Values and Image in Nursing

May 29, 2008

Objectives

1. Examine personal and professional values and their impact on decision making and professional behavior.

2. Explore the image of contemporary nursing.

VALUESPersonal beliefs about worthAct as standard to guide

behavior

What is a Value System?Framework on which actions are

based

Value Systems at UNFUNF Mission Statement

The University of North Florida (UNF) is a comprehensive public urban university whose mission is to educate students through a broad array of undergraduate and select graduate programs. The University of North Florida is dedicated to excellence in teaching, scholarship, and service; and the engagement of students in a personal, supportive, and challenging learning environment. In fulfilling its mission, the University seeks to contribute to the betterment of society.

UNF Nursing Student Handbook, p. 8

Value Systems at UNFCOH Mission Statement

The mission of the College of Health is to educate students in the health professions through excellence and innovation in teaching, scholarship and service.

Goal Statements Ensure program quality by using internal and external accountability measures to

systematically evaluate undergraduate and graduate programs. Maximize personal and professional growth of faculty and staff by supporting

teaching, research, and service. Manage program expansion by responding to community needs and interests that

are within the constraints of available resources. Advance teaching and research objectives through acquisition and support of

effective technologies. Respond to regional health needs and priorities by enhancing partnerships in the

community. Maintain program integrity by conducting ongoing internal review of organizational

structure. Acknowledge societal pluralism by increasing the diversity of the faculty, staff and

students. Augment cultural understanding by implementing diverse learning opportunities for

faculty and students. Enhance learning and scholarship by securing external support. Contribute to the collective intellectual life on campus by participating in activities

involving faculty, students and staff from other departments and colleges.

Value Systems at UNF

SON Mission StatementTo educate nursing students at beginning and advanced levels through excellence and innovation in teaching, scholarship and service.

(what we are here to do)UNF Nursing Student Handbook, p. 8

Value Systems at UNFSON Vision Statement

To be a center for excellence in nursing education; recognized for innovation, scholarship, and service in the preparation of professional nurses who advocate for health and who collaboratively care for individuals, families, communities and populations throughout the life cycle in a variety of settings.

(what we’d like to be) UNF Nursing Student Handbook, p. 8

Value Systems at UNFSON Values Statement

The School fosters a commitment to values, attitudes and ethical dimensions, including integrity, respect, collaboration, cooperation and social justice that are hallmarks of professional nursing. The School is committed to upholding and maintaining both professional nursing standards and a code of ethics for nursing.

UNF Nursing Student Handbook, p. 8

ANA Value SystemStandards of Professional Performance

Quality of practiceEducationProfessional practice evaluationCollegialityCollaborationEthicsResearchResource utilizationLeadership (how do we do our standards of care)

AACN Value SystemAltruismAutonomyHuman DignityIntegritySocial Justice(integral to professional nursing

practice) AACN Essentials of Baccalaureate Education (see UNF Nursing

Student Handbook, p. 40

Class ExerciseAltruism

Elizabeth A, Sabrina, Sheila, Ro, LizAutonomy

Shannon, Britta, Kara, Ricky, CrystalHuman Dignity

Miranda, Melissa, Heather, Jennifer, KatIntegrity

Susan, Tiffany, Cynthia, LaurenSocial Justice

Ashley, Dawn, Brittany, Wendy

Class ExerciseWhat is it?

Go into your books and out on the Internet to find definitions

Then create your own definition by consensus of the group

How would you know it if you saw it?Find images/pictures in your books or on

the Internet that convey the essence of your definition

Altruism: Concern for the welfare and well being of others

Demonstrate understanding of cultures, beliefs, and perspectives of others.

Advocate for patients, particularly the most vulnerable.

Take risks on behalf of patients and colleagues.

Mentor other professionals(giving H1N1 vaccinations b/c it is the

right thing to do, not for community hours)

AACN Essentials of Baccalaureate Education

Autonomy: Right to self-determination

Plan care in partnership with patients

Honor the right of patients and families to make decisions about health care

Provide information so patients can make informed choices

AACN Essentials of Baccalaureate Education

Human Dignity: Respect inherent worth and uniqueness of individuals/populations

Provide culturally competent and sensitive care

Protect the patient's privacyPreserve the confidentiality of

patient's and health care providersDesign care with sensitivity to

individual patient needs

AACN Essentials of Baccalaureate Education

Integrity: act according to appropriate code of ethics/accepted standards of practice

Provide honest information to patients and the public

Document care accurately and honestly

Seek to remedy errors made by self or others

Demonstrate accountability for own actions

AACN Essentials of Baccalaureate Education

Social Justice: upholding moral, legal, and humanistic principles

Support fairness and non-discrimination in the delivery of care

Promote universal access to health care

Encourage legislation and policy consistent with the advancement of nursing care and health care

AACN Essentials of Baccalaureate Education

So … what do values have to do with nursing image?

IMAGEA representation of a person or thing

A type, typical example, symbol, embodimentA mental picture of something, conception, idea, impression

And …. Why Are We Concerned?

Do you think that nurses ... nursing has image problems?

Two Views of Nursing

External ImageInternal Image

Two Views of Nursing

External ImageHow nurses are portrayed

• Media• Print

How others view nurses and nursing• Patients and families (generally have a

good impression of us…. See the value of what we do)

• Administrators• Other health care providers• The public in general

External View

The External View

Sairy Gamp from Charles Dickens, Martin Chuzzlewit (1844)

The External View

The External View

The External View

The External View

The External View

The External View

The External View

The External View

The External ViewNursing, like teaching, has long been

considered a woman's profession It was one of few options for women who

wanted a career. As career opportunities for women began

to open up in the 1970s and blossom in the 1980s, fewer chose nursing. Public money and public opinion supported

women choosing professions that had been previously closed to them, such as law, engineering or medicine

Many considered nursing a second-class option.

The External ViewThe image of nursing took another

serious blow during the recession and downsizing that began in the 1980sGraduates had a difficult time finding

jobs. Stories of layoffs and cutbacks gave

many the impression that nursing was not a good field to work in

Some nurses have not forgotten that period,

The External ViewAccording to public opinion polls, nurses

are seen as trustworthy, capable and conscientious caregivers, critical to the health care system.

A 2002 poll by Vanderbilt University's Medical Center's School of Nursing and Center for Health Services Research in Nashville, TN showed that 95 percent of Americans overwhelmingly trust,

respect and admire nurses83 percent would encourage a loved one to

enter the nursing profession.

The External View When asked how they would rate the honesty and ethical

standards of people in the fields below as "very high", "high," "average," "low" or "very low," 84 percent of Americans reported nurses have "very high" or "high" standards.

Firefighters NURSES U.S. military Police Officers Pharmacists Medical doctors Clergy

The External ViewThere is, however, a gap in the awareness

that people-especially young people-have of what nurses do. Most do not know that nursing offers career

opportunities besides patient care. Many do not understand the differences

between licensed practical nurses, registered nurses and nurse practitioners.

And most Americans have little or no idea that starting salaries in nursing compete with those of other professions.

The External View Information from the Vanderbilt study and others

show that most Americans see nurses primarily as bedside caregivers and have little understanding about what else they do.

A study of 1,800 American schoolchildren in 2005 found that most saw nursing as scary and stressful, with little chance of advancement and terrible hours.

Nurse recruiters who talk to high school students and young adults about nursing said they routinely hear comments such as "I don't like blood," and "I don't want to work nights."

The External ViewAccording to a 2001 Johnson & Johnson

study:Only half of Americans know that RNs must

have a bachelor's or an associate's degree. Fewer than one in five know that nurses must

be licensed. Less than 20 percent of Americans know that

RNs must have continual education. More than two in three Americans do not know

that nurse practitioners are allowed to prescribe drugs.

The External ViewAccording to the Johnson & Johnson study:

While most know that nurses are responsible for bedside care, administering IVs, giving injections and drawing blood, fewer than four in 10 people know that nurses are involved in reducing health care costs, working in laboratories or writing and revising hospital and clinic policies.

http://www.nurseweek.com/news/features/02-06/image.asp

External View

Two Views of Nursing

Internal ImageHow nurses see themselves as

individualsHow nurses envision the profession

Internal ImageAn Australian study was performed

with 80 RNs to identify the relationships between nurses' perception of common public stereotypes of their profession, nurses' self-concept, self-esteem, job satisfaction, and performance.

Internal ImageThe results suggest that

nurses' perception of the public stereotyping of nursing is related to the development of their self-concept, collective self-esteem, and job satisfaction, all of which are associated with their performance

encouraging professional socialization and cultivation of positive, personal self-esteem to ward off the negative influences of public stereotypes on nursing practice is important

Kershaw, T.M., & Burt, I. (2002). Does public image of nurses matter? Journal of Professional Nursing, 18, 196-205.

Internal ImageA qualitative study investigated

nurses’ accounts of their work and found thatNurses saw their role and their

professional practice as positive to the extent that they could see good in the work they do.

Value in their work was tied to making a difference to patients• Providing care that made their patients feel

better.Pask, E.J. (2003). Moral agency in nursing: seeing value in the

work and believing that I make a difference. Nursing Ethics, 10, 165-174.

Internal Image

Changing the Image of

Nurses & Nursing

What have been the past efforts of changing the image of nurses and nursing ...?

Past Strategies for Change

The focus has generally been on changing the nursing profession.

Has this strategy for change been effective?

Hint #1...

To change a large group requires a concrete plan that is effective over time

Hint #2...

The basic image of the nursing profession has already been established

The answer is,

‘no’,

changing the image of the nursing

profession has not been sufficiently effective

A More Efficient Strategy of Change

Changing the self-image of the individual nurse

Self Image Model for the Nursing Profession

A B C D

Thoughts & Self-Image Actions & Image ofBeliefs of of the Performance Nursingthe Nurse Nurse & Achievement

Profession of the Nurse

St. Francis Xavier University

(A) The Nurse’s Thoughts & Beliefs leads to (B) Self-Image of the Nurse

A B C D

Thoughts & Self-Image Actions & Image of

Beliefs of of the Performance Nursing

the Nurse Nurse & Achievement Profession

of the Nurse

St. Francis Xavier University

(B) Self-Image leads to (C) the Nurse’s Actions, Performance & Achievements

A B C D

Thoughts & Self-Image Actions & Image of

Beliefs of of the Performance Nursing

the Nurse Nurse & Achievement Profession

of the Nurse

St. Francis Xavier University

(C) Nurse’s Actions, Performance & Achievements lead to(D) Image of Nursing Profession

A B C D

Thoughts & Self-Image Actions & Image of

Beliefs of of the Performance Nursing

the Nurse Nurse & Achievement Profession

of the Nurse

St. Francis Xavier University

Direct Linkage (bi-directional)(B) Self-Image of the Nurse &(D) Image of the Professional

A B C D

Thoughts & Self-Image Actions & Image of

Beliefs of of the Performance Nursing

the Nurse Nurse & Achievement Profession

of the Nurse

St. Francis Xavier University

Will nurses want to improve their self-image?

Definitions of TermsSelf-image or self-concept:

set of beliefs and mental picture you hold about yourself.

Self-esteem: how much you like or approve of your self-concept.

Ideal self-concept: the mental picture of the person you

believe you should be.

Self-Concept, Ideal Self-Concept & Self-Esteem

Individual’sSelf-Concept(Self-Image)

DifferenceBetween

Individual'sIdeal Self-Concept

Self-Esteem& Self-Concept

Individual’sIdeal Self-Concept(Self-Image)

High Self Esteem

Difference between Individual’s

Ideal Self-Concept & Self-EsteemSelf-Concept

Low Self-Esteem

Difference between Individual’sIdeal Self-Concept Self-Esteem& Self-Concept

Image Building

Image Building

a processknowing oneselfbeing positive about one’s self

image, leading to a better chance of increasing one’s self-esteem & enjoying a meaningful, happy life

(Hugh Prather)

Image Building

Remember-

“… no one can make you feel inferior without your consent…”

(Eleanor Roosevelt)

‘Can Do’ Attitude

what can the nurse do to change self- image?

what can the nurse do to change the image of the profession?

The Image of the Nursing Profession

…is based on the individual nurse.