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Professionalism in nursing.

"Most people know they can't get into the hospital without a doctor. What they don't know is that they won't get out of one at least not alive without a nurse," Joan Lynaugh, Nursing Historian

How do we define "profession" and "professionalism"? What do these terms mean to Registered Nurses? What do these terms mean to the general public? What should the entry level to practice education be for RNs? How do we characterize attributes of the professional RN? What does the future hold for the nursing professional?

The meaning of professionalism has been the subject of much debate for decades, perhaps centuries. The Carnegie Foundation produced one of the first papers on this subject in 1910. The Flexner Report focused on the profession of medicine and tendered the incentive for future writings, discussion and efforts to define this concept. The Flexner Report suggested activities must be intellectual in their pursuit as opposed to physical; they must be based on knowledge. Additionally, it was recommended that there must be 'teachable' techniques and that practitioners must be motivated by altruism. Author Abraham Flexner is quoted "If the sick are to reap the full benefit of recent progress in medicine, a more uniformly arduous and expensive medical education is demanded" (1910).

Another report produced by Bixler and Bixler (1959) stated the characteristics of a profession must have a specialized body of knowledge and use that body of knowledge to expand and improve the techniques, education, and service through scientific research methods, it must entrust the education of its practitioner at institutes of higher education, and help formulate professional policies and control of the professional activities. As a profession, we must agree that nursing is a profession, act professionally, and propel our profession forward. We clearly have some work to do in this regard. There are many important issues 'we' must address, and decisions to be made on these matters so as to strengthen and advance the nursing profession. As counter-intuitive as it may feel or counter to conventional wisdom, we should use and exploit the current critical shortage of nurses to advance our position, our evidenced-based practices, re-examine and resolve the entry-level to professional practice issue and be assertive in controlling the practice of nursing as physicians did in the early 20th century. We can not merely permit our professional significance to be defined by arbitrary regulation, a union contract, or a hospital policy or procedure," nor can we sit idly by while policy makers dictate our patient care load, the hours we work, or the education of our future nursing professionals.

It is up to YOU, it is up to me, it is up to 'we' as part of the nursing profession to reshape our image into a strong, competent, capable, and powerful profession that is intellectually demanding, exciting, rewarding and challenging. This is not up to hospital CEO's, Senators and Congressmen, it is up to us!

Buresh and Gordon (2006) so aptly describe the work which is necessary to our success and voicing our silence as we work to improving the image of nursing and sharing with the world our professionalism and importance: "This will be hard work indeed. It means fighting against deeply rooted stereotypes ... visibility is not an option, it's an obligation ... if we fail to make our work visible, we are betraying our mission, our patients present and future, and society itself" (p. 275). Are you 'just a nurse', no YOU are something MORE, do not diminish what you do, who you are and what this profession means to the world.

(See Appendix A)

Ask Not What Nursing Can Do for YOU; ask what YOU can do for the Profession of Nursing Nurses have a lot of power

Appendix A

Just a Nurse

By Suzanne Gordon

I'm just a nurse. I just make the difference between life and death.

I'm just a nurse. I just have the educated eyes that prevent medical errors, injuries and other catastrophes.

I'm just a nurse. I just make the difference between pain and comfort.

I'm just a nurse. I'm just a nurse researcher who helps nurses and doctors give better, safer, and more effective care.

I'm just a nurse. I'm just a professor of nursing who educates future generations of nurses.

I'm just a nurse. I just work in a major teaching hospital managing and monitoring patients who are involved in cutting-edge experimental research.

I'm just a nurse. I just educate patients and families about how to maintain their health.

I'm just a nurse. I'm just a geriatric nurse practitioner who makes a difference between an elderly person staying in his own home or going to a nursing home.

I'm just a nurse. I just make the difference between dying in agony and dying in comfort and with dignity.

I'm just a nurse. I'm just the real bottom-line in health care.

Wouldn't you like to be just a nurse, too?


Artz, M. (2006). Ask not what nursing can do for you ... Nurses have a lot of power. American Journal of Nursing 106 (9), 91-92.

Beck, A. H. (2004). The Flexner report and the standardization of American medical education. JAMA 291, 2139-2140. Retrieved September 26, 2006 from

Bixler, G.K. & Bixler, R.W. (1959). The professional status of nursing, Am J Nurs 59(8):1 142-147, 1959. Brown EL: Nursing for the future, New York, 1948, Russell Sage.

Buresh, S. & Gordon, S. (2000). From silence to voice. (2nd ed.). Ottawa, Canada: Canadian Nurses Association Press.

Flexner, A. (1910). Medical education in the United States and Canada. New York, NY: Carnegie Foundation for the Advancement of Teaching.

Hallmarks of the professional nursing practice environment (2002). American Association of Colleges of Nursing. Retrieved September 2, 2006, from
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Author:Bonaldi-Moore, Lorraine
Publication:Nevada RNformation
Article Type:Essay
Geographic Code:1USA
Date:Feb 1, 2009
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