The public perception of nurses, both in the past and present, may have evolved with technological and scientific advancements. However, for those who may not pay much attention or have a deep understanding of nursing, their views on nurses might not have changed significantly from the past.
In the time before the 19th century, society viewed nurses as having a low status. Nursing was considered a duty for women, involving caregiving and compassion. Nurses in that era were often uneducated, with prisoners and slaves being among the workforce. Furthermore, nurses were sometimes perceived as substitute mothers and objects of sexual desire due to the predominantly female workforce.
With the progression of time, nursing witnessed the emergence of experts in the field, such as Florence Nightingale, who played a pivotal role in introducing and advancing nursing in the late 19th century. Nursing started to be seen as an honorable profession, characterized by sacrifice, dedication, and growing respect.
Definition of Profession
A profession is a vocation aimed at serving the interests of society rather than specific groups or individuals. It prioritizes the well-being of others, with consumers as recipients of professional nursing services. According to Webster, a profession is an occupation requiring extensive education and involving intellectual skills.
Kelly and Joel (1995) define a professional as someone exhibiting characteristics, spirit, or methods inherent to the profession, encompassing education and activities within various occupational groups that aspire to professionalism. Professionalism is a dynamic process aimed at fulfilling or transforming the characteristics of a profession.
Characteristics of a Profession
Gary and Pratt (1991), Kiozer Erb, and Wilkinson (1995) outline professional characteristics as follows:
- Open mission concept towards change
- Mastery and application of theoretical knowledge
- Problem-solving abilities
- Continuous self-development
- Formal education
- Competency validation systems
- Legal reinforcement of professional standards
- Practice based on ethics
- Legal aspects of malpractice
- Acceptance and service to the community
- Differentiation of roles between professional workers and others, allowing for autonomous practice
According to Lindberg, Hunter, Kruszewski (1993), Leddy, Pepper (1993), and Berger, Williams (1992), nursing as a profession has the following characteristics:
- Foundational knowledge supporting skills to solve problems in nursing practice Initially, nursing practice relied on intuitive skills. Now, nursing is recognized as a science incorporating various disciplines such as behavioral, social, physical, biomedical sciences, and more. Nursing also studies core knowledge supporting nursing practice, including the functions of the human body related to health and illness and the principles of providing direct nursing care.
- Ability to provide unique services to the community The unique function of a nurse is to assist individuals in activities supporting health, healing, and promoting client independence.
- Education meeting standards and conducted in colleges or universities The shift of nursing education to higher education institutions allows nurses to acquire intellectual, interpersonal, and technical knowledge and skills, enabling them to play more integrated roles in comprehensive and continuous healthcare services. Nurses are also required to develop nursing science and technology.
- Control over practice standards Practice standards emphasize the nurse’s responsibility and accountability to meet established standards aimed at protecting both the public and nurses. Nurses work independently and are not under the supervision of other professions.
- Responsibility and accountability for actions taken Being accountable means nurses are responsible for the services provided to clients. Accountability involves legal aspects concerning peer groups, superiors, and consumers. The concept of accountability has two implications: being responsible for the consequences of actions taken and accepting responsibility by not taking action in specific situations.
- Lifelong career Different from routine job tasks, nursing is a lifelong commitment. Nurses work as full-time professionals equipped with education and skills they choose throughout their lives.
- Autonomous function Nurses have full authority to provide nursing care, although collaboration with other professions is sometimes necessary based on client needs, not as an extension of other professional interventions.
Development of Nursing Professionalism
Examining the historical records of nursing’s inception in Indonesia, which is estimated to have started in the early 19th century, it is mentioned that the presence of nurses at that time resulted from the efforts of medical personnel to provide better healthcare services, necessitating assistance or auxiliary personnel.
These personnel were trained to become nurses through apprenticeship education focused on diseases and their treatments.
Up until the development of nursing in Indonesia in 1983, the Indonesian National Nurses Association (PPNI) held a National Nursing Workshop in Jakarta. Through this workshop, nurses committed and agreed to declare that nursing is a professional field.
The development of nursing professionalism in Indonesia aligns with the progress of nursing education in the country. Recognition of novice professional nurses is for those with a background in Diploma III nursing education.
This program produces novice generalist nurses as professional beginners, developed with sufficient scientific and professional foundations.
The development of nursing education towards professionalism is not limited to the diploma level. Inspired by the nursing profession’s desire for continuous education development, the Nursing Study Program at the University of Indonesia (PSIK FK-UI) was established in 1985, followed by the establishment of the postgraduate program at the Faculty of Nursing (FIK UI) in 1999.
Improving the quality of nursing professional organizations can be achieved through various methods and approaches, including:
- Developing a leadership selection system by setting criteria based on various aspects such as abilities, education, insight, views on the organization’s vision and mission, dedication, and time availability for the organization.
- Having a series of concrete programs translated through organizational activities from the central level to the regional level. The primary focus is on continuous education programs for its members.
- Activating collective bargaining functions to ensure each member receives appropriate recognition based on their education and compensation.
- Developing leadership training programs so that nursing professionals can speak up and have the potential to occupy various positions in government or the private sector.
- Enhancing collaborative activities with nursing professional organizations abroad, involving not only central executives but also potential regional executives for development.
Tree of Knowledge (Body of Knowledge)
The body of knowledge in nursing is nursing science itself. Nursing education, as a professional education, must be developed in accordance with the principles of nursing science and the nursing profession, with a strong and solid academic and professional foundation.
The development of nursing education starts with a basic understanding of nursing science, as formulated by the Health Science Consortium (1991):
“Nursing science includes basic sciences such as natural science, social science, behavioral science, biomedical science, public health science, basic nursing science, community nursing science, and clinical nursing science. Its application uses scientific problem-solving approaches to maintain, support, preserve, and improve the integrity of all human basic needs.”
The vision of nursing science encompasses sciences that study the forms and reasons for unmet human basic needs. This includes fundamental assessments of underlying factors and learning various efforts to achieve these basic needs by utilizing all available and potential sources.
The fields and phenomena that are the objects of nursing study are deviations and unmet human basic needs (bio-psycho-socio-spiritual), from the level of individual wholeness (covering the entire life cycle) to the level of society, reflected in the unmet basic needs at the functional organ system level down to sub-cellular or molecular levels.
Reflection of a Professional Nurse
Reflections of professional nurse values in nursing practice are categorized into intellectual values and moral commitment interpersonal values, as follows
Intellectual values in nursing practice include:
- Body of Knowledge
- Specialized education (continuous)
- Using knowledge in critical and creative thinking.
Moral Commitment Values
Nursing care is provided with an altruistic concept, considering nursing ethical codes. According to Beauchamp & Walters (1989), professional service to society requires integrity, moral commitment, and ethical responsibility.
The moral aspects that should form the basis of nursing behavior include:
- Beneficence: Nurses always strive to make decisions based on the desire to do what is best and not harm clients.
- Fairness: Nurses do not discriminate against clients based on religion, race, socio-cultural background, economic status, and treat each client as an individual with unique needs.
- Fidelity: Nurses behave in a caring manner, always strive to keep promises, provide adequate hope, show moral commitment, and pay attention to clients’ spiritual needs.
Writer: Intan Rosiana
Student College of Binawan University
Source: Keperawatan sebagai Profesi