Defining and understanding the conceptual frameworks of the nursing profession is a task that has challenged many people over the years, and it is my hope that this paper truthfully reveals my effort to do so. Defining nursing also plays a role in distinguishing the profession from other health care disciplines. A portion of this paper also provides key points that help prove nursing is indeed a profession. Theories and personal perspectives will also be analyzed to further answer the question, 'What is the definition of nursing?'
The definition of nursing is continually evolving. In today's society, consumers of healthcare want quality service and are collaborators in their care. So what is nursing to me? Nursing is having the ability to change in response to the evolution of healthcare consumers needs. Nursing is a profession in which individuality, beliefs and values, and life experiences all contribute to performance. Nursing is not only understanding, but utilizing numerous nursing and non-nursing theories, state nurse practice acts, and the Code of Ethics for Nurses. Nursing is communicating and collaborating with clients, families, and team members to provide excellent care. Nursing is listening and looking carefully during each client encounter. Nursing is striving to impart knowledge and guidance simultaneously to achieve the following: retaining health, regaining health, or alleviating, managing, or minimizing poor health. Nursing is a combination of values, skills, ethical responsibilities, and a specialized body of knowledge that is applied using a holistic approach. It is important to remember that no single definition holds true for all nurses. "Trying to capture the meaning accurately is perhaps almost as difficult as trying to define love, because it is interpreted in many ways ()."
Nursing is a unique and fascinating profession that allows flexibility. Nursing does not have a set educational path nor does nursing have limited opportunities. Comparing and contrasting nursing and other disciplines truly exemplifies the profound uniqueness of nursing. Evidence-based medicine and evidence-based nursing, though both healthcare disciplines, have many differences. Nurses deal with human responses to health and illness. Nursing takes into consideration the needs of each client and is a "balance of "doing" and being with" (AACN). This means, nurses tend to not only the scientific aspect of care, but also exhibit presence and consciousness to address the client's feelings. Physicians however, are typically concerned with disease prevention or treatment. Florence Nightingale stated "medicine is the surgery of functions, as surgery proper is that of limbs and organs." (p133). Medicine often involves an allopathic approach. She continued, "and what nursing has to doâ€¦is to put the patient in the best condition for nature to act upon him." (). Nightingale explained that nurses understand that the environment, which is composed of physical, biological, and social realms, contributes to a patient or client's condition. Florence Nightingale discussed how nurses should not do simply what medicine and other professions do, but to do the best that nursing can do. (). I believe Nightingale meant that nurses must provide individualized care to each person and must be "present" in each situation regardless of the approach of other healthcare professionals.
It has been long argued that nursing is a profession and with good reason. "The basic tenet of the professional paradigm is that professions "fix" something for society" (Peplau). The profession is given certain privileges by society in return for their applied knowledge; the profession in turn has certain obligations. Nursing meets these obligations which include the following: to do no harm, to be skillful, to uphold moral and ethical standards, to control and have criteria for advancement, to discipline those who fail to meet standards, and using knowledge to treat and teach the public (Pepelua). Liaschenko J. & Peter E. (2004) cited:
Although there is no overall consensus as to what constitutes the proper attributes of a profession, the following characteristics are commonly noted: a unique body of knowledge, altruistic service to society, a code of ethics, significant education and socialization, and autonomy in practice, i.e. reasonable independence in decision- making about practice and control of the work situation and conditions (pg. )
I believe nursing's unique body of knowledge is important because it is composed of science, nursing theories, and conceptual frameworks which come from research ; research thus yields the ability of nursing to be an evidence-based profession. As a nurse, having selfless concern for others without expecting an obvious reward, except believing that someone will benefit and or avoid harm is a motivational factor; it is important to note that altruism can be taught, learned, and integrated into the nursing practice (Shaw & Degazon, 2008). In nursing, the Code of Ethics regulates nurse conduct, defines nurse's responsibility, and provides guidelines for the nurse and client relationship. Competent nursing skills are necessary for safe practice and are achieved through not only education, but also through interaction with clients and their families. The ability of nurses to effectively communicate and collaborate with clients, families, and other members of the healthcare team about sensitive topics, "diverge from the concepts of autonomy and self-determination." (Shaw & Degazon, pg. ). I believe nurses must also continually push for the recognition of nursing as a profession to ensure perpetuity.
Caring is arguably the driving force of the nursing profession. Research and theories concerning the concept of caring have been a part of the nursing profession for quite some time. Nurses form relationships with clients, families, and their colleagues. Nurses often enter these relationships with intentional caring consciousness at the forefront, followed by respect, and effective listening. Understanding the mutual and reciprocal aspects of caring allows nurses to move past themselves or their ego, into a space filled with possibilities (Lewis, 2003). Possibilities allow the nurse to provide clients with hope, and hope creates endurance and strength in a person and provides motivation. If a nurse loses his or her ability to care, it will affect the nurse's ability to be present with clients (Lewis). The moment I consciously decide that I will not care about a task, situation, or person, etc., is often the very moment I lose my ability to develop and plan realistic goals, self-reflect, and make decisions. Thus, I believe the nurse who makes little effort or chooses not to care altogether will have a diminished capacity to engage in self-determination. I believe the nursing profession as we know it today would not exist and function without the integration of the caring concept.
Nursing, like other disciplines, has a philosophical foundation that attempts to define the profession and explain its existence. My personal philosophy is the belief that selfless service is pleasing to God and the plan that he has for my life and that it is my duty to not only serve the Lord, but also mankind with passion, dedication, and humility. My philosophy draws from my interpretation of the Gospels or the Holy Bible and is validated within. My philosophy reflects what I believe about myself and helped lead me to choose nursing as my profession. Hence, I believe nursing is a calling that provides selfless service to mankind, motivated by the desire to care for others, in order to alleviate suffering and or prevent future suffering. Florence Nightingale became the hard-working, disciplined, practicing mystic that is revered today because she received a calling to serve God and accordingly obeyed (Dossey, 2010). I realize that caring for others is not always an easy task. I firmly believe that having a clearing stated personal philosophy will help me face ethical issues empathetically. I also believe my personal philosophy will contribute to my professional growth and will enhance my spiritual journey.
As a young child, I declared I would be a nurse just like my mother. After all, she was the most amazing person I had met in my few short years of life. I remember wanting to dress up in a cool, colorful uniform and help people in their time of need. Honestly, I really had no idea how much hard work and dedication the nursing profession entailed. Around sixth grade, my perception of a nurse changed. I started to have several asthma exacerbations that led to hospitalizations on multiple occasions. My doctor was only concerned with using his skills and knowledge to control my disease. I can recall one of my nurses who showed me that she truly cared by interacting with me on a spiritual level while providing therapeutic care. I do not believe medicine alone would have fully restored my health. My nurse and doctor were perhaps influenced by altruism. However, I believe only my nurse was able to move beyond her ego through caring and spirituality to express essential characteristics of selfless service.
Jean Watson's Theory of Human Caring and Madeleine Leininger's Theory of Cultural Care are pertinent to the nursing profession. Leininger believes that care and culture are intertwined. She suggests "care is the essence of nursing and the central, dominant, and unifying focus of nursing" (). Identifying a core or central focus, such as caring, is necessary to pursue and direct research that develops knowledge for the advancement of nursing. Leinenger considers nursing to be scientific as well as humanistic, and she believes human care phenomenon and activities are the focus of the profession. I believe nurses are blessed with the unique opportunity to help break cultural barriers and are thus demonstrating God's desire to care for others through discernible and concrete service. Leininger has even acknowledged that it is very important to her to recognize God's creativeness and caring nature (). Leininger proposes care improves a person's condition or helps them face death (). In order to accomplish this, nurses must allow themselves to be present and empathetic during each client encounter. Nurses must not shy away from clients; instead, they must be selfless and explore the subjects of life and death with their clients. Watson's theory describes caring as your belief and attitude that becomes your purpose, goal, or promise that you achieve through genuine acts (). Watson emphasizes transpersonal caring which involves successful nurse-client interaction. My ability to render selfless service comes from my obedience to God's word; the recipient and I both benefit from the service. My belief allows me to understand Watson's consideration of "not only the cared-for but also the caregiver". () Watson also discusses ten carative factors that are comprised of principles she deems vital to help others, combined with nursing skills; she has expanded her curative factors by adding more spiritual elements (). Using these factors as a guideline allows every nurse to engage in self-actualization and become a better nurse.
Once I complete my Bachelors of Science in Nursing, my plans are to work at St. Francis Medical Center in Monroe, LA because the hospital believes in extending the ministry of Jesus Christ. As a new graduate, I'm sure I will only be able to work in certain departments, but I would I would eventually like to work in the pediatric unit. Once I become a pediatric nurse, I plan to join the Society for Pediatric Nurses because it is a "broad-based pediatric nursing organization founded for all nurses involved in the care of children and families." I also plan to join Nurses Christian Fellowship because the organization will help me live out my personal relationship with God through nursing and interact with other nurses who have the same or similar beliefs. After at least 10 years as a pediatric nurse, I plan to return to Northwestern State University to acquire a Masters of Science in Nursing. My area of concentration will be Pediatric Nurse Practitioner (PNP). I will work as pediatric nurse practitioner following graduation; I am not sure about my geographical location after graduation. I also plan to join the National Association of Pediatric Nurse Practitioners. My ultimate goal is to open a pediatric after hour's clinic, perhaps in my home town of Monroe, LA. Also, I plan to remain a healthcare advocate, regardless of my location, and exercise my voting rights and encourage others to voice their opinion as well.