Professional Identity and Autonomy Rhetoric versus Reality Implications

Professional Identity and Autonomy: Rhetoric versus Reality Implications for Developing One’s Self. Concept MADREAN SCHOBER, PHD, MSN, ANP, FAANP 10 MAY 2019 IAANMP 2019 CONFERENCE

Why Reflect On Your Professional Identity? Healthcare systems are promoting interprofessional collaboration and a clear perspective on professional identity is crucial.

Historically, nurses and midwives have been on the forefront of change. We must move from seeing ourselves as victims to identifying a clear professional identity and professionalism in our respective disciplines.

Who & What Defines Your Professional Identity? • Professional Identity can be viewed as a self concept based on identifiable attributes, values, motives and experiences. • One’s conception and perception as a member of a select profession. • Professional identity provides the individual with autonomy and designated value.

Implications for Practice No single, homogeneous experience of professional identity formation All individuals have unique perceptions of their own experiences that contribute to how they feel about their professional identity Common themes Academic/educational definitions of professional identities do not always align with what we do and how we practice Concept of professional identity cannot be taught but experiences from student life to practice can be offered to strengthen the notion of professional identity over time within authentic settings. It’s a transition! Avoid cycle of stereotypical descriptions and identity

Determinants of Professional Identity What (personal) Who (external) Education Employers, Administrators, Supervisors Work/Practice Professional Associations Life Experiences Policy, Professional Regulation and Standard Acquisition of skills, knowledge, behaviors, values, ethics and goals Funding models/reimbursement

Definitions Autonomy – the capability to make a decision & pursue a course of action Independence – free from outside control; not depending on another's authority Collaboration - the process of two or more people or organizations working together to complete a task or achieve a goal, similar to cooperation. Inter professional communication - healthcare providers communicate with each other in an open, collaborative and responsible manner.

Why is the term autonomy for ANP/AMP controversial? • Speculation: suggestion that the nature of tensions between medical, nursing and midwifery disciplines promotes a tendency to restrict the healthcare disciplines with less authority. • Issues of control? Collaboration is equated as supervision by some. • Lack of role clarity and clear professional identity? • Inability to accept broader & increased accountability with increased autonomy.

Cutting through the obstacles Attempting to establish professional identity with a role/level of practice that overlaps with the skills and knowledge of medicine, a profession sitting at the top of the hierarchy in most healthcare systems, is not an easy task. There is too much room for physicians, administrators and other healthcare providers to dictate the scope of our practice. Why do we endure construct of our professional identity by others?

Professional Expectations Treatment as autonomous professionals versus professionals who must ‘fit in’ Recognition of our professional identity based on who we are and the expertise we bring and for the manner in which we practice Capacity to halt a trajectory that may be drawing us towards a system that is not consistent with our concept of our professional identity Emphasis on a comprehensive approach to provision of healthcare services that enhances care, not only filling gaps in shortages of physicians Involvement in the political arena to challenge dated paradigms

Nuance of Language Inter professional education, collaboration and team building Collaboration does not equate to supervision task shifting and delegation or reallocation of tasks do not and should not define the ANP & AMP We are all too often defined by those in positions of authority and power with limited knowledge of what we do and how we practice In order to be effective professionally and personally as well as to raise your professional profile it is key to self identify who you are

Global Development We are not all starting at the same point of development Diversity in the maturity of nursing and midwifery in a country influences how decision makers meet the challenges of: Standardized education A professional standard, regulation & policies for ANP/AMP Funding models: education & reimbursement Imagine that each individual in each healthcare setting in each country on a day to day basis may be thinking of their own self concept of professional identity Are the perspectives compatible?

Conclusion Those of us who stand outside of society’s traditional definition of nursing and midwifery know that survival as a professional is not an academic skill. It is learning to take our professional identities and make them our strengths Acknowledgement of our own strengths leads to new ways of thinking leading to true visions of the future along with the concomitant power to effect changes which can bring the future into being Our personal visions and ambitions will help lay the groundwork for positive action, enhanced collaboration and vibrancy within the healthcare systems where we practice

References Joynes, V. C. T. (2018) Definition and understanding the relationship between professional identity and interprofessional responsibility: implications for education health and social care students. Adv in Health Sci Educ, 23: 133 -149. https: //doi. org/10. 1007/s 10459 -017 -9778 -x Melvin, M-E. , Braithwaite, S. , Plazas, P. C. (2018) Canadian nurse practitioner's quest for identity: A philosophical perspective. International Journal of Nursing Sciences. Pp. 1 -5, https: //doi. org/10. 1016/j. ijnss. 2018. 03. 001