Nurses Association of Botswana

Image campaign Flyer Number 1

Key concepts of Nursing

Aim
To appreciate the value of professional and ethical nursing practice.

Objectives

1. Provide a professional definition of nursing. 2. Discuss the essence of nursing care. 3. Apply the core values of nursing to practice. 4. Justify nursing as a profession

It is important to describe nursing, its scope and essence, as it enables nurses and the public to clarify the role and functions of nurses in the health care system. The word nursing is derived from the Latin word nutrire which means to nourish. The unique function of the nurse, according to Henderson, 1 is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to a peaceful death) that s/he would perform unaided if s/he had the necessary strength, will or knowledge. The International Council of Nurses 2 (ICN) states that nursing is an integral part of the health care system. It encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles.
Nursing is a caring profession. Caring is what nurses do (care about people) and what nurses provide (care for people).

Essence refers to the intrinsic nature of something, something we cannot do without. The essence of nursing is the essential or crucial characteristics that determine the nature of nursing. Its nature may differ slightly from person to person and from nurse to nurse, but in general the essence of nursing is patient care. The patient is always central to nursing.

Essence of Practice

Care Compassion Commitment Confidentiality Courtesy Conscience Competency Courage Culture Communication

The 10 Cs of Nursing

A scope of nursing practice assists nurses to articulate its parameters in order to respond to the current needs of society. 3 The scope of nursing practice communicates the roles, competencies, professional responsibilities and accountability of a nurse. It provides the foundation for standards of nursing practice and education, and communicates to the public the characteristics of who is qualified to provide particular nursing services. As professionals, nurses determine their own scope of practice. Lack of a documented scope of practice may lead to care being fragmented, too restricted or limitless and not meeting the needs of the public. 4
1 http:www.nursingtimes.net/whats-new- in-nursing/hall-of-fame/ Virginia-henderson-developed-a-definition-of-nursing/5012099.article 2 International Council of Nurses. (Undated). Definition of Nursing. Geneva, ICN. 3 A. Morrison. (2010). Scope of Nursing Practice and Decision-Making Framework Toolkit. Geneva, ICN. 4 Ibid.

Scope of Practice

Values are ideas that we believe in, views that are important, beliefs that we regard very highly. In nursing there are several core values on which the nursing practice is founded.

Core Nursing Values

Putting patients at the forefront: Making the care of people your primary concern Integrity

Dignity refers to how people feel, think and behave in relation to the worth or value of themselves and others. To treat somebody with dignity is to treat them as being of worth, respect and being valued.5 When people are treated with dignity, they feel in control, they feel valued, confident and comfortable and be able to participate in decision making about their health.

Dignity

Integrity refers to basing ones actions on principles and values. It encompasses being honest, truthful, trustworthy and fair, while upholding the highest standards of professional and ethical conduct.9

Altruism is the quality of unselfish concern for the welfare of others, for humanity.6 This selfless concern for the welfare of others is a traditional virtue in many cultures, and a core aspect of religion. It is an ethical doctrine that holds that individuals have a moral obligation to help, serve, or benefit others, if necessary at the sacrifice of self interest.7

Altruism

Autonomy is the right to make your own decisions. Autonomy in nursing comprises two aspects, the right of nurses to self-government and the right of the patient to make informed decisions.10

Autonomy

Empathy is generally defined as the extent to which one has the ability to understand and accept anothers feelings and emotions. Some view empathy simply as ones ability to put themselves in another persons shoes or view an issue from another persons perspective. Empathy is a particular important factor in the success of those people who work in jobs where there is a high degree of interaction with other people.8
5 6 7 8 9 10 11 12 13 14 15 16 17 18 Adapted from the Royal College of Nursings Definition of Dignity. (2008). wordnetweb.princeton.edu/perl/webwn en.wikipedia.org/wiki/altruism_(ethics) www.referenceforbusiness.com/management/Em.../empathy.html www.hubpages.com/hub/Why-Become-a-Nurse Ibid. Vision 2016; a Long Term Vision for Botswana (1997). Gaborone, Government Printers. En.wikipedia.org/wiki/professionalism www.nesc.nhs.uk/trecruitment_careers/careers_support/glossary_of_terms/glossary_of_terms_i_-_p.aspx http://e-space.openrepository.com/e_space/bitstream/2173/1795/1/ swtronach%20and%20corbin.pdf. Hall, C. and Ritchie, D. (2009). What is Nursing? Exploring Theory and Practice. Great Britain, Learning Matters. Hall, C. and Ritchie, D. (2009). What is Nursing? Exploring Theory and Practice. Great Britain, Learning Matters. Page 26. Ibid, Page 26. www.medical-dictionary.the free dictionary.com/nursing+ethics

Empathy

Botho is the fifth national principle for Botswana, embedded in the countrys culture. The concept of botho refers to humanness and is central to nursing. It refers to a person who has a well rounded character, who is well mannered, courteous, disciplined and realizes his or her full potential as an individual and as part of the community to which the individual belongs. 11

Botho

Standards of the Nursing Practice

Standards of nursing practice refer to the expected level of competency at which a nurse should practice. Nurses are expected to always practice according to standards so as to ensure quality services and not to endanger the life of the patient in their care. Nursing care standards are available from the NMCB and from NAB.

Nurses Association of Botswana

Professionalism
Professionalism refers to acting as a professional. A professional is a member of a vocation with skills founded upon specialized educational training. 12 Professionalism includes the adherence to a set of values comprising statutory professional obligations, formally agreed upon codes of conduct, and the informal expectations of patients and colleagues.13 Few professionals talk as much about being professionals as those whose professional stature is doubted.14 Traditionally, nursing has been considered a vocation, occupation and calling. During the last several decades, nursing has been striving to be recognized as a fully fledged profession.15 Nursing has experienced problems delineating a sufficient body of specific knowledge different from that of other disciplines. However, more recently, many nursing specific theories and models have been developed. Another issue is autonomy; nurses have not yet gained full self sufficiency in their decision making. Of late, the focus on professionalism has shifted somewhat towards exploring the role of nurses.

Being a professional Nurse

To be considered as a professional implies that one possesses proficiency in specific knowledge, skills and attitudes. It further suggests membership of a privileged and restricted occupational group (professional organization). In many countries, nursing has published statements on what qualified nurses are capable of doing and what the public can expect of nurses. The publics expectations of nurses include that they are trustworthy and always have the best interest of the public at heart. The public also expects that nurses are competent in what they are doing and work according to set standards. 16 Most countries require registration of nurses with the regulatory body, which may include proof of continued professional education. Ideally, registration should ensure that nurses are fit to practice. 17

The fundamental features that characterize a profession include:

1. Altruistic service to society. 2. A distinct knowledge base. 3. Autonomy and accountability. 4. Licensing and regulation. 5. Professional organization. 6. Ethical code.
Protect the public and serve Society

Ethics
Ethics refer to a theory or a system of moral values, a set of principles of right conduct. It reflects the rules or standards governing the conduct of a person or the members of a profession. In nursing, ethics include the values or moral principles governing relationships between the nurse and the patient, the patients family and other members of the health team.18 Nurses always practice within the framework of a code of ethics by taking a pledge.

A Pledge A code of ethics

is like a contract through which a profession informs the public about the principles and rules by which the profession functions. is a solemn binding promise to do, give, or refrain from doing something: a statement of principles for the nursing profession. The first pledge (Nightingale Pledge) was developed by a committee in 1893.

Image campaign: Essence of Nursing

Professional Organization
A professional organization is an association of practitioners of a given profession, devoted to developing the field of professional knowledge, advancing the service given by the profession, promoting high standards of service in the interest of the recipients of that service and enhancing members status.19 It is important for nurses to belong to their professional organization because it: 20 Provides information, publications, workshops, conferences and events. l Connects professionals (unity and network). l Facilitates participation in professional activities. l Advocates for improved conditions of service. l Sets practice standards. l Enhances the status of the nurse. l Keeps the nurse abreast of current issues and developments.
l

Points for Reflection

The Association
The Nurses Association of Botswana (NAB) is the national spokesperson for nurses in Botswana. Operated for and by nurses since 1968, the Association currently represents over 3800 nurses in the country (>50%). In its pursuit to deliver quality nursing services to its customers, NAB is committed to advance and maintain professional growth and integrity of its members.

SunDesign / Impression House

Why did you enter nursing? What makes a good nurse, what makes a bad nurse? What are your core values? What are the crucial values underpinning the nursing profession? What makes a nurse a professional? What constitutes respect in the context of nursing?

The Council
The Nursing and Midwifery Council of Botswana (NMCB) is the regulatory body for nursing and midwifery in Botswana. The NMCB exists to regulate nursing and midwifery education and practice, to ensure public safety and protection and reinforcement of set standards.

Regulatory Body
The practice of nursing is governed by a regulatory body, usually established by government, which regulates the activities of the nursing profession. Most regulatory bodies require nurses to maintain both professional knowledge and clinical competence in order to receive an annual practicing certificate (license). A regulatory body also maintains standards of practice and has the authority to refuse or de-register nurses. 21

19 http://www.nursingworld.org/Especially ForYou/StudentNurses/ YourProfessionalOrganizations.aspx 20 http://www.ehow.com/about_6702912_belong-professionalnursing-organization_.html 21 http://www.websters-online-dictionary.orgl