The profession of nursing has been redefined as compare to previous times. It is well recognized and respected due to the fact that it now involves extensive knowledge, study, research obtaining a degree. The nurses have different fields of skills and specializations such as advanced nurse practitioner, nurse anesthesiologist, wound nurse, nurse case managers, etc. But there are other factors too, such as society and environment, culture. In some cultures, nursing is not considered an ideal profession because income is not satisfactory, work condition is tough. Nurses have less autonomy and respect and their image is negative because people are not aware that what nurses are capable of. Governments and institutions are not providing enough awareness and knowledge about the dignity of this profession. Only students low income and poor families are coming to this profession.

The factors that can influence the perception of nurses is continuing education and awareness. In my opinion, the public perception of nursing is based on who a nurse portray herself while providing patient care. A knowledgeable, well prepared and patient-focused nurse will have respect, dignity, and value. The attitude also plays an important role as this differentiate one nurse from the other. People always respect the nurses who are professional, knowledgeable, focused kind and respectful with a positive attitude.

There are several factors that can influence the scope of nurses including individual factors relating to professional development and continuity of education and preparation in the field. The other factors are work-related factors including a relationship with the doctors, health professionals, and other interdisciplinary health care team. The organizational factors like policies, practices, and providing benefits and acknowledging the contribution of nurses and providing respect and autonomy. The nurses should be a part of the legislative committee policy-making and shared governance so they can have a more defined role in their future. The general public should be educated about the role and importance of nursing through print and electronic media.

 

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“The first half of the nineteenth century saw nursing conditions at their worst. Nursing had become a job for the “undesirables” in society — the immoral, the alcoholic, and the illiterate. The pay for nursing care was poor and was frequently supplemented in any way possible. There was little organization associated with nursing and certainly no social standing. No one would enter nursing who could possibly earn a living in some other way. Through the work of early nursing figures, nursing gained the respect of the military and the government, ushering the birth of what is now considered modern nursing.”(Nursing Timeline)The hospitals were so disgraceful, dirty contaminated with infections. There was no proper ventilation in hospital rooms that’s increase risk of dying.

“Florence Nightingale1820 – 1910

Widely recognized as the founding mother of modern nursing, Florence Nightingale’s work led to the reform of sanitary conditions in military hospitals, the organization and advancement of nursing education and the development of measures to analyze disease and morality rates using statistical methods. Her observations and writings contributed to the development of an applied theory of communicable disease. Her seminal work, Notes on Nursing: What it is and What it is Not has, for centuries, formally defined the work of nursing as unique and separate from that of medicine and the social sciences.”(Nursing Timeline) She provided clean dressings, clean bed, well cooked food, proper sanitation and fresh air to patients and do her rounds with a lamp. “The profession of nursing was strengthened by the development of nursing training and degree programs that would adhere to standards of care and regulations developed by nursing associations and nurse licensure. Fewer than twenty nurses attended the first convention in 1896 of the Nurses Associated Alumnae of the United States and Canada which became in 1911 the American Nurses Association.”(Nursing Timeline)Big hospitals start their own nursing schools to produce more qualified and educated nurses to help community. Because in back days there was only lay people who work as nurses without proper education and knowledge. With education nursing profession changed a lot with new ways of thinking and knowledge specific to nursing. Nursing theory is essential to continuing evolution of the discipline of nursing. The use of nursing theory in research is very important. Nurses often use theories from other disciplines instead of their own and this expands the knowledge of another discipline.(Marlaine.S &Marilyn.P 2010)

 

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Nursing practice started as far back as 250 B.C. Most of the early nursing professionals were men of God. Then they slowly became men associated with the military. During the Crimean War, nursing took a dive for the worst. “Nursing had become a job for the “undesirables” in society — the immoral, the alcoholic, and the illiterate” (Grand Canyon University, n.d.). The income for people within the field, wasn’t sufficient enough to live off of, let alone anything else. After gaining some backing from the military, nursing become a more recognized profession.

Way before our leading lady, Florence Nightingale, stepped into the spotlight, there was the great Dorothea Dix. Dorothea was a pioneer, “she began the movement toward recognizing the role of women in medicine and the development of nursing as a profession” (Grand Canyon University, n.d.). She was an advocate for how our mentally ill patients were being treated and their living conditions. She fought for the people who could not fight for themselves, and she traveled all over to do it. 

Another person to shed some light on the nursing profession was not known for his nursing qualities, but his writing. Walt Whitman became a caregiver by accident, by caring for his brother after being wound during the Civil War. “When he went to Washington, DC to care for his brother he saw the plight of many wounded soldiers and decided to stay and care for the sick and wounded” (Grand Canyon University, n.d). After his experiences, he put pen to paper, and did what he did best. He wrote a poem called “The Wound Dresser”. Not only did it explain what he did, but is expressed how badly the men were hurt and how bad the conditions were. The poem is moving and you can almost see all of the men Walt Whitman helped.

Mildred Montag addressed issues within the education for nursing professionals. Mildred “revolutionized nursing education by the creation of the 2 year associate degree in nursing” (Grand Canyon University, n.d). She set up a program that could be achieved in less time than attending a 4 year college. This assisted with the nursing shortage and allowed more nursing to be produced. 

All three of these people, changed nursing in some way. History allows us to look back, and remember that this is a profession that is full of compassion and devotion. What an honor it is to be apart of it all.

 

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    In an article titled Promoting professional accountability and ownership: Nursing leaders set the tone for a culture of professional responsibility published by American Nurse Today authors Sherman, Rose O.; Cohn, Tanya M. examine and attempt to come up with their definition of professional accountability. The authors state,“Professional accountability is an internally driven mindset. It’s a commitment that you make to yourself and your career when you become a nurse to advance, grow, improve, and adapt to your work. It’s also a pledge to apply your talents, energies, and gifts to improve patient outcomes.” (Sherman, R. O., & Cohn, T. M. 2019 para. 5) The authors explained how professional accountability applies to nursing but focuses on the individual making themselves accountable. While holding oneself accountable as a nurse is very important it will be more effective if the each and every professional holds their counterparts accountable as well. This has the weight of the 3 plus million nurses each leaning on each other to maintain standards of care and act as a “professional” should. 

    Application of professional accountability in clinical expertise occurs on a regular basis as the nurse is working. How this is happening is due to the fact the nurses are continually expanding their clinical experience with each and every patient they care for. Through detailed systematic assessments they are utilizing a clinical skill and will often refer to professional resources to learn more and ensure they are providing the best level of care possible. They will often utilize more experienced nurses for advice. The nurse will also apply professional accountability in the clinical setting in regard to the nursing process usually by communicating with others in the Interdisciplinary Team (IDT) on the plan of care. The nurse is continually applying the nursing process, but it is verbalized to the IDT and usually the charge nurse during the shift. This is a demonstration of professional accountability because the members of the IDT are expecting the nurse present the nursing process to them so they can have input. This expectation of others is the accountability part. Another area of professional accountability is in evidence-based practice (EBP). The general public and the profession expect that nurses are utilizing current EBP in their care for others as this allows for better patient outcomes and is the standard of care. The nurse is held to this standard and is accountable by the other nurses that will care for the client. An example would be a client admitted to the hospital for a surgical procedure will potential have multiple nurses caring for them during their stay in the hospital. Every nurse that cares for the same client need to have continuity and consistency in their care and this is established by standards of care and EBP.

 

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2 postsRe: Topic 4 DQ 2

To be professionally accountable in nursing is necessary and vital for patient care and safety. According to The American Nurses Association Code of Ethics, the definition of accountability “ is to be answerable to oneself and others for one’s own actions.”
The nurse has to ensure that while delivering care, accountability is owed to themselves and the client, the client’s family, colleagues, the workplace and the profession.

An example of professional accountability is during the admission process of a client to a psychiatric unit for the first time. The client is involuntary and is not sure what this status means for them. With professional accountability, the nurse explains the involuntary status and also ensures that the family understands what this status is in a psychiatric facility. Due to the fact that the hospital is a teaching facility and nursing students are always present, each opportunity must be seen as a teaching moment, so nursing students can understand how professional accountability impacts the care of clients from the time of admission.

A senior nurse knows that establishing a therapeutic relationship allows the client to feel safe and being professionally accountable impacts both client and student especially during the assessment phase. Here the nursing process is key to clinical expertise and using the nursing process demonstrates that quality of care must start from the point of admission to discharge. This nursing process is kept in mind by a highly educated nurse who also uses evidence-based practice to deliver safe and effective care.

Evidence-based practice in professional accountability allows the nurse to have a better understanding of the practice and how accountability influences her to make decisions that fully impacts patient care.(Brower & Nemec,2017) An example of evidence-based practice in mental health is to form a client-centered plan of care to ensure all decisions are shared-decision making. The care team and the client seeking help with mental health issues come together to have client-centered care and self-directed care. 

With accountability to the client and self, the nurse is an advocate for the client and ensures that the latest evidence is used to drive change for better patient outcomes. ( Brower & Nemec, 2017).

Professional Accountability is one of the best ways for a nurse to self regulate, be conscious of the care and their impact when imparting knowledge to the future generation of nurses.

 

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