NURSE AS A

PROFESSION
INTRODUCTION

 Nursing has been called the oldest of the arts and the youngest of the
professions. The term ‘Nurse’ evolve from the Latin word nutrix, which means
to nourish or to cherish. Today nursing emerged as a learned profession, that is
both a science and an art.
 It is a body of knowledge. Knowledge is an awareness or perception of reality,
which is acquired through learning or investigation .
 Science is defined as both a unified body of knowledge concerned with
specific subject matter, the skills and methodology necessary to provide such
knowledge.
DEFINITION OF NURSING
“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(American Nurses Association)
"The unique function of the nurse is to assist the individual, sick or well, in
the performance of those activities contributing to health or its recovery
(or to a peaceful death) that he would perform unaided if he had the
necessary strength, will or knowledge. And to do this in such a way as to
help him gain independence as rapidly as possible”.
--Virginia Henderson( 1977)
BASIC NURSING PRINCIPLES
● Safety
● Therapeutic effectiveness
● Comfort
● Use of resources
● Good workmanship
● Individuality
OBJECTIVES
● Prepare nurses who will give expert bedside nursing care
● Provide integration of health and social aspects theory & practice
● Provide an adequate ,sound scientific foundation to understand the functioning of
body & mind in health & disease
● Prepare to work cooperatively, develop sense of responsibility
● Provide opportunity to develop skills& personality
● Upgrade nursing as a profession
CONCEPT OF NURSING
• The tasks of nursing are:
1) To promote health
2) To prevent disease
3) To help ill-person to healing (to assist healing)
4) To assist the dying patient to pass away with quietude, peace, and dignity.(to ease suffering)
5) The client is a holistic human being, including suffering person and healthy person
6) The working place is not only in the hospital, but also in family, community and whole
society.
7) Nursing is not only a science, but also an art.
8) The nursing science attaches importance to human being’s living environment and the
interrelation between human being and its environment.
9) The nursing science is a gradually perfect and developing science
NURSING AS A PROFESSION
• Nursing as a profession, is a discipline focused on promoting health,
preventing illness, and providing care for individuals of all ages,
families, groups, and communities, whether they are healthy or ill,
and in all settings. It is characterized by its unique blend of science-
based knowledge, technical skills, ethical standards, and therapeutic
relationships. Nursing involves not only direct patient care but also
advocacy, health promotion, research, and participation in shaping
health policy
 CRITERIA OF PROFESSION
● High Intellectual Level Of Functioning: Modern nurses use assessment skill and
knowledge, have the ability to reason and make routine judgment depending on patient’s
condition. Professional nurses' functions at a high intellectual level. Florence nightingale
raised the bar for education and graduates of her school were considered to be highly
educated.
● High Level Of Individual Responsibility And Accountability: Nurses must be accountable
and demonstrate a high level of individual responsibility for the care and services they
provide. The concept of accountability has legal, ethical and professional implications that
include accepting responsibility for action taken to provide client care as well as accepting
responsibility for the consequences of action that are not performed.
● Specialized Body Of Knowledge: Nursing has developed into an identifiable separate
discipline, a specialized body of knowledge called as nursing science. It was compiled
through the research effort of nurses with advanced educational degrees. Although this
body of specialized knowledge is relatively small, it forms a theoretical basis for the practice
of nursing today. As more nurses obtain advanced degrees, conduct research and develop
philosophies, and theories about nursing, this body of knowledge will increase in scope
● Evidence Based Practice: Almost all the currently used nursing theories address this issue
in some way. Evidenced based practice is the practice of nursing in which interventions are
based on data obtained from research that demonstrate that, the findings are appropriate
and successful. It involves a systematic process of uncovering, evaluating and using
information from research as the basis for making decisions about providing client care.
● Public Service and Altruistic Activities: Individual is the focal point of all nursing models
and nursing practice. Nursing has been viewed universally as being an altruistic profession
composed of selfless individuals who place the lives and well being of their clients above
their personal safety. Dedicated nurses provide care for victims of deadly diseases with little
regard for their own welfare.
● Well organized And Strong Representation: Professional organizations represent the
members of the profession and control the quality of professional practice. In India TNAI &
SNA are the two organizations that represent nursing in today’s health care system. Many do
belong to specialty organizations that represent a specific area of practice.
● Code of Ethics: A code of ethics document may outline the mission and values of the
business or organization, how professionals are supposed to approach problems, the ethical
principles based on the organization's core values and the standards to which the
professional is held. Some of the ethical principles are autonomy, justice, non-maleficence .
● Competencies And Professional License: Nurses must pass a national licensure
examination to demonstrate that they are qualified to practice nursing. Only after passing
the examination the nurses are allowed to practice. The granting of a nursing license is a
legal activity conducted by the individual state under the regulations contained in the
state’s nursing practice act.
● Autonomy And Independence Of Practice: In reality nursing is both an independent and
interdependent discipline. Nurses in all health care setting must work with physicians,
hospital administrators, pharmacists and other groups in the provision of care. In some
cases, nurses in advanced practice role eg. Nurse practitioners can do establish their
independent practices. To be considered a true profession, nursing will need to be
recognized by other disciplines as having practitioners who practice nursing independently.
● Professional Identity And Development: Until nurses are fully committed to the
profession of nursing, identify with it as a profession and are dedicated to its future
development, nursing will probably not achieve professional status.
● A basic profession requires an extended education of its members, as well as a basic
liberal foundation. A profession has a theoretical body of knowledge leading to defined
skills, abilities and norms. A profession provides a specific service. Members of a
profession have autonomy in decision-making and practice. The profession has a code of
• Nursing practice, as defined by the American Nurses Association, is a
profession that utilizes the art and science of caring to protect,
promote, and optimize health.
PRACTICE STANDARDS FOR
NURSING
INTRODUCTION
• Standard is a predetermined baseline condition or level of
excellence that comprises a model to be followed and practiced.
• STANDARD OF NURSING CARE
Standard of nursing care define and describe competent level of
nursing care. The levels of care are demonstrated through nursing
process: Assessment, diagnosis, outcome identification, planning,
implementation and evaluation.
PURPOSES OF STANDARDS
The purposes of the standard setting are as follows:
• Standards give direction and provide guidelines for performance of nursing care.
• Standards provide base for evaluating quality of nursing care.
• Standards identify unsafe care and hazards.
• Standards help to improve quality care.
• Standards help to improve documentation of nursing care.
• Standards determine the degree to which standard of nursing care are
maintained.
• Standards also help to guide and supervise nursing staff for quality care
performance.
• Standards assist to take decision in delivery of nursing care.
• Standards help nurses to be accountable for rendered care.
• Standards help to define level of nursing care.
 GENERAL PRINCIPLES OF STANDARDS OF PRACTICE
• Like other professions, the practice of professional nursing has standards of practice. Standards are set for
minimum levels of acceptable performance for which its practitioners are accountable. These standards
provide the patient with a means of measuring the quality of care they receive.
• The authority for the practice of nursing is based on a social contract that acknowledge rights and
responsibilities along with mechanisms for public accountability.
• The professional nurse needs to be familiar with all standards applicable to his/her own practice area.
• Standards and parameters are a source of legal protection for the nurse practitioners.
• Standards typically consist of simple, realistic series of steps that will always apply to certain clinical
scenarios.
• Standards and parameters should outline only the minimum requirements for safe care and need to be
updated as scientific knowledge changes.
• A deviation from the protocol should be documented in the patient's chart with clear, concise statements
of the nurses' decisions, actions and reason(s) for deviation. This is best done at the time the care is
rendered because passage of time may lead to a less than accurate recollection of specific events.
• Informal or volunteer practice may afford the professional nurse. Some legal protection if it can be
documented that the care rendered was the standard of practice within a community or state. Informal
or volunteer care still needs to comply with the applicable standards of care.
SOURCES OF NURSING CARE
STANDARDS
The standards of nursing always based on achievable level of performance and specific
adequate standard. The standards can be established, developed, reviewed or enforced by
variety of sources as follows:
Professional organizations e.g. Nurses associations like Trained Nurses Association of India,
Nursing Research Society of India etc.
Licensing bodies, e.g. Statutory bodies like Indian Nursing Council, State Nurses' Registration
Councils, Medical Council of India and Academic Council bodies of various Universities etc.
Institutions health care agencies e.g. National Institute of Health & Family Welfare (NIHFW),
University's hospitals, health canters etc.
Departments of Institutions: Department of Nursing.
Patient Care Units E.g. Satisfaction feedback of specific units.
Government units at National, State and Local Government units.
Individual e.g. Personal experiences.
CLASSIFICATION OF STANDARDS
Classification
of Standards

According to
According to Result
infrastructur
quality Oriented
e

Normative Structure Ends

Empirical process Means

Outcome
• Normative:
Normative standards describe practices considered "good" or "ideal " by committee or authority.
• Empirical:
Empirical standards describe practices actually observed in a large number of patients.
• Structure:
Structural standards involve facilities available at institutions to provide ideal care.
• Process:
Process standards describe the behaviour or action taken by nurses to perform nursing care to get
desired result.
• Outcome:
Results of action taken in process standards are the outcome standards. This I can also be defined
as result of nursing intervention.
• Ends:
Ends standards are patient oriented; they describe the change as desired in a patient's physical
behaviour.
• Means:
Means standards are nursing oriented; they describe the activities and behaviour designed to
achieve the positive result.
STANDARDS OF CLINICAL NURSING BY AMERICAN NURSES ASSOCIATIONS

• Competent
levels of nursing
care are
RESOURCE PERFORMANCE
UTILIZATION APPRAISAL

described by
the standards of
Clinical Practice. RESEARCH

The levels of
care are
demonstrated E
D

through the
COLLABORATION
U COLLEGIALITY
C
A
nursing process. T
I
O
N
ETHICS
• Performance Appraisal: The nurse evaluates one's own nursing practice in relation to professional
practice standards and relevant statutes and regulations. Engaged in performance appraisal on
regular basis and seeks feedback regarding one's owns practice. Participate in peer review
regularly.
• Education: The nurse acquires and maintains current knowledge and competency in nursing
practice. Participate in on going educational activities related to clinical knowledge and
professional issues.
• Collegiality: The nurse interacts with and contributes to the professional development of peers
and other health care providers as colleagues. Shares knowledge and skills with colleagues and
provides peer with constructive feedback.
• Ethics: The nurses' decisions and actions on behalf of patients are determined in an ethical
manner. Practices are always performed in guidance with the Code of Nurses.
• Collaboration: The nurse collaborates with the patient, family and other health care provides in
providing patient care. Communicates with the patient, significant others and healthcare
provider's regarding patient care and nurse's role in provision of care.
• Research: -The nurse uses research findings in nursing practice, utilizes best available evidence,
preferable research data, to develop the plan of care and interventions. Participants in research
activities as appropriate to the nurse's education and position.
• Resource Utilization: The nurse considers factors related to safety, effectiveness and cost
Introduction
• The Consumer Protection Act is a crucial piece of legislation relevant
to nursing management, as it addresses the rights and responsibilities
of both consumers (patients) and service providers (healthcare
professionals, including nurses).
• The Act aims to ensure that consumers receive quality goods and
services and have access to redressal mechanisms for grievances.
• Nurses must be aware of patient rights, informed consent,
documentation, and the potential for legal repercussions if they fail to
uphold these standards.
Cont.…
• CPA was passed by the parliament in the year 1986.
• This act consider patient as “ consumers” i.e., buyers of the services
and doctor as providers of these services on payment.
• Introduced on 19th December,1986, passed on 21st December in Lok
Sabha, it came into force on 15th August 1987.
CONSUMER FORUM

A DISTRICT FORUM
A STATE FORUM
A NATIONAL FORUM
1. Right to Information:
Patients have the right to receive adequate information about their illness, diagnosis, treatment
options, and potential risks in a way they understand.
2. Right to Records and Reports:
Patients have the right to access their medical records, including case papers, investigation
reports, and indoor patient records.
3. Right to Emergency Medical Care:
Hospitals are obligated to provide emergency medical care to everyone, including those injured,
without demanding prior payment.
4. Right to Informed Consent:
Patients must give their informed consent before undergoing any potentially hazardous treatment
or procedure.
5. Right to Confidentiality, Privacy, and Dignity:
Healthcare providers must respect patient privacy, confidentiality, and dignity.
6. Right to Second Opinion:
Patients have the right to seek a second opinion from another healthcare provider.
7. Right to Transparency in Rates:
Patients have the right to know the costs associated with their treatment.
8. Right to Non-Discrimination:
Patients should not be discriminated against based on their background, gender, religion, or other
factors.
9. Right to Safety and Quality Care:
Patients have the right to receive safe and quality healthcare according to established standards.
10. Right to Choose Alternative Treatment Options:
If available, patients have the right to choose alternative treatment options.
11. Right to Choose Source for Medicines and Tests:
Patients can choose where to obtain their medications and diagnostic tests.
12. Right to Proper Referral and Transfer:
Patients have the right to be referred to appropriate specialists or
transferred to other facilities when necessary.
13. Right to Protection in Clinical Trials:
Patients participating in clinical trials have specific rights and protections.
14. Right to Protection in Biomedical and Health Research:
Patients involved in research have specific rights to ensure their well-being.
15. Right to Discharge and Release of Remains:
Patients have the right to be discharged from the hospital and, in case of
death, for their remains to be released to their family.
16. Right to Patient Education:
Patients have the right to be educated about their health condition and
treatment.
17. Right to be Heard and Seek Redressal:
Patients have the right to voice their concerns and seek solutions for any
grievances they may have.