Section Editor(s): Witt, Catherine L. MS, NNP-BC
The author declares no conflict of interest.
I have often heard nurses use the phrase “I just want to be treated like a professional.” Often it is in conjunction with activities such as punching a time clock or issues like break times or pay scales. Once I heard it around a complaint about mandatory education requirements. Is this what being treated like a professional is about? What do we mean when we say that?
Merriam-Webster defines professionalism as a. of, relating to, or characteristic of a profession; b. engaged in one of the learned professions; c. (1) characterized by or conforming to the technical or ethical standards of a profession (2) exhibiting a courteous, conscientious, and generally businesslike manner in the workplace.1
As nurses, we have standards that have been developed by our professional organization, with input from members. These standards outline what nurses are held accountable for. NANN has recently updated the Scope and Standards of Practice for Neonatal Nurses. The book describes the standards that nurses, and neonatal nurses in particular, are expected to uphold. It also describes how to uphold the standards—what it means in practical terms to meet the standards outlined.
Nursing standards of practice do not just include nursing process—assessing the patient, determining the patient's issues and desired outcomes, and developing, implementing, and evaluating a plan of care. They also include things like ethical practice. They include education, not just nursing school but ongoing, to keep up with current knowledge and changes in practice. They include contributing to quality, to ensuring that care in your unit is the best it can be. They include communication, leadership, and collaboration. This means collaborating not only with other healthcare team members but with the new graduate nurse on your unit, the students who need preceptors, and the person on the other shift you may not like. They include honest evaluation of your professional practice. They include using resources wisely, not just supplies, but your time. They include environmental health as part of nursing practice.2
A professional demonstrates those behaviors as defined by the profession. How many have actually taken the time to read the Neonatal Nurses Scope and Standards of Practice or know what the standards actually are? How many do we actually live up to? The first 6 standards of nursing practice, which have to do mostly with patient care, are perhaps easier. We are used to doing assessments, making a plan of care, identifying desired outcomes, and evaluating the care to see if it worked. The others, the standards of professional performance, are perhaps harder. Not many want to participate in quality improvement committees. Only a few attend professional conferences or read the latest research during their down time. Most of us avoid self-reflection and an honest appraisal of our own practice; and if forced to obtain peer reviews, we try to pick our friends. We sometimes avoid sharing information with the new graduate nurse. We forget the difference between professional, therapeutic relationships, and friendships, not only with our patients but sometimes with our coworkers. We complain that we do not like research and that it is too hard to read. We are often not fiscally responsible and do not always use our downtime productively. We expect leadership from others, but not from ourselves.
A recent article talks about professional comportment. The authors define professional comportment as behavior that is dignified, competent, and conscious, and includes caring and compassion.3 It includes commitment to the profession, respect for others, and collaboration. In some ways, comportment is really about good manners and doing a job well. Without comportment, a unit becomes an unpleasant place to work. We all prefer to work with colleagues who are committed, are easy to get along with, and are compassionate, not only toward their patients, but toward their coworkers. Professional comportment incorporates the nursing standards that we are accountable for.
Professionalism has nothing to do with time clocks. It has to do with how we hold ourselves and our peers accountable to being the best we can be, not only for the sake of the patients and families we care for, but for the profession of nursing. We cannot worry about others treating us as professionals. Rather, we must treat ourselves as professionals. That is what will make the difference. If you are not familiar with the Neonatal Scope and Standards of Practice, make sure you get a copy and read it. You are accountable to these standards whether you know what they are or not.
2. National Association of Neonatal Nurses, American Nurses Association. Neonatal Nursing: Scope and Standards of Practice. 2nd ed. Silver Spring, MD: American Nurses Association; 2013.
3. Clinkner DA, Shirey MR. Professional comportment. The missing element in nursing practice. Nurs Forum. 2013;48(2):106–113.