The Development of Profession

Joseph T. Catalano
Chapter 1
 Approaches to define a profession
◦ Position: a group of tasks assigned to one individual
◦ Job: a group of positions that are similar in type and
level of skill that can be carried by one or more
individuals
◦ Occupation: a group of jobs that are similar in type of
work and are found throughout an industry
 Profession: a type of occupation that meet
certain criteria that raise it to the level above
that of an occupation

 Professional: a person who belongs to and

practices a profession

 Professionalism: the demonstration of high

level personal, ethical and skill characteristic
of a member of a profession
 ‫ وبخالف الوظيفة‬.‫مهنة هي عبارة عن عمل أو صنعة يقوم بها الشخص لفترة طويلة من الزمن‬
‫ المهنة هي‬.‫تتطور معك وتنمو خالل فترة زمنية طويلة‬
ّ ‫التي قد تكون سريعة الزوال؛ فإن المهنة‬
‫ كما تمتاز المهنة بإمكانية‬.‫ وتتطلب منك التخطيط ووضع األهداف‬،‫عمل تقوم به بكل شغف وحب‬
.‫التقدم بشكل تصاعدي منظم‬
1. Process approach
◦ Process approach: the process approach views all
occupations as points of development into a
profession along a continuum ranging from position
to profession

position
Profession
 Occupations such as medicine and law are
widely accepted by public as being closest to
the professional end of the continuum, other
occupations are less clearly defied
 The major difficulty of this approach is that it
lacks criteria on which to base judgment
 Final determination of the status of the
profession depends on public perception of
the activities of that occupation
 Nursing always had poor public image when it
comes to being viewed as a profession

2. Power approach
It had criteria to define a profession
◦ How much “power” does the group have?
◦ How independent is the group?
◦ How did the group get its independence?
 Money and political influence become
critical
 It refers to political power and the amount of
money that the person in that occupation
earns
 Using this model, occupations like medicine,
law, and politics are considered professions.

 The members of these occupations earn high

incomes, practice their skills with a wide range
of independence, and exhibit power over
individuals and on the public.
➢ Nursing with its relatively lower salaries, low
membership in professional organizations
and perceived lack of political power would
clearly not meet the power criteria for the
profession
3. Trait approach
◦ Looks at “traits” criteria or characteristics that are
found in true professions
◦ If the group meets the criteria, then it is considered
a profession
◦ Most common way of defining a profession
1. High intellectual level

2. High level of individual responsibility and

accountability

3. Specialized body of knowledge

4. Knowledge that can be learned in

institution of higher education
5. Public service and altruistic activities

6. Public service valued over financial gain

7. Relatively high degree of autonomy and

independence of practice

8. Need for well organized and strong

organization representing the member of the
profession and controlling the quality of
practice
9. A code of ethics that guides the members of
the profession in their practice

10. Strong professional identity and

commitment to the development of the
profession

11. Demonstration of professional competency

and profession of a legally recognized
license
1. High intellectual level
2. High level of individual responsibility and accountability
3. Specialized body of knowledge
4. Knowledge that can be learned in institution of higher education
5. Public service and altruistic activities
6. Public service valued over financial gain
7. Relatively high degree of autonomy and independence of
practice
8. Need for well-organized and strong organization representing
the member of the profession and controlling the quality of
practice
9. A code of ethics that guides the members of the profession in
their practice
10. Strong professional identity and commitment to the
development of the profession
11. Demonstration of professional competency and profession of a
legally recognized license
DOES NURSING MEET ALL THESE CRITERIA?

The profession of nursing meets most of the

criteria but falls short in a few areas
1) High intellectual level of functioning

❖ As health care has advanced and made a great

strides in technology, and all branches of the
physical sciences, a high level of intellectual
functioning is required for even relatively simple
nursing tasks such as taking client’s blood pressure
using automated equipment
❖ Nursinguse assessment skills and knowledge,
have the ability to reason, and make
judgments based on client's condition
2- High level of individual responsibility and
accountability
❖ nurses are often the primary and frequently the
only defendant named when errors are made that
result in injury to the client

❖ the concept of accountability has legal, ethical

and professional implications that include
accepting responsibility for actions taken to
provide client care as well as accepting
responsibility for consequences of actions that
are not performed
Nurses can no longer state that “the physician 
told me to do it” as a method of avoiding
responsibility for their actions.
 3- specialized body of knowledge:
 As nursing developed into identifiable,
separate discipline, a specialized body of
knowledge called nursing science was
complied through research efforts of nurses
with advanced educational degrees and it
forms theoretical and philosophical basis for
the practice of nursing today
❑ Evidence based practice (EBP): Is the practice
of nursing in which interventions are based
on data from research that demonstrate that
they are appropriate and successful
 It involves systematic process of uncovering,
evaluating and using information from
research as the bases for deciding about and
providing client care
 Nursing education today requires nurses to
perform web based search for papers and
projects to practice access to most up to date
evidence
 4- Public service and altruistic activities: the
goal of nursing is helping clients adapt to
illness and achieve their highest level of
functioning

 The public referred to as consumers,

patients, clients, individuals, or humans
 Nursing is viewed universally as altruistic
profession composed of selfless individuals
who place the lives and well being of their
clients above their personal safety

 Nurses are found in remote and hostile areas

providing care for the sick and dying, working
12-hours shift, being on call, and working
rotating shift
5- Well organized and strong representation:
Professional organization represent the
member of the profession and control the
quality of professional practice

National league of Nursing (NLN) and the

American Nurses Associations (ANA) are the
tow major national organizations that
represent nursing in today's health care system
 The NLN is responsible for regulating the
quality of educational programs that prepare
nurses for the practice of nursing

 The ANA is more concerned with the quality

of nursing practice in the daily health care
setting
6- Nurses’ code of ethics:
Nursing has several code of ethics that are
used to guide nursing practice

ANA code of ethics for nursing is the most

widely used in the USA
7- Competency and professional license:
Nurses must pass a national licensure
examination to demonstrate that they are
qualified to practice nursing
 8- Autonomy and independence of practice:
Unfortunately, despite efforts to expand
nursing practice into more independent areas
through up date nursing practice legislations,
nursing retains much of its subservient image.

Nurses must work in all health care setting

closely with physicians hospital administrators,
pharmacists and other groups in the provision
of care.
-To be considered a true profession, nursing
will need to be recognized by other disciplines
as having practitioners who practice nursing
independently.

- Nurses in advanced practice roles, such as

nurse practitioners, can and do establish their
own independent practice.
 9- Professional identity and development:
the issue of job versus career is in question
here
There is little commitment to a job, individuals
move from one job to another with little regard
to the long- term outcomes.

A career is usually viewed as a person's major

lifework, which progress and develops as the
person grows older.
 It’s pretty close but still lacking in a few areas
 Main area is education
 It will be hard to claim that nursing is a full
profession until the entry level is a BS degree
 Public still does not see nursing as a
profession
 Career and profession have many of same
characteristics including a formal education, full
time employment, requirement for lifelong
learning, and a dedication to what is being
achieved.

 Many still treat nursing more as a job

 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.
 What is it? Is the capacity to exert
influence over another person or group
of persons
◦ The ability to get other people to do
things even they may or may not want
to do
 Power is two-way street
 When power is exerted by one person,
another person is affected

 Empowerment: is increasing the amount of

power that an individual or group is either
given or gains
 Where does power come from? Six primary
sources for power or types of power:
1. Referent
2. Expert
3. Reward
4. Coercion
5. Legitimate
6. Collective
 Referent power: it depends on establishing
and maintaining a close personal relationship
with someone.

 Nurses often obtain power from this source

when they establish and maintain good
therapeutic relationship with their clients
 Expert power: it derived from the amount of
knowledge, skills or expertise that an
individual or group has

 Nurses in advanced nursing role are good

example
 Power of rewards: this depend on the ability
of one person to grant another some type of
reward for specific behaviors or changing in
behavior

 The rewards may include personnel favors,

promotions, money, eradication of
punishment
 Coercive power: is the flip side of the reward
power

 The ability to punish, withhold rewards, and

threaten punishment is the key element
underlying the coercive source of power

 In nursing this type consider illegal or

unethical
 Legitimate power: this depend on the
legislative or legal act that give the individual
or the organization a right to make decisions
that they may not otherwise have the
authority to make

Political figures and legislators have this source

of power
 Collective power: when a large group of
individuals who have similar beliefs, desired
or needs become organized

 The professional organization is the focal

point for this source of power
 The main goal of any organization is to
influence policies that affect the members of
the organization
 This influence is usually carried by politicians
and lobbyists
 1- Professional unity:
 Probably the first and most important

 The most powerful groups are those that are

best organized and most united
2- Political Activity:
- Nurses can gain power when involved in
political actions
- Nurses should realize that they are affected
by politics and political decisions in their
practice
- nurses need to involve in political activities
from local or national level
3. Accountability and professionalism by:
 establishing standards for high-quality of
nursing care
 Demonstrating and delivering high- quality
client care
 3- Networking:
 Nurses can gain power by establishing a
nurse support network
◦ Like the ”old-boy” system used in most
organizations
◦ Nurture and teach upcoming nurses to take over
the positions at the top
◦ Don’t criticize each other in public
◦ Don’t eat your young
 NHS study: 44% of nursing workforce reported being bullied,
26.6% of nurses face hostile actions in the workplace once or
more a week.
 A Norwegian study: 20% of nurses were exposed to bullying
behaviors and that these behaviors were frequently inflicted
by nurses, assistant nurses and head nurses in their own
department.
 Previous studies have determined that the most common type
of violence that healthcare personnel face is verbal violence,
followed by bullying/mobbing.
 These behaviors frequently include shouting, reprimanding
and belittling in front of patients and/or other employees in
the ward by people in high‐level positions.
 Regardless of educational level and position, every nurse can
face workplace bullying behaviors. However, young nurses
faced more types of negative behaviors.
 Because of excessive workload and time pressure, nurses
cannot finish their duties in a timely manner, often resulting
in nurse managers treating other nurses, especially the
younger nurses.
 depression experienced by the nurses had a significant effect
(33%) on being exposed to psychologically violent behaviors.
This also shows that nurses who are exposed to workplace
bullying experience symptoms of depression.