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Professional and Educational
Development in NursingFall, 2012
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At the end of this discussion, thestudent will be able to:
Explain the difference between an occupationand a profession (this is one of the questions)
Define characteristics of a profession Analyze barriers to professionalism Use models to examine nursing professionalism Name key people and events that influenced the
development of nursing education. Describe current educational pathways of nursing. Examine challenges of nursing education and
professional development.
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I Want a Job!
Why did you enter the nursing program?
What did you do before becoming anursing student? (Do you even rememberback that far?)
Who are you now?
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Occupation-
Defined as what a person does to make a living orhow one spends time.
Task-oriented (mindless, something very repetitivewithout any thought process)
Most of work is manual
Trained on-the-job
No specific value-system associated
No specific career path
Accountability lies with supervisor/employer
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Profession -requires a specialized knowledge Develops from an occupation that specializes in
Service (advocating for your patient)
Knowledge (a specialized knowledge is what separates
you)
Autonomy (you dont have to go back to your supervisor
when a decision has to be made)
Professions develop a collective identity
Formal education
Evidence based practice Integrated value-system (code of ethics, same familiar value
system)
Legal protection (protecting your license)
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Professionals are different fromworkers in an occupation
1. Preparation
College setting
Prolonged education, specialized
Orientation (socialization) to beliefs/values
2. Commitment
Calling
Part ofpersonal identityIm a nurse!
Transcends expectation of material reward
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Barriers to Professionalism in
Nursing (question on test) Variability of educational background (see later
discussion) Historical issues
Gender (1901 men banned from nursing in military)
Obedience (1868 AMA/Hospital Admin promotedtraining.persisted through 1960s)
Altruism (less expectation of monetary compensation) Power of other organizations (AMA, legislation)
Public perception The nurse does what the doctor says The nurse helps the doctor
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Kellys Criteria of a Profession
Accountability (personalintegrity)
Autonomy (still under
development innursing)
Altruistic (motivated byservice)
Associations(advocates for theprofession)
Body of knowledge
(specialized)
College (higher learning
Caring (vital tohumanity)
Code (guide todecisions/conduct)
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Millers Wheel of Professionalism
Publication
Organization
Self-regulatory
Research
Continuing
Education
CommunityService
Theory
Code
University educationand
Science background
Professionalism in Nursing
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Professional Nursing Documents
ANA published books (3)
(Foundation of Nursing package)Nursing Social Policy Statement (a published
contract outlining nurses obligations to society)Nursing: Scope and Standards of Practice (what a
reasonable and prudent nurse would do)Code of Ethics for Nurses With Interpretative
Statements (see back cover of your Chitty and
Black text)*These publications are available for purchase
from ANA website, e-versions only $3.95*
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Collegiality What does this mean to you? Treating you as
equals, shared understanding, shared purpose Do you think nursing has a reputation for this?
No they dont (nurses eat their young)
Why? b/c it was passed down Why not? it was miserable for me and so I will
make it miserable for you
What are ways we can promote collegiality inthe nursing profession?
(further discussion week 4)
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Nursing Education History 1800s
(1860-1899)Training schools affiliated with hospitals(Nightingale suggested administration separatefrom nursing education, and public funds to beused for nursing education)U.S. at turn-of-century was focused on hospital-based training.
*Note different mind-set between training and
education*Primary reason for nurse training structure
was to staff the hospitals with free labor*
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Nursing Education History 1900s
Main concerns of nursing leaders: Training not well-regulated
Need for leadership and scholarship
1899 ANA founded (professionals getting togethercreating the structure)
1900 International Council of Nurses formed
1901 American Journal of Nursing first published
(created the literacy) 1907 Mary Adelaide Nutting, worlds 1st
nursing professor (Teachers College, New
York)
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Nursing Education History
Famous studies:
1912 (Nutting) nationwide study of nursingstudents training
1923 (Goldmark Report) advocated for educationat collegiate level rather hospital-based training
1934, 1937 (NLN) recommend college education,
but also outlined 3 year diploma curriculum(hospital based, but with college coursesincluded) they create the standards (what shouldwe be teaching)
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Early Studies Consensus
College for nurses
Students NOT to be used to staff
hospitals Standards are needed
Minimum qualifications for graduation
identified
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Nursing History set the stage
Registration required 1903, North Carolina passed 1st nurse
practice act
By 1921, 48 states had laws regulatingnursing practice (but note that women did notreceive the right to vote in this country until1920, so laws made by non-nurse men!*)
*problem with early laws is that people couldfunction as caregivers, for less pay, as longas they did not use the title nurse.
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LPN (LVN) Pathway
Started in 1930s in response to shortagedue to WW II
Technical degree
1 year program Limited scope of practice by law
(question: What has your experience been as
an LPN in the area of scope of practice bylaw, and scope of practice by facilityadministration demand?)
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RN Nursing Education Pathways 1
Diploma
Hospital-based
Most popular 1900-1960s
Used to be 3 years, now 2 years
(question: Health care more complicated now,so what is left out in a 2 year education?
Currently offers college credit (didntpreviously)
Least used path at this time
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RN Nursing Education Pathways 2
Associate Degree 1952 Mildred Montags doctorial dissertation
Originally a technical degree, 2 years
*Main reason was nursing shortage*(question: Is shortage an adequate reason to
lessen the educational standard?)
Montags model was changed from atechnical degree to a pathway to RN (includesleadership, decision-making education, etc.)
Usually 3 years for completion
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RN Nursing Education Pathways 3
BSN Recommended by every major study and
organization since early 1900s as the minimumpreparation for professional nursing.
ANA position papers 1965 BSN minimum for professional practice and ADN for
technical practice (LPN not recommended)
1979 dates emphasized (by 1985, BSN, and only 2 levels ofpractice by 1980)
(questions: How many levels of practice for nurse do we havein the United States? Does this title matter? Does the publicknow the educational levels of its nursing caregivers? Doesthat matter?)
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Questions
Do you believe classes not directly relatedto clinical practice are less important,equally important or more important than
additional clinical classes?
How would you structure a nursingcurriculum to cover what is important in
nursing education?
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How do we solve the problems ofNursing Pathways?
Promote Articulated Programs
Decide by legislation the minimum qualifications
Cooperation needed between ANA, NLN,
AACN, bedside nurses, facility administrators,the public, legislators, educators, and all otherstakeholders
Promote acceptance into BSN/MSN programs(students with other degrees, ADNs wishing to
further education, fast-track to MSN, etc.)
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Certification Programs
Certification comes AFTER License Differs from licensure in that license is state-
regulated and certification is given by adiscipline-recognized accrediting organization
Applies to area of specialty
Validates proficiency in practice
(remember Benners novice to expert theory?)
youhave different areas based on yourknowledge base. Novice, beginner, expert
http://www.testprepreview.com/nursing_certifications.htm
http://www.testprepreview.com/nursing_certifications.htmhttp://www.testprepreview.com/nursing_certifications.htmhttp://www.testprepreview.com/nursing_certifications.htmhttp://www.testprepreview.com/nursing_certifications.htm7/27/2019 Professional and Educational Development in Nursing
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Certification Programs.Problems?
Who decides the standards of all thecertifications?
American Association of Colleges of Nursing
(AACN) 2008 Consensus Modelhttp://www.nursecredentialing.org/APRN-FAQ.aspx#Q25
This is gold-standard in organizing standards
and focus for advanced practice nursing. Can beused as model for organizing standards in otherareas of certification.
http://www.nursecredentialing.org/APRN-FAQ.aspxhttp://www.nursecredentialing.org/APRN-FAQ.aspxhttp://www.nursecredentialing.org/APRN-FAQ.aspxhttp://www.nursecredentialing.org/APRN-FAQ.aspxhttp://www.nursecredentialing.org/APRN-FAQ.aspx7/27/2019 Professional and Educational Development in Nursing
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Graduate Programs
1950s/1960s Masters viewed as terminaldegree
1970s/1980s focus: clinical specialization
CNS very popular, not a Masters degree PhD was educator track
ND phased to DNP for clinical practice
1990s/2000s Masters for NursePractitioner very popular
2010s Consensus Model Implemented
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Continuing Education
Means post-licensure education
State of OHIO 24 hours every 2 years
See Code of Ethics provision # 5 Some states require continuing education
for re-licensure.
Some do not! (see page 165 in Chitty andBlack text as well as updated website)
http://ce.nurse.com/state-nurse-ce-
requirements
http://ce.nurse.com/state-nurse-ce-requirementshttp://ce.nurse.com/state-nurse-ce-requirementshttp://ce.nurse.com/state-nurse-ce-requirementshttp://ce.nurse.com/state-nurse-ce-requirementshttp://ce.nurse.com/state-nurse-ce-requirementshttp://ce.nurse.com/state-nurse-ce-requirementshttp://ce.nurse.com/state-nurse-ce-requirementshttp://ce.nurse.com/state-nurse-ce-requirementshttp://ce.nurse.com/state-nurse-ce-requirements7/27/2019 Professional and Educational Development in Nursing
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Continuing Education Notes
Continuing Education (CE) is counted in numberof contact hours(1 50-60 minute hour = 1 CE)
13 states still have NO continuing educationrequirements (click on website names of statesto find out which ones)
2 states do not have CE requirement stated in
number of hours, but the practice actsspecifically list continued competency andpersonal self-regulation as law!
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Interesting CE examples
New York4 hours every 4 years on infectious disease
2 hours on child abuse (1 time only)
Oklahoma
1 of 5 options for re-licensure is 24 CEs Washington
531 hours of clinical nursing practice every 3 years
(for a part timer need to work at least 177 hours/year on average)
45 hours of CE, to include self-assessment and reflection!
OregonNothing needed except 7 hours of pain management
(question: Why only just pain management?)
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Ohio Continuing Education
CE Requirements for RNs:Each person licensed as an RN in Ohio must complete twenty-four(24) contact hours of approved CE to renew their license. A nursewho has been licensed by endorsement for less than or equal to one(1) year must complete twelve (12) contact hours. At least one (1) ofthe required contact hours must be Category A. The contact hours
must be completed within two (2) years prior to renewal. ALLlicensee and certificate holders are required to complete at least onecontact hour related to Chapters 4723,1-23 of the Ohio nursepractice code and rules.
ref: http://ce.nurse.com/state-nurse-ce-requirements/ohio
Also see FAQ:
http://www.nursing.ohio.gov/PDFS/education/CE%20FAQ%203.12.pdf
http://ce.nurse.com/state-nurse-ce-requirements/ohiohttp://www.nursing.ohio.gov/PDFS/education/CE%20FAQ%203.12.pdfhttp://www.nursing.ohio.gov/PDFS/education/CE%20FAQ%203.12.pdfhttp://ce.nurse.com/state-nurse-ce-requirements/ohiohttp://ce.nurse.com/state-nurse-ce-requirements/ohiohttp://ce.nurse.com/state-nurse-ce-requirements/ohiohttp://ce.nurse.com/state-nurse-ce-requirements/ohiohttp://ce.nurse.com/state-nurse-ce-requirements/ohiohttp://ce.nurse.com/state-nurse-ce-requirements/ohiohttp://ce.nurse.com/state-nurse-ce-requirements/ohio7/27/2019 Professional and Educational Development in Nursing
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Current/Future Challenges
Diversity issues
Critical thinking
Collaboration Health promotion issues
Informatics
Health care costs Faculty shortage expected