Professional Adjustment as a Nurse

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Adjustment

• an educational process referring to changes in  behavior towards better life, better relationships and better contribution to society

Profession

• a calling by which members profess to have acquired special knowledge by training, by experience or both so that they may guide or advice or serve others in that field
• an occupation usually involving relatively long and specialized preparation on the level of higher education and governed by its own code of ethics

Professional Adjustment

• the growth of the whole individual and development of all his/her capacities, physical, mental, social and spiritual towards efficient and effective performance of his/her profession

NURSING AS A PROFESSION

• Education
• with a well-defined knowledge and expertise
• a profession requires an extended education of its member, as well as basic liberal foundation
• Code of Ethics
• required integrity of its members, that is, a member is expected to do what is considered right regardless of the personal cost
• means to monitor professional behavior
• Mastery of the Craft
• depth of knowledge and skills that others without similar education
• expected to make independent decisions using this body of knowledge
• Theory - a profession has a theoretical body of knowledge leading to defined skills, abilities and norms
• Professional Organization
• need to be aware of the issues confronting nursing and the trends in nursing practice
• Accountability
• nurses participates in making decisions and learns to live with these decisions
• responsibility
• Service
• a profession that provides basic service
• Autonomy
• members of a profession have autonomy in decision making and in practice
• Caring
• The most unique characteristic of nursing as a profession is that, it is a caring profession

I. Fundamentals of Nursing Practice

1. Ethics - system of moral principles or moral standards governing conduct; a system of rule of practice applied to a single class of human action (e.g. legal ethics, medical ethics, nursing ethics); a standard to examine and understand moral life
2. Professional Ethics - a branch of moral science concerned with the obligations that member of the profession owes to the public
3. Health Ethics - division of ethics that relates to human health
4. Bioethics - a specific domain of ethics that focuses on moral issues in the field of health care
5. Nursing Ethics - system of principles governing the conduct of nurses; her relationship to the patient, patient's family, fellow nurses and society. Reinforces the nurse's ideals and motives in order to maximize the effectivity of their service. Johnston defines nursing ethics as the "examination of all ethical and bioethical issues from the prospective of nursing theory and nursing ethics"

II. Difference between Ethics and Moral

1. Ethics - moral conduct of the principles underlying the desirable types of human conduct. It is a science of ideals which guides our judgment concerning morality of human acts. Whereas;
2. Moral - refers  to the human conduct of ethics; the application of ethics

• Ethicist Joseph Fletcher differentiates morality from ethics. He states that morality is what you believe is right and good while ethics is the critical reflection about morality and rational analysis about it

III. Importance of Ethics

1. Ethics makes clear why one act is better than another
2. Ethics keep an elderly social life by having agreements, understanding, principles or rules of procedures
3. Moral conduct and ethical system must be intelligently and appraised and criticized
4. Ethics seeks to point out to men the true value of life and attempts to stimulate the moral sense, discover true values of life and inspire men to gain in for quest for these values
5. Ethics is a requirement for human life. It is our means of deciding a course of action. Without it, our actions would be random and aimless. There would be no way to work towards a goal because there would be no way to pick between a limitless number of goals. Even with an ethical standard, we may be unable to pursue our goals with the possibility of success. To the degree which a rational ethical standard is taken, we are able to correctly organize our goals and actions to accomplish our most important values. Any flaw in our ethics will reduce our ability to be successful in our endeavors. (Jeff Landauer and Joseph Rowlands, 2001)

IV. Importance of the Code of Ethics for Nurses

• the four elements of the Code of Ethics for Nurses: nurses and people, nurses and practice, nurses and coworkers, nurses, society and environment and, nurses and the profession give a framework for the standards of conduct. Nurses and nursing students can therefore,

1. Study the standards under each element of the Code
2. Reflect on what each standard means to you. Think about how you can apply ethics in your nursing domain: practice, education, research or management
3. Discuss the Code with coworkers and others
4. Use a specific example from experience to identify ethical dilemmas and standards of conduct as outlined in the Code. Identify how you would resolve the dilemmas
5. Work in groups to clarify ethical decision making and reach a consensus on standards of ethical conduct
6. Collaborate with your national nurses' association, coworkers and others in the continuous application of ethical standards in nursing practice, education, management and research

• Excerpts from ICN - International Council of Nurses, 3, place Jean-Marteau, 1201 Geneva, Switzerland

V. Concept of Nursing

• aspect of moral philosophy which serves as guide in one's judgment or appraisal of the goodness or badness of acts relative to the practice of nursing
• Guiding principles:

1. Nursing practice is predicated on the ideals of service
2. Premised or personal sacrifices and devotion to duty for the benefit of the people
3. As a practitioner, her primary object is to render satisfactory professional service
4. A profound devotion to her professional duties and genuine concern in the advancement of her profession for the promotion of public health and public welfare
5. Primary responsibility is to help in the promotion of health and conversation of human lives commensurate with her knowledge, training, and experience, serve and care with utmost solicitude and giving him always the best of her talent and skill
6. Assumes IPSO-FACTO - the obligation to uphold the noble traditions of the profession
7. As a citizen, a nurse is bound to fulfill her civic duties to abide by the laws, to sufficient knowledge of nursing and medical laws and to cooperate with the state promotion of public health and welfare
8. As a professional practitioner, the nurse should safeguard the reputation and dignity of her co-workers

VI. Responsibilities to the Patient

1. The primary responsibility of the nurse to the patient is to give him/her the kind of care his/her condition needs regardless of his/her race, creed, color, nationality or status. In doing so, the patient's care shall be based on needs, the physician's orders, and the ailment; and shall involve the patient and/or his/her family so that he/she or any of the family can participate in his/her case
2. The nurse can plan with the patient and family a specific nursing care of the patient according to his or family's needs and requirements
3. The nurse should promote learning for the patient
4. When giving care she should not forget that patient and human beings not just bodies afflicted with illness (treatment of person not symptom)
5. A nurse is expected to show more commission to the patient than the physician
6. Her primary consideration in assuming care is a concern for the patient's welfare and safety
7. A nurse is responsible to give facts or information to the patient and his family which they entitled to know
8. A nurse guard as a sacred trust any confidential or private information from the patient even after death of the patient except when it is required to show the interest of justice, public health or public safety
9. Nurses are advised to become familiar with the patient's bill of rights and observe its provisions
10. Nurses should commit themselves to the welfare of those entrusted to their care. They should be loyal to their sworn duty

VII. Responsibilities to the Physician

1. It is expected that nurses will not only carry out doctor's orders accurately and conscientiously but help plan and implement patient care as well
2. He/She should call the physician's attention when he makes mistakes before carrying out his prescriptions otherwise he/she may be liable for the consequences
3. Nurses must report patient's condition including results of therapies so that management of care can be properly monitored and modified as necessary
4. Nurses should familiarize themselves with the various routines, methods or idiosyncrasies of physicians, so that smooth relationships can be maintained. In case the patient has a complaint against the physician, this shall be tactfully brought to the latter's attention
5. Any case of illegal, incompetent or unethical practice by any member of the health team shall be brought to the attention of the appropriate authority through channels within the institutional or agency setting
6. Nurses should remember that any medical act relegated to them is illegal because it is specified in the Medical Law that any licensed nurse who does this, even if supervised, can be held for illegal practice of medicine

VIII. Responsibilities to the Public

1. A nurse should cooperate with the proper authorities in the enforcement of sanitary laws and regulations and in the education of the masses on the promotion of individual and community health
2. Takes part in enlightening the public regarding communicable disease (prevention and cure)
3. Must be active in the performance of her duties as a citizen

IX. Responsibilities to Colleagues

1. Nurses are expected to be able to get along smoothly with their colleagues
2. Nurses shall adjust themselves to the organization and know its policies and procedures. They shall establish good working relationships with coworkers
3. It is important that nurses know their place in the total organization so that they may cooperate, coordinate and maximize their work
4. Situations such as when nurses see their colleagues neglect their duties or are incompetent shall be brought to the attention of the immediate supervisor or appropriate authority within the agency setting before any life could be endangered
5. Nurses should observe utmost caution, tact and prudence with respect to the official conduct of his/her superiors or another nurse
6. Should refrain from making unfair and unwarranted criticisms against another nurse or doing anything that would discredit her colleagues
7. Should not interfere with or take over the nursing care of a patient already under the care of another nurse unless in case of emergency

X. Responsibilities to the Profession

1. A nurse should be zealous in her professional growth by keeping abreast with the least trends in nursing science, act and practice (join a bona fide professional organization)
2. Should be upright, diligent, sober, modest and well versed in both science and the act of her profession
3. Should not solicit patient by any means such as through advertisements, solicitors or agents
4. Must refrain from performing any act or any transaction that may be a discredit to herself or to the profession and to bring to the attention of proper authorities any unethical conduct of any registered nurse

XI. Responsibilities to Other Profession

1. She ought to cooperate in safeguarding the reputation and dignity of the members of other profession