Defining the Nursing Profession

The definition of nursing has evolved since the introduction of the definition by the American Nurses Association in 1980. In that year, the ANA, in their Social Policy Statement, published their official definition of nursing. According to the American Nurses Association, “nursing is the diagnosis and treatment of human responses to actual and potential health problems” (1980). This definition has been massaged since 1980 and the most recent Social Policy Statement still uses the basic concepts as above, but with expanded explanations. It defines nursing as:

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). The American Nurses Association’s definition is an example of the discipline describing the domain of nursing, which is to protect, promote, optimize, and alleviate suffering, which therefore defines the profession of nursing. The International Council of Nursing defines nursing as:

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 (INC, 2005). Although the definitions provided by the American Nurses Association and the International Council of Nursing are exceptional ones they are only two definitions out of many.

The nursing profession is very difficult to define in straight lines and absolute parameters. As a profession nursing is many things to many people. The following pages will give you another definition of nursing. It explains why nursing is considered a profession, its mission, and how caring fits into the nursing concept. This definition of nursing is expressed in the form of a core supported by five defining characteristics. It is important to recognize that nursing is the totality. While some parts of the definition are shared with other health care professions, the uniqueness of nursing lies in their combination.

The definition takes in account the great diversity of nursing, which includes the care of people who are healthy as well as those who are sick, and of groups of people as well as individuals. The definition expresses the common core of nursing which remains constant. Nursing is the use of clinical judgment in the provision of care to enable people to improve, maintain, or recover their health. Nursing also help people cope with health problems, and to achieve the best possible quality of life, whatever their disease or disability, until death.

Nursing is an applied science which has a unique body of knowledge that utilizes principles from the physical, biological, and behavioral sciences. The central concern of nursing is the holistic person. The focus of nursing is health promotion, maintenance, curative, restorative, supportive and terminal care to individuals and groups of all ages, taking into consideration the factors that influence them in the total environment. The first defining characteristic of nursing is its purpose. The purpose of nursing is to promote health, healing, growth, and development.

It is to prevent disease, illness, injury, and disability. When people become ill or disabled the purpose of nursing is to minimize distress and suffering, and to enable people to understand and cope with their disease or disability, its treatment and its consequences. When death is inevitable, the purpose of nursing is to maintain the best possible quality of life until the end. The second defining characteristic of nursing is the mode of intervention. Nursing interventions are concerned with empowering people, and helping them to achieve, maintain, or recover independence.

Nursing is an intellectual, physical, emotional, and moral process which includes the identification of nursing needs therapeutic interventions and personal care; information, education, advice and advocacy; and physical, emotional and spiritual support. In addition to direct patient care, nursing practice includes management, teaching, and policy and knowledge development. The third characteristic is the domain of nursing. The specific domain of nursing is people’s unique responses to and experience of health, illness, frailty, disability and health related life events in whatever environment or circumstances they find themselves.

People’s responses may be physiological, psychological, social, cultural, or spiritual. This includes individuals of all ages, families, and communities throughout the entire lifespan. Next, is the focus and value base of nursing. Nursing hones in on the whole person and the human response rather than a particular aspect of the person or a particular pathological condition. Nursing is based on ethical values which respect the dignity, autonomy, and uniqueness of human beings, the privileged nurse-patient relationship, and the acceptance of personal accountability for decisions and actions.

These values are expressed in written codes of ethics and supported by a system of professional regulations. Lastly, is a commitment to partnership. Nurses work in partnership with patients, their relatives and other caregivers and in collaboration with others as members of a multidisciplinary team. Where appropriate they will lead the team, prescribing, delegating and supervising the work of others. At other times they will participate under the leadership of others. At all times, however, they remain personally and professionally accountable for their own decisions and actions.

The ability of nurses to respond to people’s need for nursing within the rapidly changing environment of health care fundamentally depends on the way in which nursing is defined. Nursing is a profession and a calling for people who are motivated to serve others. They are the professionals most trusted by the public. Friends and family come to them for knowledge, care, and empathy during times of illness, stress, and bereavement. Nursing is an art and a science combined with compassion and caring. Nursing like all things continues to progress into and throughout the millennium.

To know if nursing is truly a profession one must know the definition of a profession. A profession has a systemic body of theory, requires extensive training and has higher degrees of specialization. A profession also has self-regulatory association and requires formal certification. Professions also consist of a highly developed code of ethics. As a profession, nursing is a self-governing organization of persons with unique knowledge obtained through specific educational programs. Members of the profession provide a distinctive service in accordance with a code of ethics.

The knowledge on which the service is based includes nursing knowledge and knowledge from the natural and social sciences, and from the arts and humanities. The essence of the service is an interpersonal process aimed at facilitating the health of persons, families, and groups. Because nursing service is mandated by society, provision of the service fulfills a contract between society and the profession. To support the nursing profession nurses must continue to educate themselves in all areas of nursing. This gives a nurse a broader range of knowledge that is use to care for the patients.

Most individuals choose nursing as a profession because of their desire to care for other individuals. Caring is the central concept in the discipline of nursing. It also encompassed in the mission of nursing which is to enhance healing by providing care that honors persons’ essential unity of mind, body, and spirit and to provide and environment where caring sustains optimal healing and wellness. The concept of caring has led to the development of several caring theories. One of the well known theories is Jean Watson’s theory of human caring. She states:

Caring is a science that encompasses a humanitarian, human science orientation to human caring processes, phenomena, and experiences. Caring science includes arts and humanities as well as science. A caring science perspective is grounded in relational ontology of being-in-relation, and a world view of unity and connectedness of all. The goal of nursing in Watson’s theory is centered on helping the patient gain a higher degree of harmony within the mind, body, and soul. It is achieved through caring transactions. Caring takes place every time a nurse-to-patient contact is make.

The nurse enters the world of he patient in order to come to know the patient as a caring person. Caring makes a difference to the patient’s sense if well-being. In order for a nurse to successfully care for a patient the proper training is needed. Education entails the acquisition if critical thinking abilities, as well as skills in problem solving, effective communication and the demonstration of empathy and caring. Education is much more than simply gaining knowledge. It is also gaining the ability to utilize and apply that message. Nursing programs emphasize application of concepts and principles to deliver safe and effective care.

The extensive training is necessary to gain a body of knowledge that is pertinent to the role of a nurse. Nursing in the future will depend upon nursing maturing as a distinct health, healing and caring profession that it has always represented across time, but has yet to actualize. Nursing, thus ironically, now is challenged to stand and mature within its own paradigm, while simultaneously having to transcend it and share with others. The future already reveals that all health care practitioners will need to work within a shared framework of caring relationships.

Thus, nursing is at its own cross road of possibilities, among world views, paradigms, centuries and eras; invited and required to build upon its heritage and latest evolution in science and technology; but, to transcend itself for a postmodern future yet to be known. However, nursing’s future holds promises of caring and healing mysteries and models yet to unfold as opportunities for offering compassionate caring service awaits at individual, system, societal, national and global levels for self, profession, and the broader world community.

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