like mercy, kindness, gentleness, patience and understanding are a must in a successful nurse. All her service for the sick and disabled are sponsored by these qualities. Without these essential characteristics the nurse becomes only a mechanical aid.
  • 35.  Willingness and self-sacrifice: These two qualities are complimentary to each another. Because she is willing to serve under any trying situation, a nurse sacrifices her time, comfort and even material benefits. Eg. Florence Nightingale at Scutari.  Reliability: A nurse is one who can be depended upon for a faithful discharging of her duties, the patients under her care, their families, doctors and members of the "health team" depend on her, for she is trust worthy and competent.
  • 36.  Resourcefulness: In critical circumstances she uses her wisdom and knowledge and performs her duties to the best of her ability with whatever means that are at her disposal. She tackles situations with clarity.  Courage: In times of confusion, calamity or catastrophe, the nurse manages her work with compassion and is ready to meet any problem with courage. She is cool and levelheaded and does not get agitated easily.
  • 37.  Loyalty and honesty: Her relationship with the patient, the doctor and her associates are marked by utmost loyalty and honesty.  Observant : A good nurse is always vigilant. She keeps a close and constant watch on the patients, their progress, their changes and reactions to treatment etc. and gives the doctor timely reports, A nurse should anticipate and meet the patients' needs.
  • 38.  Willingness to learn: A nurse must keep in touch with the latest discoveries and developments in medicine and treatment and must "maintain her knowledge and skill at a consistently high level".  Co-operative and considerate: A nurse learns to live in harmony with patients, doctors and other members of the health team and tries to help them in times of need.
  • 39.  Cleanliness: A nurse is always clean and neat personally and in her work. She must be tidy and demand high standards of cleanliness from those whom she is associated within her profession.  Spirituality: A nurse must learn to create a spiritual atmosphere for the patient and must try and help the patients to put their confidence and trust in a "Power" that is higher than any other power in the world.
  • 40. QUALITIES OF A NURSE  Love for fellow beings, honest, courteous, dignified & loyal  Disciplined, obedient, alert & intelligent  Technically competent, resourceful & economic  Dependable & adjustable  Able to inspire confidence  Sympathetic, empathetic, tactful & poised  Patient & with a sense of humour  Physically and mentally healthy  Generous  Gentle & quiet
  • 41. Conti….  Self confident  Loyal  Cooperative  Good listener  Observer  Administrator  Impartial  Capable  Responsible  Competent  Decision making
  • 42. FUNCTIONS OF A PROFESSIONAL NURSE  Provide basic care to clients  Administer treatments as advised  Observe patients response and adaptation to illness  Observe patients response and adaptation to treatments  Teach self care and counsel on health matters
  • 43. Conti….  Supervise/ guide in rehabilitative activities related to daily living  Participate in research work related to health care  Plan care with the patient (trust & self worth)  Coordinate all services for client care  Teach & supervise nursing students, auxiliary personnel and clients  Maintain own physical and mental health
  • 44. Roles of a Professional nurse Caregiver/ Care provider  The traditional and most essential role  Functions as nurturer, comforter, provider  “mothering actions” of the nurse  Provides direct care and promotes comfort of client  Activities involves knowledge and sensitivity to what matters and what is important to clients  Show concern for client welfare and acceptance of the client as a person
  • 45. Teacher  Provides information and helps the client to learn or acquire new knowledge and technical skills  Encourages compliance with prescribed therapy.  Promotes healthy lifestyles  Interprets information to the client
  • 46. Counselor  Helps client to recognize and cope with stressful psychological or social problems; to develop an improve interpersonal relationships and to promote personal growth.  Provides emotional, intellectual to and psychological support.  Focuses on helping a client to develop new attitudes, feelings and behaviors rather than promoting intellectual growth.  Encourages the client to look at alternative behaviors recognize the choices and develop a sense of control.
  • 47. Change agent  Initiate changes or assist clients to make modifications in themselves or in the system of care. Client advocate  Involves concern for and actions in behalf of the client to bring about a change.  Promotes what is best for the client, ensuring that the client’s needs are met and protecting the client’s right.  Provides explanation in clients language and support clients decisions.
  • 48. Manager  Makes decisions, coordinates activities of others, allocate resource  Evaluate care and personnel  Plans, give direction, develop staff, monitors operations, give the rewards fairly and represents both staff and administrations as needed.
  • 49. Researcher  participates in identifying significant researchable problems  participates in scientific investigation and must be a consumer of research findings  must be aware of the research process, language of research, a sensitive to issues related to protecting the rights of human subjects.
  • 50. Extended roles of nurse  Communicator  Teacher  Client Advocate  Counselor  Change agent  Leader  Manager  Decision maker  Rehabilitator  Comforter  Nurse practitioner  Nurse clinician  Nurse midwives  Nurse anesthetist  Nurse researcher  Nurse entrepreneur  Nurse advisors
  • 51. Expanded roles of nurse • Flight Nurse • Aerospace Nurse • Industrial Nurse • School Nurse • Hotel Nurse • Nurse informaticist
  • 52. Trends and issues in nursing  Trends denote general direction and tendencies especially of events.  so the nursing trends refer to the general direction towards which the different nursing events have moved and are moving as well as opinions in and around nursing and tendencies that we find in and about our profession.
  • 53. Changes in society For the past five decades, five social factors have greatly influenced present trends in nursing.  These are,  Intensive efforts of government to meet the health needs of people.  Gradual improved literacy level of the people with the growing awareness of health needs.  Advanced scientific technology  The changing role of women and the continuing growth of population.
  • 54. Changes in other professions  Trends in the nursing profession have always been closely related to those in the medical profession.  Growing specialization in medical field is resulting in a trend towards increased specialization in nursing.  The development of new diagnostic procedure and equipments make specialization even more necessary.
  • 55.  Patients Bill of Rights, patients care and legal responsibilities for the patient.  Developments in other discipline  Developments in other discipline other than medicine also influence trends in nursing profession.  Nursing is moving towards more specific nursing functions as other members of health team like dieticians, social workers and physiotherapists are more available and more highly specialized.
  • 56. Leadership within the profession  Leadership within the profession also influences the trends in nursing.  Nursing is moving towards professionalism due to the untiring efforts of nurses who have been dedicated to achieve the aim.
  • 57. Working and studying in abroad  Working and studying in abroad is influenced by many factors within India and in other countries. Shortage of nurses in other countries, higher salary paid in abroad is the main causes for the working of Indian nurses in abroad. Greater specialization in nursing education and practice.  Greater specialization in nursing education and practice is a trend related to that in the medical profession and the growing amount of scientific knowledge available.
  • 58. Working conditions  Working conditions for nurses are also changing. There is a gradual change towards shorter and more convenient hours of duty, better accommodations and higher salaries. Trends in other countries  Trends in other country also influence the trends in nursing profession in India. The rapid development of the degree programme has promoted the same emphasis and development here for professional nursing.
  • 59. Changing roles and functions of the nurse as perceived in the globe.  The nurses in India are also prepared and more privileged to face the changes and ready to accept the challenging roles and functions of the nurse as perceived in the globe because of the development in the education and training system.
  • 60. The following roles and positions perceived as in the globe are given below.  a. Nurse educator works in schools of nursing, staff development departments. They provide the educational programme for student’s nurses and nurses, teach clients about the self-care and home care.  b. Clinical nurse specialist specializes in managing specific diseases and they function as clinicians, educators, managers, consultants and researchers.  c. Nurse practitioners are certified to provide health care to clients in out-patient or community settings.
  • 61.  Certified nurse-midwife are certified by the American College of Nurse- Midwives to provide independent care for women during normal pregnancy, labour and delivery.  Nurse anesthetist, having advance training in anesthesiology, provides surgical anesthesia to the client under the supervision of an anesthesiologist during minor surgery with baccalaureate degrees or master’s degree.  Nurse administrators manage client care within the healthcare agencies in a middle level or upper level management position.  Nurse researcher with Doctoral degree investigate nursing problem to improve care and to define and expand the scope of nursing practice. Advancements in science increase health needs of the society and thereby expect changes in the role of nurses and thus increases the scope for nurses.
  • 62. Issues in nursing  It refers to items for consideration or questions for discussion. Issues grouped in to three broad areas.  Issues related to the profession of nursing.  Issues related to the areas of nursing education and nursing practice.  Issues related to the nurses themselves.
  • 63. Issues related to profession of nursing  Status of nursing in society in the health care delivery system.  Values reflected in our nursing performances.  Attitude, humane approach and concern shown in our behavioral pattern.  Quality in nursing education and practice.  Is nursing within the mainstream of health? How does nursing relate itself to the country’s health policy programmes and goals.
  • 64. Issues…  Has nursing leadership in India formulated its own strategies in the perspective of changing health scenarios and demands.  Has nursing leadership disseminated the essential information in this regard to the nurses.  Has nursing developed a nursing information network.  Has leadership been able to create its rightful place in the health administration.
  • 65.  Have today’s nursing educational programmes in the country taken into consideration of national health policy goals and programmes.  Have it Shifted the emphasis from traditional to community health oriented approach and reoriented nursing curriculum accordingly.  whether sincere efforts are put to prepare nurses for the jobs, where they are expected to perform in their work fields in terms of appropriate skills, knowledge and right attitude and desired behavior pattern. Issues related to nursing education and nursing practice.
  • 66. Related to nursing education…  Did country had been preparing nurses by keeping the states and country’s health needs in mind.  Did country had Been making efforts for leadership building, management and skill training.  Made efforts in organizing higher education in nursing including post diploma etc.  Giving the due emphasis on nursing research.
  • 67. Issues related to area of nursing practice  The nurses have to work under tremendous constraints and pressure both in community settings and institutional setting.  Are nurses as a matter of policy consulted in all matters related to decision areas for nursing practice?  Have nursing man hour studies been conducted in relation to various nursing practice areas?  Do they have the necessary backup support from the system for performing the way they are required to perform.
  • 68. Issues related to area of nursing practice…  Do the practicing nurses feel confident and secure in independently performing the different nursing tasks required of them at the community and institutional settings?  Is there a hospital nursing management information system available where the nursing records play a vital role?
  • 69. Issues related to nurses themselves  Long hours of duty with very little time for recreation.  Working against the presence of:  Overcrowding  Shortage of staff  Dearth of essential supplies and equipment  Attending to many bosses  Non availability of guidance and counseling services when ever necessary  irregular staff development including in-service education and continuing education.
  • 70. Issues related to nurses themselves  Non availability of regular health care programmes for nurses  Non availability of crèches for the children of married nurses coming from outside.  Non availability of residential accommodation for nurses working in emergency services.  Pressure from influential people.  Inadequate dietary provisions for on duty nurses.  Non- involvement of nurses in nursing matters  Poor pay structure.
  • 71.  Lack of promotional opportunities leading to job dissatisfaction, stagnation and frustration.  Work environment-not always congenial or friendly.  Lack of security and safety.  Non availability of basic amenities like toilet facilities in the residential accommodation of community nurses.  Non availability of transport facilities for community nursing services.
  • 72. Categories of nursing professional  Director / superintendent  Deputy superintendent  Asst nsg. Superintendent  Ward inchrges/Tuter  Senior nurse  Junior nurse/staff nurses  Principal  Professor  Associate professor  Assistant professor  Lecturer  Asst. Lecturer  Tutor
  • 73.  Organizations provide a means through which united efforts are made to elevate standards of nursing education and practice. It also offers a means of voicing and opinions, developing our abilities and keeping informed of new trends. a) The Indian Nursing Council (INC)  The Indian Nursing Council was authorized by the Indian Nursing Council Act of 1947. It was established in 1949 to provide uniform standards in nursing education and reciprocity in nursing registration throughout the country. Professional Organizations
  • 74. Indian Nursing Council  The Indian Nursing Council is an Autonomous Body under the Government of India, Ministry of Health & Family Welfare was constituted by the Central Government under section 3(1) of the Indian Nursing Council Act, 1947 of parliament.  The basic Aims, Objectives and functions of Indian Nursing Council are as follows:
  • 75. Indian Nursing Council  To establish and monitor a uniform standard of nursing education for nurses midwife, Auxiliary Nurse-Midwives and health visitors by doing inspection of the institutions.  To recognize the qualifications under section 10(2)(4) of the Indian Nursing Council Act, 1947 for the purpose of registration and employment in India and abroad.  To give approval for registration of Indian and Foreign Nurses possessing foreign qualification under section 11(2)(a) of the Indian Nursing Council Act, 1947. lieu
  • 76. Indian Nursing Council  To prescribe the syllabus & regulations for Nursing programs.  Power to withdraw the recognition of qualification under section 14 of the Act in case the institution fails to maintain its standards under Section 14 (1)(b) that an institution recognized by a State Council for the training of nurses, midwives, auxiliary nurse midwives or health visitors does not satisfy the requirements of the Council.  To advise the State Nursing Councils, Examining Boards, State Governments and Central Government in various important items regarding Nursing Education in the Country.
  • 77. Functions 1. It provides uniform standards in nursing education and reciprocity in nursing registration. 2. It has authority to prescribe curriculum for nursing education in all states. 3. It has authority to recognize programme of nursing education or to refuse recognition of a programme if it did not meet the standards required by the council. 4. It is registering the foreign nurses. 5. It also maintains the Indian Nurses Register. 6. The INC authorizes State Nurses Registration Council and examining boards to issue qualifying certificates.
  • 78. Organizational Structure of Indian Nursing Council  President  Vice President  Secretary  Joint Secretary  Deputy Secretary  Assistant Secretary  Office Staff
  • 79. Committees Executive Committee of the Council to deliberate on the issues related to maintenance of standards of nursing programs The Nursing Education Committee, The committee is constituted to deliberate on the issues concerned mainly with nursing education and policy matters concerning the nursing education. Equivalence Committee – to deliberate on the issues of recognition of foreign qualifications which is essential for the purpose of registration under section 11(2)(a) or (b) of the Indian Nursing Council Act, 1947, as amended.
  • 80.  Regulation of training programme of the diploma, Graduate and Post Graduate Courses.  Supervision of the practice of the profession by its Member.  Granting recognition to the training institutions and periodical Inspection there on, as the Council is governing authority of physical and clinical facilities in almost all the nursing courses conducted in the institution. FUNCTION OF STATE NURSING COUNCIL
  • 81. FUNCTION OF STATE NURSING COUNCIL…  Proscribing syllabus and curriculum for various nursing courses and conducting qualifying examination there for.  Registration and granting certificate to qualified persons to practice their profession and to watch and take action against practice of profession by quacks and check mal-practice as well and to take action.