Values and Image in Nursing

1. Values and Image in Nursing May 29, 2008

2. Objectives • Examine personal and professional values and their impact on decision making and professional behavior. • Explore the image of contemporary nursing.

3. VALUES Personal beliefs about worth Act as standard to guide behavior

4. What is a Value System? • Framework on which actions are based

5. Value Systems at UNF UNF 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

6. Value Systems at UNF COH 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.

7. Value Systems at UNF SON Mission Statement To 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

8. Value Systems at UNF SON 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

9. Value Systems at UNF SON 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

10. ANA Value System • Standards of Professional Performance • Quality of practice • Education • Professional practice evaluation • Collegiality • Collaboration • Ethics • Research • Resource utilization • Leadership • (how do we do our standards of care)

11. AACN Value System • Altruism • Autonomy • Human Dignity • Integrity • Social Justice (integral to professional nursing practice) AACN Essentials of Baccalaureate Education (see UNF Nursing Student Handbook, p. 40

12. Class Exercise • Altruism • Elizabeth A, Sabrina, Sheila, Ro, Liz • Autonomy • Shannon, Britta, Kara, Ricky, Crystal • Human Dignity • Miranda, Melissa, Heather, Jennifer, Kat • Integrity • Susan, Tiffany, Cynthia, Lauren • Social Justice • Ashley, Dawn, Brittany, Wendy

13. Class Exercise • What 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

14. 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

15. 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

16. Human Dignity: Respect inherent worth and uniqueness of individuals/populations • Provide culturally competent and sensitive care • Protect the patient's privacy • Preserve the confidentiality of patient's and health care providers • Design care with sensitivity to individual patient needs AACN Essentials of Baccalaureate Education

17. 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

18. 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

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

20. IMAGE A representation of a person or thing A type, typical example, symbol, embodiment A mental picture of something, conception, idea, impression

21. And …. Why Are We Concerned?

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

23. External Image Internal Image Two Views of Nursing

24. External Image How 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 Two Views of Nursing

25. External View

26. The External View Sairy Gamp from Charles Dickens, Martin Chuzzlewit (1844)

27. The External View

28. The External View

29. The External View

30. The External View

31. The External View

32. The External View

33. The External View

34. The External View

35. The External View • Nursing, 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.

36. The External View • The image of nursing took another serious blow during the recession and downsizing that began in the 1980s • Graduates 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,

37. The External View • According 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 nurses • 83 percent would encourage a loved one to enter the nursing profession.

38. 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

39. The External View • There 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.

40. 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."

41. The External View • According 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.

42. The External View • According 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

43. External View

44. Internal Image How nurses see themselves as individuals How nurses envision the profession Two Views of Nursing

45. Internal Image • An 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.

46. Internal Image • The 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.

47. Internal Image • A qualitative study investigated nurses’ accounts of their work and found that • Nurses 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.

48. Internal Image

49. Changing the Image of Nurses & Nursing

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