2 Socialization to Professional Nursing Roles
Hallmark Features • A focus on foundational knowledge related to professional nursing • Includes nursing history, nursing theory, ethics, and legal aspects, etc. • An overview of professional nursing roles, issues, and changes in the profession • Discusses nurses as healthcare providers, learners and teachers, and leaders.
Learning Objective 2.1 Discuss professionalism and nursing.
Common Mistakes (cont’d) • writing an unattainable, unrealistic objective • writing objectives unrelated to stated goal • cluttering an objective with unnecessary information • making an objective too general so that the outcome is not clear
Nursing as a Profession • A profession is distinguished from other kinds of occupations by • Requirement of specialized training • Orientation toward service, either to a community or an organization • The standards are determined by its members
Nursing as a Profession • The education involves a complete socialization process • Debates about whether nursing is a profession
Challenges for the Nursing Profession • Level of entry into practice • Multiple levels • Associate degree • Diploma • Baccalaureate degree • Gaps between education and practice • Professional identity: job versus career
Nursing as a Discipline and Profession • History and trends in the education of nursing • Earliest type of education was in hospitals • Emergence of baccalaureate and associate degree programs • Shift from diploma (hospital-based) programs to associate and baccalaureate
Nursing as a Discipline and Profession • ANA 1965 position paper • Proposing master’s degree as minimum education for entry level nurse • Definition of profession, six conceptualizations • A discipline is a branch of knowledge • Disciplines are divided • Academic–research and education
Professional–Component of Clinical Practice • Standards of clinical nursing practice • Reflect values and priorities • Provide direction for professional nursing practice • Provide a framework for evaluation
Define the Professions Accountability • ANA established standards of clinical nursing practice • Six standards of practice known as nursing process • Nine standards of professional performance
Learning Objective 2.2 Describe socialization to professional nursing.
Professional Socialization • Socialization is a learned process • Professional socialization is to internalize a professional identity • Social control is intrinsic • Capacity of a social group to regulate itself through conformity and adherence to group norms • Sanctions are used to enforce norms • Norms become internalized standards
Professional Socialization • Agents of socialization are the people who initiate the socialization process • Children –family, teachers, peers, media • Adults – superiors, subordinates in the workplace, peers, people of other social groups • Nursing students – clients, faculty, health professionals, and professional colleagues • Nursing – preceptors, mentors, staff development on the job
Learning Objective 2.3 Compare socialization models.
Process of Professional Socialization • Models that describe the process of socialization • Simpson • Hinshaw • Davis
Process of Professional Socialization • Simpson Model • Three phases • Proficiency • Attachment • Internalization
Process of Professional Socialization • Hinshaw Model • Three phases • Transition • Attachment • Internalization • Value and standards
Process of Professional Socialization • Davis Model • Six stages • Initial innocence • Labeled recognition of incongruity • “Psyching out” • Role simulation • Provisional internalization • Stable internalization
Process of Professional Socialization • Ongoing professional socialization and resocialization • Process does not terminate with graduation or start of a new job
Process of Professional Socialization • Three models of career stages or development • Kramer’s Postgraduate Resocialization Model • Reality shock • Dalton’s Career Stages Model • Development of competencies derived from experience • Benner’s Stages from Novice to Expert • Implications of teaching and learning
Learning Objective 2.4 Analyze elements of and boundaries for nursing roles.
Role Theory • Role theory emerged from sociology • A role is a set of expectations associated with a position in society
Role Theory • Elements of roles • Ideal • The socially prescribed or agreed-upon rights and responsibilities associated with the role • Perceived • How a person believes he or she should behave in this role • Performed • What the person actually does
Role Theory • Role performance factors include • Health status • Personal and professional values • Needs of clients and support person • Politics of employing agency
Role Theory • Role transition is the process by which a person assumes or develops a new role • Two components associated with role behaviors • Norms • Values
Role Theory • Role transition is influenced by many factors • Individual • Interpersonal • Organizational
Boundaries for Nursing Roles • Five determinants form boundaries for nursing roles • Theoretical and conceptual frameworks • The nursing process • Standards of nursing practice • Nursing practice acts • National and international codes of ethics
Learning Objective 2.5 Discuss ways to manage role stress and strain while enhancing professional identity.
Role Stress and Role Strain • Factors associated with role stress for nurses • Little control in the job • High demands • Few supportive relationships
Role Stress and Role Strain • Role stress may create role strain • Common role stress problems • Role ambiguity • Role conflict • Role incongruity • Role overload or underload • Role over-qualification or under-qualification
Role Stress and Role Strain • Four major causes for role conflict for nurses • Professional bureaucratic work conflict • Different views concerning what nursing is and should be • Discrepancy between the nursing and medical view of what the nurse’s role should be
Role Stress and Role Strain • Strategies for relieving role stress • Priority setting and time management • Rewriting job descriptions for clarity • Integrating multiple roles into a larger whole
Characteristics of a Positive Self-Concept • Characteristics of a person with a positive self-concept • Future orientation • Copes with life’s problems and disappointments • Helps others and accepts help • Can see and value uniqueness in all individuals • Feels emotion but does not allow feelings to affect behavior
Characteristics of a Positive Self-Concept • To develop a positive self-concept • Accept your present self but have a better self in mind • Set attainable goals • Develop expertise
Preventing Burnout • Personal goal setting • Long- and short-term goals • Problem identification • What is causing the stress • Problem-solving strategies • See Table 2–3 • Time management skills • Delegation
Overcoming Procrastination • Caring for one’s self
3 Historical Foundations of Professional Nursing
Learning Objective 3.1 Discuss the historical development of nursing from ancient times to the present.
History of Nursing • Primitive societies • Traditional female roles
History of Nursing • Ancient civilizations • Midwives, wet nurses • Belief about disease imbedded in superstition and magic • Earliest recording of healing practice is a 4,000 year old tablet • Earliest documentation of law governing medicine is Code of Hammurabi dating to 1900 B.C.
History of Nursing • Egyptian culture • Ebers papyrus oldest medical text, approximately from 1550 B.C. • Mummification or embalming • Hebrew culture • Mosiac Health Code • Christian culture • The Bible mentions nurses in Old Testament • Ancient civilizations
History of Nursing • African culture • Midwife, herbalist, wet nurses, caregivers • Indian culture • Male nurses • China • Acupuncture • Herbal remedies
History of Nursing • Greece • Mythology • Hippocrates, father of medicine • Rome • Public sanitation
Learning Objective 3.2 Discuss the role of religion in the development of nursing.
History of Nursing • Role of religion • Benevolence as a Christian value • Parabolani Brotherhood • Knighthoods • Knights Hospitallers of St. John of Jerusalam • Teutonic Knights • Knights of Lazarus • Specialized institutions supported by the church
History of Nursing • Other groups • Military and secular orders • Islamic women • Sisters of Charity • Deaconess groups
Learning Objective 3.3 Discuss the influence of war on the development of nursing.
Development of Modern Nursing • Deaconess Institute at Kaiserwerth, Germany • Recognized the need for services of women in caring for the sick, poor, children, and female prisoners • Developed a training school for nurses at Kaiserwerth • Deaconess movement spread to 4 continents