Professional Nursing Practice Concepts and Perspectives Seventh Edition

Professional Nursing Practice Concepts and Perspectives Seventh Edition Chapter 2 Socialization to Professional Nursing Roles Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Learning Objectives 2. 1 Discuss professionalism and nursing. 2. 2 Describe socialization to professional nursing. 2. 3 Compare socialization models. 2. 4 Analyze elements of and boundaries for nursing roles. 2. 5 Discuss ways to manage role stress and strain while enhancing professional identity. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Hallmark Features • A focus on foundational knowledge related to professional nursing – Includes nursing history, nursing theory, ethics, legal aspects, etc. • An overview of professional nursing roles, issues, and changes in the profession – Discusses nurses as healthcare providers, learners and teachers, and leaders Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Challenges and Opportunities • Multiple levels of entry into the position • Gaps between education and practice • Professional identity, job, career Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Learning Objective 2. 1 Discuss professionalism and nursing. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Nursing as a Profession • A profession is distinguished from other kinds of occupations by – Requirement of specialized training – Orientation toward service, either to a community or an organization • The standards are determined by its members Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Nursing as a Profession • The education involves a complete socialization process • Debates about whether nursing is a profession Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Challenges for the Nursing Profession • Level of entry into practice – Multiple levels ªAssociate degree ªDiploma ªBaccalaureate degree • Gaps between education and practice • Professional identity: job versus career Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Nursing as a Discipline and Profession • History and trends in the education of nursing – Earliest type of education was in hospitals – Emergence of baccalaureate and associate degree programs – Shift from diploma (hospital-based) programs to associate and baccalaureate Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Nursing as a Discipline and Profession • ANA 1965 position paper – Proposing master’s degree as minimum education for entry-level nurse • Definition of profession, six conceptualizations – A discipline is a branch of knowledge – Disciplines are divided ªAcademic – research and education Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Professional Component of Clinical Practice • Standards of clinical nursing practice – Reflect values and priorities – Provide direction for professional nursing practice – Provide a framework for evaluation Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Define the Profession’s Accountability • ANA established standards of clinical nursing practice – Six standards of practice known as nursing process – Nine standards of professional performance Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Learning Objective 2. 2 Describe socialization to professional nursing. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Professional Socialization • Socialization is a learned process • Professional socialization is to internalize a professional identity • Social control is intrinsic – Capacity of a social group to regulate itself through conformity and adherence to group norms ªSanctions are used to enforce norms ªNorms become internalized standards Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Professional Socialization • Agents of socialization are the people who initiate the socialization process – Children – family, teachers, peers, media – Adults – superiors, subordinates in the workplace, peers, people of other social groups – Nursing students – clients, faculty, health professionals, and professional colleagues – Nursing – preceptors, mentors, staff development on the job Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Learning Objective 2. 3 Compare socialization models. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Process of Professional Socialization • Models that describe the process of socialization – Simpson – Hinshaw – Davis Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Process of Professional Socialization • Simpson Model – Three phases ªProficiency ªAttachment ªInternalization Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Process of Professional Socialization • Hinshaw Model – Three phases ªTransition ªAttachment ªInternalization • Values and standards Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Process of Professional Socialization • Davis Model – Six stages ªInitial innocence ªLabeled recognition of incongruity ª“Psyching out” ªRole simulation ªProvisional internalization ªStable internalization Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Process of Professional Socialization • Ongoing professional socialization and resocialization – Process does not terminate with graduation or start of a new job Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Process of Professional Socialization • Three models of career stages or development – Kramer’s Postgraduate Resocialization Model ª Reality shock – Dalton’s Career Stages Model ª Development of competencies derived from experience – Benner’s Stages from Novice to Expert ª Implications of teaching and learning Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Learning Objective 2. 4 Analyze elements of and boundaries for nursing roles. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Role Theory • Role theory emerged from sociology • A role is a set of expectations associated with a position in society Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Role Theory • Elements of roles – Ideal ªThe socially prescribed or agreed-upon rights and responsibilities associated with the role – Perceived ªHow a person believes he or she should behave in this role – Performed ªWhat the person actually does Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Role Theory • Role performance factors include – – Health status Personal and professional values Needs of clients and support persons Politics of employing agency Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Role Theory • Role transition is the process by which a person assumes or develops a new role • Two components associated with role behaviors – Norms – Values Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Role Theory • Role transition is influenced by many factors – Individual – Interpersonal – Organizational Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Boundaries for Nursing Roles • Five determinants form boundaries for nursing roles – – – Theoretical and conceptual frameworks The nursing process Standards of nursing practice Nursing practice acts National and international codes of ethics Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Learning Objective 2. 5 Discuss ways to manage role stress and strain while enhancing professional identity. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Role Stress and Role Strain • Factors associated with role stress for nurses – Little control in the job – High demands – Few supportive relationships Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Role Stress and Role Strain • Role stress may create role strain – Common role stress problems ªRole ambiguity ªRole conflict ªRole incongruity ªRole overload or underload ªRole overqualification or underqualification Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Role Stress and Role Strain • Four major causes for role conflict for nurses – Professional bureaucratic work conflict – Different views concerning what nursing is and should be – Discrepancy between the nursing and medical view of what the nurse’s role should be Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Role Stress and Role Strain • Strategies for relieving role stress – Priority setting and time management – Rewriting job descriptions for clarity – Integrating multiple roles into a larger whole Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Characteristics of a Positive -Concept Self • Characteristics of a person with a positive selfconcept – – – Future orientation Copes with life’s problems and disappointments Helps others and accepts help Can see and value uniqueness in all individuals Feels emotion but does not allow feelings to affect behavior Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Characteristics of a Positive -Concept Self • To develop a positive self-concept – Accept your present self but have a better self in mind – Set attainable goals – Develop expertise Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Preventing Burnout • Personal goal setting – Long- and short-term goals • Problem identification – What is causing the stress • Problem-solving strategies – See Table 2– 3 • Time management skills – Delegation Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved

Table 2 -3 Strategies for Stress Reduction and Time Management Personal Professional Care for yourself Exercise regularly Have a healthy diet Get adequate sleep and rest Examine your lifestyle Build time for relaxation activities such as meditation and yoga Reflect on what has been helpful in the past Budget time according to priorities Develop new coping skills Let go of perfectionism Let go of the need to do it all Attend time-management workshop Attend assertiveness program Continue education to develop expertise in areas that give you satisfaction Select employment thoughtfully Compare your values to the agency’s mission Know your competencies and make a match Participate in policy development opportunities Join committees that contribute to governance Participate in organizational structure to target problematic job and role design Use negotiation skills Seek win-win resolutions to conflict Manage your role positively Network with colleagues Communicate clearly Support excellence in practice Be a self-advocate; use positive self-talk Develop good delegation skills Participate in support groups Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved