Pillars of Professionalism

As a faculty member and an ABSN program director, I continue to attempt to develop professionalism in our future nurses.  I always speak to my students about professionalism and accountability.  I tell them that part of professionalism is accountability.  I explain that this accountability is not just accountability to the decisions they make, but also accountability to the outcomes of those decisions as well.  As a future, professional nurse, students need to understand how to be accountable for their choices and actions.

While in my doctoral program, I decided to create a model of professionalism.  I called it the Pillars of Professionalism.  I have recently copyrighted this model and am beginning to disseminate my idea as an innovative strategy with which to use with students.

The Institute of Medicine (IOM) (Finkelman & Kenner, 2012) report and the American Association of Colleges of Nursing (AACN) Essentials of Baccalaureate Education (2008) influenced my ideas for the pillars.  The purpose of the pillars, both literally and metaphorically, is to strengthen professionalism in the nursing profession. 

The pillars of professionalism denote core values while erecting a base to support the pillars.  The bases of the pillars include leadership and social responsibility.  The bases represent the building blocks to support the ten pillars of professionalism.  The pillars are also meant to denote strength and an ability to exist, and persist, over time.

Crigger and Godfrey (2011) speak about multiphrenia as “the fragmentation and decentering that results primarily from technology being the method that brings large numbers of social contacts and information sources to an individual.”   The Pillars of Professionalism is the model of choice to avoid that fragmentation, especially in a world that is now so technologically focused.  The nursing students of today need to remain centered and focused on developing into professional nurses.

In my model, there are ten pillars of professionalism.  The pillars will each be discussed here. 

1. Altruism is "a concern for the welfare and well-being of others."  This concern and advocacy includes not only patients, but also other nurses and health care providers (AACN, 2008).  Under altruism, the students need to understand that they need to be concerned with the welfare of others including their patients.  However, this pillar of altruism includes concern for the fellow nurses and health care providers working alongside them. I also view altruism, as a concept, where the students really learn to advocate for their patients needs and issues.  I feel this comprises a large part of their duties as a professional nurse.

2. Autonomy, as defined by the AACN, is the right to self-determination.  Also, this pillar includes the nurses respecting the patients’ rights to make decisions about their healthcare (AACN, 2008).  Here, the nursing students showing respect for their patients’ decisions about their healthcare treatment leads to the actualization of a high-level of responsibility.  I view autonomy as being related to teaching the students how to be autonomous in their decisions as nurses. Therefore, this pillar results in good decision-making on the part of the nursing student.  This trait is evaluated as evidenced by critical thinking skills and clinical judgment in the clinical settings by student nurses.

3. Communication, as a pillar of professionalism, needs to be taught to the students by example. The example of good communication will be evident through interactions that the students witness between faculty and staff, faculty and administration, and faculty and students. Essential avenues of communication include verbal means, written means, and nonverbal communication, in both the clinical arena and in the classroom.

4. Empowerment.  I do not view empowerment just as patient empowerment.  Rather, I see student empowerment as encompassing acting prudently in the clinical areas, as well as, the ability to make good choices as students and then as future professionals.  The students are held accountable for their decisions according to the school’s policies, procedures and student handbook.  Empowerment is not another word for allowing bad behavior by the students.  Rather, it is a positive activity to be reinforced when appropriate by faculty, staff, and administration.

5. Human dignity is “a respect for the inherent worth and uniqueness of individuals”.   It represents nurse values and respect for all patients and colleagues (AACN, 2008).  The students need to be taught to understand the power of human dignity.  They need to understand that patients are individuals and that nurses need to demonstrate respect for all individuals regardless of their individual differences. The students also learn dignity through examples set forth by the faculty, staff and administration in their interactions not just with one another but with students too.

6. Knowledge is defined as a specialized body of knowledge research and utilization of evidence-based practice. A profession is learned through education (Joel, 2002).  Knowledge, as a pillar, is important because it denotes not just the knowledge related to patient care but also being able to use that specialized knowledge or evidence-based practice in clinical care. The students need to understand that the profession of nursing has been learned through the educational process (Joel, 2002).  Without knowledge, the students will be powerless in providing patient centered care for their patients. As Claire Fagin said (9/16/2013), "I see nursing as the application of science in an artistic way." I want my students to have that solid knowledge base in which to apply nursing artistically to their patient care.

7. Integrity is acting in accordance with the appropriate code of ethics and accepted standards of practice (AACN, 2008).  In nursing, integrity is evident through the code of ethics, as well as, acceptable standards of practice as set forth by professional nursing organizations.  The students, faculty, staff, and administration need to execute integrity as a pillar of professionalism at all times. Anytime there is a breach in integrity, there is the potential for future negative fallout from the experience. Students need to recognize that integrity, as a pillar of professionalism, is paramount to the profession of nursing.

8. Morality, as a pillar of professionalism, also needs to be reinforced with students. We, as educators, need to ensure that good conduct is executed on the part of the students, faculty, and staff.

9. Social justice is acting in accordance with the treatment of patients regardless of their economic status, race, ethnicity, age, citizenship, disability, or sexual orientation (AACN, 2008).  Students need to understand the importance of not treating people differently based upon race, religion, sexual orientation, or any other component of social justice.  Patients deserve unconditional, unbiased care.  This is a concept that needs to be communicated to students.  For nurses to be leaders, with regard to embracing social responsibility, the students must acknowledge the role of this pillar within the profession (Tyer-Viola et al, 2009).

10. Virtue is defined as “the qualities or characteristics developed by individuals when acted on in a balanced way, that are morally praiseworthy, and reinforce acting in the same way in the future” (Crigger and Godfrey, 2011).  Virtue can be viewed as two states of character (Crigger and Godfrey, 2011).  Virtue, as a state of character, was first defined by Crigger and Godfrey, as ‘makes one good’.  Second, virtue, as a state of character, makes a person perform well in their own work (Crigger and Godfrey, 2011).  The students need to understand the importance of virtue and how it plays into patient care. This virtuous care will not only benefit their patients but their personhood as well.

As always, I appreciate any feedback or comments.  I hope you find this model useful in the education of future nurses.

Here is my model: The Pillars of Professionalism

                                           copyrighted by Mary Ann McLaughlin, 2017   

References

American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice. Washington, DC.

Crigger, N. & Godfrey, N. (2011). The Making of Nurse Professionals. Jones & Bartlett: Sudbury, MA. 

Finkelman, A. & Kenner, C. (2012). Teaching IOM: Implications of the Institute of   Medicine Reports for Nursing Education (3^rd ed.). Nursebooks.org.

Joel, L. A. (2002). Education for entry into nursing practice: Revisited for the 21^st century. The Online Journal of Issues in Nursing, 7(2). Available at http://www.nursingworld.org/ojin/topic18/tpc18_4.htm.

Tyer-Viola, L., Nicholas, P.K., Corless, I. B., Barry, D. M., Hoyt, P., Fitzpatrick, J. J. & Davis, S. M. (2009). Social Responsibility of Nursing: A Global Perspective.

Policy, Politics, & Nursing Practice. http://www.sagepublications.com.

http://www.tc.columbia.edu/admin/125/moments.asp?id=8999 Mini Moments with Big Thinkers, Claire Fagin MA ’51, September 16, 2013.