Nursing as a profession

Dr R.RAJALAKSHMI,
M.SC (PSY. NURSING)., MBA-(HR)., MA-SOCIOLOGY, P h.D

COLLEGE OF NURSING,

NATIONAL INSTITUTE OF MENTAL HEALTH & NEURO SCIENCES,

BANGALORE-560 029
 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).
Virginia HendersonNursing
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
 Definition of Nursing

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

 Concept of nursing

Person

Environment

Health

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
 Aims and Objectives of Nursing

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

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.

 Conti…….

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.
 Profession
Meaning
Profession has been defined as an occupation that
requires extensive education, that requires special
knowledge, skill and preparation

Professionalism

Professionalization
 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.

It utilizes in its practice of well defined & well organized body

of specialized knowledge which is on the intellectual level of

higher learning
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.
Occupation Profession
Differences
Training may occur in the Education take place at
job and length of training college or university, based on
varies the curriculum
Values ethics belief are not Values ethics belief are
important integral part
Commitment and personal Commitments and personal
identification vary or poor identification is strong and
Workers are supervised necessary
People often change the job Workers are autonomous
Accountability rest with People unlikely to change the
employer 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 Nurse practitioner
Teacher Nurse clinician
Client Advocate Nurse midwives
Counselor
Nurse anesthetist
Change agent
Nurse researcher
Leader
Nurse entrepreneur
Manager
Nurse advisors
Decision maker
Rehabilitator
Comforter
 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.

Issues related to nursing education and
nursing practice.

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.
 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

Principal
Director / superintendent
Professor
Deputy superintendent
Associate professor

Asst nsg. Superintendent Assistant professor

Ward inchrges/Tuter Lecturer

Asst. Lecturer
Senior nurse
Tutor
Junior nurse/staff nurses
 Professional Organizations
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.
 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.
lieu
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.
 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.
 FUNCTION OF STATE NURSING COUNCIL

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…

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