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Professional Role Development of a Nurse

Brenda Del Fierro

College of Nursing, University of Houston

NURS 3310: Professional Role Development and Practice Issues Undergraduate

Professor McManaman-Bridges

November 16, 2020

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Professional Role Development of a Nurse

Nursing has been the most trusted profession every year since 1999 except for 2001

(Masters, 2017). The baccalaureate nurse holds many different roles that affect patients, families,

communities, and populations. The BSN is prepared to know what to do in many different

situations, through education in which they learn different theories and many other things that

help guide their everyday work. The roles of the baccalaureate nurse can be split into four roles:

member of the profession, provider of patient centered care, patient safety advocate, and member

of the health care team (Texas Board of Nursing, 2011).

Member of Profession

A profession is defined as an occupational group who becomes responsible for itself and

its members, has a license, and a code of ethics (Masters, 2017). As a member of a profession,

the baccalaureate prepared nurse constantly seeks for continued competence and develops insight

through reflection, self-analysis, self-care, and lifelong learning that allows him/her to be a

member of the nursing profession (Texas Board of Nursing, 2011). The baccalaureate nurse not

only seeks for more educational opportunities, but seeks for constant involvement whether it is

through a professional organization, community involvement, or political involvement.

The professional BSN nurse is one that seeks to constantly better themselves to be able to

provide the best care. There are many professional organizations at the national, state, and

international level the nurse can join. An example of an organization would be the American

Nurses Association (ANA). These organizations can also vary according to specialties such as

the Society of Pediatric Nurses, Academy of Neonatal Nursing, and or Association of Women’s

Health, Obstetrics, and Neonatal Nurses. By joining a professional organization, the professional

nurse is constantly involved and can receive continued education from selected organization. As
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a member of an organization the professional nurse is able to meet the Texas Board of Nursing’s

criteria for being a member of a profession (BON, 2011). Self-reflection and self-evaluation is

also the duty of the professional nurse. According to Masters (2017), the nurse will engage in

self-reflection and evaluation to identify areas for professional growth and will ensure that

nursing practice is consistent with regulatory requirements. According to a longitudinal study,

nursing competence is significantly positively related to self-reflection and insight and

negatively related to practice stress (Pai, 2015). This study places an emphasis on the importance

of self-reflection to the baccalaureate nurse. The Texas Board of Nursing (2011), states that a

baccalaureate prepared nurse is a member of the profession when he/she develops insight

through reflection and is committed to lifelong learning. Professional organizations are a very

important part of the professional nurse because they provide opportunities for lifelong learning

and involvement.

The difference between an ADN, a baccalaureate nurse, and vocational nursing has to do

with the extent in which they are involved and the responsibilities they carry. The baccalaureate

nurse constantly looks for continuing education opportunities while the ADN and vocational

nursing obtain the minimum amount of CE’s to keep their license. The baccalaureate nurse seeks

for lifelong learning opportunities to facilitate continuing competence through certifications or

graduate education (BON, 2011). The baccalaureate nurse is also responsible for doing what the

professional organization he/she is in says in order to uphold the organization.

Provider of Patient Centered Care

Patient centered care involves the coordination of continuous care, listening,

communicating, and educating patients and caregivers regarding the health, wellness, and disease

prevention and management (AACN, 2008). The baccalaureate prepared nurse is able to utilize
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her knowledge and provide patient centered care. Patient centered care focuses on respect for the

patient’s values, preferences, and expressed needs such as: coordination of care, education,

emotional support, and involvement of family and friends (Masters, 2017). The nurse can fulfill

her role by implementing teaching plans for patients and families with common health problems

and well-defined learning needs (Texas Board of Nursing, 2011).

In order for the baccalaureate nurse to be able to provide effective patient centered care,

she must be able to develop the partnership between the nurse and patient (AACN, 2008). The

professional nurse is responsible for being able to identify the different learning theories and best

practices for evaluating methods of learning and teaching (Texas Board of Nursing, 2011). An

example of this would be when the nurse educates the patient, family, community, or population

about the prevention of hypertension. The nurse would educate the patient/family/community on

what their diet should consist of as well as the implementation of exercise in their lives. The

BSN is responsible for promoting health as well as preventing illness by teaching. Even after

acquired a disease there is plenty of room for the nurse to educate the clients.

The baccalaureate nurse differs greatly from the vocational nurse. The vocational nurse is

responsible for implementing the teaching plan to patients and their families. On the other hand,

the BSN must develop, implement, and evaluate not only for patients and families, but also

populations and communities. Maintenance, restoration, and population risk reduction also fall

within the scope of the professional baccalaureate nurse (Texas Board of Nursing, 2011).

Patient Safety Advocate

The professional nurse is prepared to utilize his/her knowledge and be a patient safety

advocate. It is the nurse’s duty to look after patients/families/populations/communities and play

the important role of being an advocate. One way the BSN serves as an advocate is to comply
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with the mandatory reporting requirements of the Texas Nursing Practice Act (Texas Board of

Nursing, 2011). To be advocates of high quality patient care for all patients, the professional

nurse demonstrates knowledge and is active in the policy processes defining healthcare delivery

and systems of care (AACN, 2008). The professional nurse also requires the development of an

appropriate set of values and ethical framework which aids in the delivery of acting as an

advocate. The values important to the professional nurse consist of altruism, autonomy, human

dignity, integrity, and social justice (Masters, 2017).

To be able to fulfill the role of an advocate, the professional nurse must act ethically.

Ethics is a crucial part of the nursing practice and involves respect and advocacy for the rights

and needs of patients regardless of the setting (AACN, 2008). As mentioned before, the BSN

must report according to the Texas Nursing Practice Act. This act requires that the nurse reports

to the board if there is any suspicion that another nurse has engaged in conduct subject to

reporting or if the ability of a nursing student to perform services would be impaired by chemical

dependency. The prepared baccalaureate nurse also holds the responsibility to report abuse of

neglect of a child.

The LVN or RN promotes safety in patient and family environment by following their

scope of practice and reporting, but the BSN advocates for the patient, families, populations, and

communities (Texas Board of Nursing, 2011). The Baccalaureate nurse also carries the

responsibility to interpret and guide others toward safe and legal practice, use her knowledge to

identify systems issues that impact the nursing practice. The professional nurse also participates

in committees that promote safety. At the lower lever, the vocational nurse implements safety

and risk management and the ADN can participate in committees (Texas Board of Nursing,

2011).
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Member of Health Care Team

The baccalaureate degree nurse is a member of the health care team who is prepared to

utilize her leadership skills while providing care for not only individuals, but also populations

and communities. According to the Texas Board of Nursing (2011), in order for the BSN to be a

part of the health care team, he/she must be able to assign or delegate the nursing care to other

members of the health care team based upon analysis of the patient. The AACN (2008) defines

delegation as the process for the nurse to direct another person to perform nursing tasks or

activities. Delegation is not only done through direct communication (verbal instructions), but it

can also be indirect (tasks verified by hospital policy) (Masters, 2017). The BSN must be able to

delegate by following the Texas Board of Nursing’s rules and regulations. Failure to do this can

result into taking disciplinary actions against the nurse’s licensure.

The licensed nurse is held accountable for outcomes of both her own and delegated care.

This makes it crucial for the nurse to be able to delegate following the rules and regulations. The

baccalaureate nurse must delegate by following the “five rights of delegation” provided by the

American Nurses Association. These five rights include: right task, right person, right

direction/communication, right supervision/evaluation. However, there are also tasks that

prohibit delegation. One cannot delegate if it is not within their scope of practice, if there are no

regulations that support delegation, if the nurse delegating is not competent, or if the task is not

consistent with criteria for delegation (ANA, 2012).

The BSN differs from vocational, diploma, and associate nursing in that the baccalaureate

nurse uses leadership skills to promote team building and team work (Texas Board of Nursing,

2011). It is stated by the ANA that leadership and communication skills are needed for the nurse

to be able to delegate. Leadership is what makes a baccalaureate nurse. The BSN must be able
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manage activities to develop competency levels of team members as opposed to the vocational

and ADN who are only responsible for planning and providing feedback to team members

(Texas Board of Nursing, 2011). Also, another key difference would be that vocational and

ADN’s focus on individual care while the baccalaureate nurse does that and also populations and

communities. A study conducted in 2019, examined the perceptions of their own roles (BSN,

ADN, or LVN) and what they thought of each other. According to Kusi (2019), the BSN/RN’s

perception of their role included: patient assessment, high quality and safe care, personal and

emotional care, and coordinating the delivery of care, ADN’s saw their role as doing clerical

tasks, working, with RN’s, and providing direct care. According to the study, vocational nurses

saw their role as responding to patients’ immediate needs and liaising with nurses (Kusi, 2019).

This further proves that the baccalaureate prepared nurse takes a leadership role by coordinating

the delivery of care while the ADN or vocational nurse perform tasks and are attentive to the

patients’ needs.

Plan

As a graduate nurse, one will be prepared to practice within the scope of the

baccalaureate nurse and be familiar with the policies of the employer. The Texas Board of

Nursing as well as the American Association of Colleges of Nursing provide a framework for the

baccalaureate graduate nurse that serves as a guide. According to the American Association of

Colleges of Nursing (2008), the baccalaureate nurse must be a provider of care,

designer/manager/coordinator of care, and member of the profession. The graduate nurse should

familiarize herself with her employers’ policies within the first year to be able to carry out her

job and know what to do during certain situations. Also, following the Code of Ethics is also

important.
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Conclusion

The baccalaureate nurse carries many different roles that can be narrowed down into 4

main roles (Texas Board of Nursing, 2011). These roles give the nurse the ability to promote

safety and quality patient care, care for diverse populations, and use clinical/critical reasoning to

address complex situations among others. By being a member of a profession, patient safety

advocate, provider of patient centered care and member of the health care team, the professional

nurse can provide excellent care and provide evidence on why nursing is the most trusted

profession. The professional nurse will follow a code of ethics and practice to the full extent of

their training and education.

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References

American Association of Colleges of Nursing. (2008). The essentials of baccalaureate

education of professional nursing p ractice.

https://www.aacnnursing.org/portals/42/publications/baccessentials08.pdf

American Nurses Association. (2012). ANA's principles for delegation. 

https://www.nursingworld.org/~4af4f2/globalassets/docs/ana/ethics/principlesofdelegatio

n.pdf

Kusi‐Appiah, E., Dahlke, S., Stahlke, S., & Hunter, K. F. (2019). Acute care nursing team

members' perceptions of roles: Their own and each other's. Journal of Nursing

Management (John Wiley & Sons, Inc.), 27(8), 1784-1790.

10.1111/jonm.12877

Masters, K. (Ed.). (2017). Role development in professional nursing practice (5th ed.).

Burlington, MA: Jones and Bartlett.

Pai, H. (2015). The effect of a self-reflection and insight program on the nursing competence

of nursing students: A Longitudinal Study. Journal of Professional Nursing, 31(5), 424-

431. https://doi-org.ezproxy.lib.uh.edu/10.1016/j.profnurs.2015.03.003

Texas Board of Nursing. (2011). Differentiated Essential Competencies of Graduates of Texas

Nursing Programs.

https://www.bon.texas.gov/pdfs/differentiated_essential_competencies-2010.pdf