Nursing Professional Practice: Concept Analysis and Implications for Care and Education

Concept of Nursing

Introduction

Studies have been conducted to research caring because it is an integral part of nursing. There is still a knowledge gap as far as caring in nursing is concerned. This project aimed at exploring the nursing professional practice concept and show the importance of this concept of a practice, discipline, and ethical point of view using evolutionary concept analysis. The project describes the uses of nursing professional practice as a concept. The project also identifies attributes related to nursing professional practice. They are derived from a Canadian context, and the definition of nursing professional practice is further elaborated to establish a foundation for future inquiry (Rodgers, 2000). In the nursing profession, examples of professional practice are outlined as per the concept attributes, which have been identified as genuine findings of an evolutionary concept analysis. The project concludes by outlining the implications shown in the final outcome of the concept analysis.

My interest in the nursing profession has intensified as a result of my experiences in many roles that I have executed in the field of nursing. Caring in nursing is a very important aspect as far as handling patients in health institutions is concerned. All professionals in the field of nursing should be well conversant with the nursing professional practice as a concept in order to deliver good care to patients. It is, therefore, inevitable for nursing professionals to learn more about the concept of nursing professional practice.

Organizational Perspective

In an organizational context, departments related to Professional practice have been recently added as a component of structures in the organization of various health authorities in British Columbia. In the early 2000s, those departments were formed to supplement the work of the newly formed role of chief nursing officer in the province. These departments have been identified to be responsible for promoting recommended professional practice in places of work. The services and programs within departments are aimed at supporting professionals in the health sector by promoting their professional standards in their workplaces. The programs also promote inter-professional collaboration and evidence-based practices. The interest to further explore nursing professional practice becomes inevitable with the sole aim of supporting professional roles in providing consultations in the field of nursing (Mathew and Lankshear, 2003). Many authors have established that there is no clarity as far as the significance and meaning of the nursing professional practice as a concept.

Disciplinary Perspective

The roles in the field of nursing have provided me with an opportunity to relate the importance of the concept of nursing professional practice to nursing as a profession that involves caregiving. This is shown in multiple ways by which the concept is used in the field of nursing. The nursing literature also describes the influence of collective interrelated conceptualizations relating to nursing as a profession that involves practical work. It is evident that there is a discourse in the field of nursing regarding the concept of nursing professional practice. The concept is not distinctive enough to be fully relied upon in the nursing profession. There is a need for conceptual clarity concerning the concept of nursing professional practice to enable nurses to carry out their duties without confusion. Professionals in the field of nursing should be well conversant with the concept of nursing professional practice in order to deliver in their discipline. This is important because it helps to strengthen current disciplinary support and professional structures (Cronin & Coughlan, 2010).

Professional Perspective

Health institutions that offer nursing services have established groups meant to advocate for the caring practice in nursing. The groups consist of professionals in the field of nursing who closely study the concept of nursing professional practice in order to give the best professional advice to professionals in the nursing sector. The group structure is divided into standards of practice, provisional legislation, curriculum, and practice and policy support groups. The purpose of such professional groups is to promote caring professional practice regarding the quality of care and services offered to clients. A study conducted in British Colombia showed that nurses experience moral residues and distress because of their working environment. This is attributed to the fact that they work in areas where there are few or no caring professionals. This finally leads to poor service delivery. The study shows that nurses report moral distress when they are exposed to environments with poor-quality professional practices.

Consequently, their ability to deliver better caring services is hampered. They are, therefor,e unable to provide compassionate, competent, safe and ethical care to clients (CAN, 2008). This shows that further research is needed in order to find better solutions to improve the delivery of competent and safe services. This can only be achieved through reviewing the concept of nursing professional practice and the evaluation of conceptual analysis in order to find lasting solutions that professionals in the nursing field can use when caring for patients. It is recommended that further studies on the concept of nursing professional practice will help nurses and other health professionals understand the concept well. It will also help them to recognize, improve, sustain and acknowledge a healthy environment. A better understanding of the concept of nursing professional practice will also help nurses to individually demonstrate professional practice to promote competent, compassionate, and ethical care in various health organizations. They can also demonstrate such professional practice within groups and within their health organizations.

It is a common challenge in many health organizations where nurses and other health professionals find it hard to conceptualize the nursing professional practice leading to poor delivery of health care. Unless specific challenges are addressed, nurses will continue to experience difficulties when executing their duties in their respective health organizations. Comprehensive programs should be developed by various stakeholders to make sure that nurses are trained on how to understand the concept of nursing professional practice. They should also be provided by enabling the environment to deliver better services.

Bystander Perspective

This is another context that nurses experience during the nursing professional practice. Nurses may be influenced by their journey through the entire health care system when some of their close family members are in need of care. There is a need for conceptual clarity to demystify the concept of nursing professional practice when a nurse encounters close family members who require care. There should be clear guidelines for health professionals on the right measures to take when they are faced with such situations in their profession. Nursing professionals whose close family members require care can get first-hand information from them regarding the conduct of different nurses offering care for them. By so doing, a professional can identify the positive attributes that a good nurse should have. This is done through listening to their description of good and bad nurses based on the care they have received from them.

Significance of Project

This project, therefore, seeks to establish the need for creating conceptual clarity to help individual nurses and professional group leaders in various health organizations to execute their duties effectively. Scholars in the field of nursing have established that the clarity of the concept of nursing professional practice helps in strengthening the development of current disciplinary and professional support structures. This positively influences the ability of nurses to show professional practice by providing competent, quality and ethical care to various clients in the health organizations where they work. It is a project meant to find ways of making the concept of nursing professional practice easy to understand among nurses and other health professionals who deliver care services to patients in various health organizations (Coughlan and Cronin, 2010).

Concept Analysis

The concept refers to attributes in a cluster. It is noted that currently, there is no agreement on the concept theory (Coughlan and Cronin, 2000). Rodgers identified the dispositional view and entity view as the two main views of concepts. He argues that people with an entity view are able to identify concepts having important elements which do not change (Rodgers, 2000). This view is linked to the philosophical perspective of logical positivism. This view was held by renowned philosophers such as Locke, Kant, Descartes and Aristotle. The dispositional view is linked with constructivist or interpretive philosophical perspectives. This perspective suggests that a concept may have one term with many meanings. Rodgers indicated that the belief that shows concepts as the disposition is viewed in concepts’ differing meanings in different disciplines

Concept analysis refers to a scientific activity that involves analyzing and defining concepts, as legitimised by Aristotle (Coughlin and Cronin, 2010). Scholars in the field of nursing have established that the development of concepts plays a big role in knowledge development (Rodgers, 2000). Conceptual analysis, concept derivation, and concept synthesis are types of concept development in nursing that are useful in conceptualizing nursing professional practice. Nursing scholars have linked concept analysis with the responsibility of different disciplines in order to have concepts that are easily conceptualized.

Critical theory perspective is utilized by people who use the pragmatic utility approach to establish characteristics of a particular concept through critique of a literature. This helps to identify similar criteria which demonstrate usefulness in practice (Morse, 2000). Nursing professionals can utilize the constructivist perspective to help in determining the attributes of a concept through its commonly understood uses in practice. It is noted that all three analytical approaches use literature to identify characteristics or attributes of a concept. There is a major difference that exists between the evolutionary approach and other approaches, that researchers use results to understand them as a heuristic. This is done with the aim of promoting further inquiry and research.

Evolutionary Concept Analysis

Concept analysis is linked to the process of developing concepts. The cycle of concept development considers the significance, use, and application of a concept. The evolutionary concept analysis involves utilizing phase development. There are six phases that Rodgers identified, which involve the following activities:

Identification of names and concepts and association of expressions.

Identification and selection of appropriate setting

Collection of data

Data analysis

Identification of a concept exemplar

Identification of implications and hypotheses for the development of a concept.

This approach helps in establishing a proper foundation for concept development contrary to static and universal criteria. The six phases mentioned above will provide a detailed framework to guide in analyzing the professional practice concept discussed in this paper (Lankshear & Mathews, 2003).

Reasons for Selecting Evolutionary Concept Analysis

There are various reasons for selecting the evolutionary analysis by Rodgers, is to explore the nursing professional practice concept. Rodgers’ approach is ideal because the nursing professional practice concept has evolved with time through contextual influences. This approach is contextual and dynamic making it congruent with the widely accepted nursing perspective, which indicates that human beings are ever-changing, and they interact with their environment in order to establish their health. It is, therefore, inevitable to use Rodger’s approach in the concept analysis of nursing professional practice (Rodgers, 2000).

Evolutionary Concept Analysis

Step 1: Identification of names and concepts and association of expressions.

Rodgers defined the concept as characteristics or ideas associated with a word and not that particular word itself. This project deals with the nursing profession practice as the concept of interest. Surrogate terms used in the field of nursing to refer to nursing professional practice include professional practice, professional nursing practice, nursing practice, professionalism, professional, and practice. These surrogate terms have been considered as antecedents in the evolutionary concept analysis. However, they are considered discrete terminologies from the combined nursing professional practice concept. Determination of context or direction of analysis also plays a major role in the initial decision-making process of the evolutionary concept analysis.

Step 2: Identification and selection of appropriate setting

The setting is defined as the period of time which is explored as well as the types of disciplinary literature involved. This project, therefore, focuses on nursing literature established between the years 2005 and year 2011 as the appropriate setting. The disciplinary literature used includes grey literature and peer-reviewed literature. ERIC and CINAHL online databases were used to search for the peer-reviewed literature. These databases were chosen because they give credible information relating to the field of nursing. Professional practice was used as the title, whereas nursing was used as the subject. They were used as the keywords when searching for information in the ERIC and CINAHAL databases. Grey literature was obtained form from the Archives and Library of Canada, and Google Canada as the main internet search engine. The sources of grey literature were obtained from established and credible governments, professional associations, health authorities, regulatory colleges and union websites.

Step 3: Collection of data

The step exploratory search of the literature was used in this project. This helped to establish limits that included search terms and articles between 2005 and 2011. The final step of this search using the above mentioned limits produced 60 citations. Peer reviewed literature and grey literature were determined from the 60 citations that were revealed. They were finally included in the analysis using the following criteria:

Inclusion Criteria

A definition of nursing professional practice in the context of nursing should be provided.

The articles must be published in English

The focus of the article should be the nursing professional practice

Exclusion Criteria

If professional practice is not the focus of the article.

Professional practice is described in a context that does not include nursing.

A nursing professional practice described regarding advanced practice nursing.

Nursing professional practice is described regarding specialty nursing.

Step 4: Data analysis

This involves the review of all the articles collected with the aim of identifying elements such as surrogate terms, references, related concepts, consequences, antecedents, and attributes. The inductive analysis process started with reviews of all the documents collected. All the contents relating to the six-element categories were extracted and entered in the appropriate columns of spreadsheets in Excel. Thematic analysis was used to organize and reorganize the same literature points to generate a relevant descriptor system. The key themes were identified by establishing selection criteria for the analytic elements. This helped to arrange data in an organized manner, which later helped in the easy analysis of data.

The attributes of a nursing professional practice include accountability, client-centred, autonomy, context, collaboration, ethics, continuing competence, innovation, self-regulation, leadership, disciplinary knowledge, and service.

Step 5: Identification of a concept exemplar

Rodgers established that the discovery of an exemplar is a critical part as far as concept analysis is concerned. The goal was to describe various characteristics of the analysis in order to enhance clarity of the concept and its effective application. They are identified using an analytic process and are chosen as real versus a constructed concept example. In this project, three nursing professional practice examples are used to show the importance of the concept from a practice, discipline, and ethical perspective (Mark et al., 2003).

Step 6: Identification of implications and hypotheses for the development of the concept.

This is the final step that Rodgers uses in his evolutionary concept analysis. It gives an opportunity to discuss all the implications that were discovered during the process. The development cycle of the concept considers the application, use, and significance of the concept. This paper has generally focused on the use of the concept of the nursing professional practice. The implications include engagement of concept strategies meant for nurses, with the aim of lessening moral distress. This is achieved by improving the quality of environments where professionals in the field of nursing practice. The approach of showing the implications indicates the connection of evolutionary concept analysis in a cyclical manner with the concept development process.

Implications

Implications for PolicyThe results reveal implications for nurses involved in health care reform and policy development phase. The definition of this concept identifies key attributes that policymakers in health authorities, nursing groups, and government use to develop policies for influencing nursing professional practice. The three areas of policy should be considered because nursing is entrenched within social structures with both formal and informal powers (Buresh, B. & Gordon, S., 2006).

Implications for AdministrationThis analysis reveals implications for nurses and other non-nurses who work in administration mainly in three specific ways. The administrator’s implication is to promote their ability to enable them to practice through professional development. Nurse Managers who fully understand and have all the attributes recommended for nursing professional practice and can be easily reached by staff always offer a key element necessary for a good working environment.

Clinical Practice Implications

This analysis reveals four specific implications for nurses in clinical practice. The delineation of attributes is recommended for nursing professional practice to assist nurses in developing personal learning plans as well as meeting continuing competence requirements. There is also an opportunity for nursing professionals to use nursing the attributes of nursing professional practice to fight for quality environments for professional practice. The definition of the nursing professional practice identifies the attributes of the nursing professional practice in system uses. It is also noted that participating in activities that are associated with strengthening environments of professional practice and continuing competence can assist in identifying pragmatic solutions meant for practising environment challenges (Marck, 2004).

Implications for Education

The main implications resulting from this analysis include the nursing curriculum, student placements, and mentorship programs. There is a great opportunity to integrate all the attributes of the nursing professional practice. The attributes provide the framework for programs meant for mentor and student placements.

Implications for ResearchThis analysis reveals five main implications that require further research. The first implication deals withthe  identification of the organizational, nurses and client outcomes in relation to the practice environment. The second implication explores the perception of nurses on how the attributes impact their practice. The third implication compares the definition of professional practice regarding nursing. The fourth implication validates the scale of professional practice in different practice settings. The fifth implication discovers how the definition of nursing professional practice of nursing compares to that from the analysis (Weaver, K. & Mitcham, C., 2008).

References

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