Nursing Practice For Professional Essays.
 
In this essay we are going to explore the connection between professional nursing practice and professional caring. I will outline the terms of professional nursing practice and what makes nursing a profession? I will describe the term of professional caring and the connection to the nursing practice and discuss the dilemma of care and cure. And also determine the importance of both in professional nursing practice.Nursing Practice For Professional Essays.
Professional nursing practice has been developing for several centuries. Nursing as a profession can be traced back to the early Christian era. Since then the perception of nursing practice has changed significantly. “Nursing is caring, commitment, and dedication to meeting the functional health needs of all people” (Craven & Hirnle, 2009, p. 32). First of all I want to find out if the nursing is actually a profession. So let’s explore the definition of the profession and if nursing has got all the components to it. Dr John Southwick in 1997 defined the profession as
A disciplined group of individuals who adhere to high ethical standards and uphold themselves to, and are accepted by, the public as possessing special knowledge and skills in a widely recognised, organised body of learning derived from education and training at a high level, and who are prepared to exercise this knowledge and these skills in the interest of others. Inherent in this definition is the concept that the responsibility for the welfare, health and safety of the community shall take precedence over other considerations (Southwick, 1997, para. 2).
As can be clearly seen definition of the profession consists of seven components. They are: knowledge, control over training and education, registration, selfless service, a code of ethics, sociali…
Professional Nursing Practice: Craven and Hirnle, (2009) suggest that in general professions have a knowledge base and a collection of skills and values that distinguish one from another. Knowledge base, power and authority over training and education, registration, altruistic service, a code of ethics, lengthy socialisation and autonomy are the seven qualities that have been recognized as being the characteristics of a profession (McEwen & Wills, 2007).The question of whether nursing is a profession has been an ongoing debate. The need for higher education, a specific body of knowledge, increased public interest and responsibility and internal organisation are among several standards proposed to assess nursing’s professional status. As…show more content…Nursing Practice For Professional Essays.
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The profession is subject to misconception because definitions of nursing are reflected by society’s values and influences. As a profession nursing has advanced over the centuries and continues to grow as a reaction to societies needs (Craven & Hirnle, 2009). I have come to an understanding that the term ‘professional nursing practice’ is not relatively simple to define; it is a complex and widespread concept that involves caring for communities and populations of people and addressing issues with far reaching social implications, it means being socially responsible, involved, and committed to the health of all people (Craven & Hirnle, 2009). Professional Caring: Craven and Hirnle, (2009), suggest that nursing is caring, dedication and devotion to providing the health functional requirements of all people. This care is directed by nurses to promote, maintain and restore health in various settings within a functional framework. The New Zealand Nursing Organisation, 2001 suggest that caring is the ethical foundation of nursing and is a further involvement further outside the charge whilst on duty.
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Subia Parveen Rasheed, RN, BScN
Student of Erasmus Mundus Masters’ in Emergency and Critical Care Nursing, University of Oviedo,
Department of Health Sciences, 33600, Asturias, Spain.
Correspondence: Subia Parveen, Portimopolku 14 A 4, 00800 Helsinki, Finland
E-mail:sobiaparveen@gmail.com
Abstract
Introduction: Self-awareness is a process of objective examination of oneself and is one of the important
components in nurse-client relationship. Self-awareness is considered as an important tool to develop a therapeutic
relationship with patients for therapeutic healing.
Objectives: The purpose of this paper was to review the literature to explore an in-depth understanding of the
concept self-awareness and how it influences nurse client relationship. The paper further emphasized on the
importance and how self-awareness can be developed.
Method: A comprehensive literature search was performed using specific keywords. Main focus of the literature
search was about self-awareness and its relation with nursing care and therapeutic relationship in nursing. Literature
mostly published in past 10 years was included, with exception to few landmark literatures in the field. In addition
Johari Window was integrated as framework to understand the concept in a practical way.
Results: The review literature showed that self-awareness is an ongoing process and needs conscious efforts. It is
important for nurses to know themselves well and it ultimately helps them to build a therapeutic environment of
caring and healing. The paper further emphasized on the importance of self-awareness in professional life and also
developed an in-depth analysis on how self-awareness can be developed. Many practical strategies were highlighted
in the paper to develop self-awareness at individual and professional level.
Conclusion: In conclusion, self-awareness is considered as the therapeutic tool for nurse client relationship. The
more the nurse will be self-aware the more a therapeutic environment for caring will be enhanced. Therefore, it is
recommended that nursing curricula should include some aspects on development of self-awareness. There should
also be some opportunity for professional nurses whereby they can get help and guidance to learn about self as a
continuous learning process.
Key Words: Self-awareness, Therapeutic Relationship, Communication, Johari window and self-awareness, selfreflection. Nurse/client relationship
Introduction
Knowing about oneself is not an easy task; it is a
painful and time consuming process. This process
starts with conscious awareness and struggling for
change through continuous efforts. There is no
doubt that Self-awareness is one of the important
components in nurse client relationship. Nurses
spend most time with the patients than of any other
health care professionals so self-awareness is
considered as an important tool to develop a
therapeutic relationship with the client. According
to Hildegard Peplau (As cited in Vandemark,
2006), “The central task of the basic professional
school of nursing is viewed as the fullest
development of the nurse as a person who is aware
of how she functions in a situation” (p.606). So
this very well emphasizes the importance of selfawareness in nursing education as well as in
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nursing care. Therefore, the purpose of this review
paper is to examine the aspects of self-awareness
and get in depth understanding of this concept. In
addition explore the practical implications of selfawareness in nursing profession. The author was
also interested in looking for possibilities which
could be helpful and practical to help nurses in
developing self-awareness. For this purpose
literature has been selected specifically which
addresses self-awareness and therapeutic
relationship for nurses. The specific focus in paper
will be the concept of Self-awareness, its
significance in nursing, and how self-awareness is
developed. In addition Johari Window will be
integrated as framework to understand the concept
in a practical way.Nursing Practice For Professional Essays.
Self-Awareness
Eckroth-Bucher (2010), defines the concept as
“Self-awareness involves the cerebral exercise of
introspection. This attribute reflects the cognitive
exploration of own thoughts, feelings, beliefs,
values, behaviors, and the feedback from others.”
(p. 297). Self-awareness is getting to know about
one self as a person and the important things in life
which influences us in different ways. It also
includes the reflection on how our attitude and
belief can influence others. If we get the awareness
of our own life then we can understand another
person better. The concept is further elaborated by
the authors; self-awareness is the continuous
process of understanding and knowing of one’s
own identity, beliefs, thoughts, traits, motivations,
feeling and behavior and to recognize how they
affect others in different ways. In addition, it
involves objectively examining one’s personal
beliefs, attitudes, strengths and limitations. (Boyd,
2005; Stuart and Laaia, 2005). Thus all these
literatures support the idea of self-evaluation and
realizing why you behave the way you do, it also
gives the dimension to explore oneself in different
context and the way others reaction towards you.
Self-awareness to a greater extent gives
satisfaction in life.
Fig: 1. The Johari Window: A graphical Model of Awareness in Interpersonal Relations
(Luft, 1982)
Know
Area of Free Activity (Open) Blind Area
Avoided or Hidden Area Area of Unknown Activity
Known to Self Not Known to Self
Known
to
others
Not
known
to
others
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Importance of self-awareness:
In general, self-awareness is important for personal
growth; it helps an individual to manage self and to
improve performance. It further helps in setting
appropriate and realistic goals, and career and
manage personal life stressors. But it first starts
with the understanding and acknowledging of its
importance in life. As Palmiere (2012), very well
explains and justifies these points as:
Self-awareness is a core personality strength that
can help us manage our businesses, our careers and
our lives. When we lack self-awareness skills, we
tend to make the same mistakes and encounter the
same obstacles over and over again. But when we
know where our unique strengths and limitation
lie, we’re better equipped to face challenges, solve
problems, choose our battles, make decisions, and
predict the outcomes of those decisions. (Para 1).
Furthermore, this process helps in analyzing the
difference and similarities between individuals.
This will further help in developing interpersonal
relationship and direct our communication towards
other’s need.Nursing Practice For Professional Essays.
Significance of self-awareness in nursing:
In the nursing literature, Self-awareness is always
discussed and considered as the most important
and essential aspect of a professional nurse. In
addition, with the insight that, this will lead to
competency in provision of high quality nursing
care and finally greater satisfaction in client care.
Further analysis of different literature shows that
self-awareness is a dynamic and transformative
process of self-reflection and change. Eventually,
self-awareness is the use of self-assessment to
analyze and guide behavior in a genuine way;
which enables nurses to create an environment
which helps in promoting interpersonal
relationship with the patients. Thus it helps in
recovery process by providing therapeutic
environment (Eckroth-Bucher, 2010). Moreover,
going through the process of self-awareness and
then using it in a healthy way is important. Infact it
is a first step towards taking better care of yourself
and it also helps in becoming resilient.
Furthermore, it helps in engaging in healthy
behaviors and ultimately helps in becoming better
nurses and leads to better client care. Some people
have very good understanding and evaluation of
their feelings and emotions but for some it needs
time and conscious effort to develop selfawareness. It is really crucial that one should listen
to the inner dialogue to have more self-awareness
of the needs and behaviors. Then finally
recognizing the unhealthy behavior and justifying
them and changing them into healthier ones.
(Gessler and Ferron, 2012 p. 41).Nursing Practice For Professional Essays.
To support the significance of self-awareness in
nursing profession, Scheick (2011) further claims
that “Nursing students and nurses bring not only
caring to their wounded clients but also at times
their own unresolved personal stress. Especially
without mindful awareness, projection of the
nurse’s unacknowledged emotional encumbrances
(counter transference) threatens the effectiveness
of nurse-client relationship” (p.114).
Looking at the literature evidences, it is really
important that as nurses we should have the
understanding of our verbal and non-verbal
gestures. We should learn how to react and manage
different situations rather than avoiding them.
Being a nurse we care for our patients from
different sociocultural background and different
value systems. So, appreciating and
acknowledging these differences will help us in
developing therapeutic alliance which will lead to
healthy therapeutic relationship.Nursing Practice For Professional Essays.
Therapeutic communication is important and
critical skill in nursing practice. The importance of
therapeutic communication can never be
underestimated in nursing. This is the only skill
which helps nurses in caring for the patients in a
holistic manner. Through this process the nurses
can interact with their client and provide a
therapeutic environment of caring and healing.
Row (1999) further emphasized the importance as
“Communication is a key skill of modern nursing
practice, yet often it is an area in which nurses’
fail. Self-awareness exercises can help us to
improve our communication skills and enhance
healthcare delivery” (p. 37). Self-awareness is
considered as the key aspect for therapeutic
communication skills. Nurses self-awareness can
help direct the communication towards the needs
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of the patient thus creating a therapeutic
environment for care.Nursing Practice For Professional Essays.
To further elaborate the concept, self-awareness is
to know about own self, who you are? It is
important for nurses to understand their own
attitude, behavior and values because they are
always in interaction with people who are unique
and not necessarily have same characteristics. So
to provide holistic care to our patients it’s
important to understand the similarities and
differences in every individual. We are dealing
with people so we should know what our motives
are and how our emotions and reaction can affect
others. As without knowing our own self how can
we ensure the care and priorities of others? The
literature also supports this view that the nurse
must examine personal feelings, actions and
reactions. The process of self-awareness compels
nurses to examine their own value positions so
these biases and prejudices are not projected on to
others and so nurses do not reject others who do
not share similar values. (Eckroth-Bucher, 2001).
Thus by effective use the self as a tool ‘nurses
must possess knowledge of their personal response
pattern s, strengths and limitations (EckrothBucher,2001; Stuart and Laaia, 2005).
In specific to mental health, knowing thyself is a
basic principle of psychiatric nursing. The process
of self-awareness is important because nurses’
psychological state influences the way patients’
information is analysed. The process of personal
introspection adds dimension to the nurse-client
relationship and is pertinent to understanding client
responses, thus enabling the nurse to explore these
issues with their client. As if we are not aware of
our reactions then we might endanger the nurse
client relationship. The author mentions that
“Unconscious body language, uncontrolled
emotions and lack of insight are potentially
harmful” (Winson, 2007, p. 59). And this quote
gives very well the significance of self-awareness
in nursing so that we are able to provide holistic
care and work for the wellbeing of our patients and
their families.Nursing Practice For Professional Essays.
Practical strategies for development of selfawareness
As in this article self-awareness and why it is
important was discussed, and now the focus will be
on certain ways which one can adopt to promote
individual self-awareness. Improving selfawareness on personal and professional level is
important for success, professional growth and
quality patient care. Nurses are there all the time
for taking care of their patients and it is important
that to help others you need to first know yourself.
For nurses, self-awareness needs efforts with
rational approach and reflection. It’s important that
they are aware of their own needs and how they
influence themselves and others. The literature
identifies some practical ways which can be
utilized to become self-aware are asking for
feedback from genuine person, reflection on one’s
own actions, journal writing, talking to a mentor or
friend, practicing mindfulness and meditation.
(Gessler and Ferron, 2012).
Further review of literature gives certain strategies
which can be easily adopted to better
understanding of self includes “Keeping a
reflective diary, learning about body language and
using models of reflection” (Winson, 2007, p.59).
Self-awareness is an ongoing process which needs
continuous self-evaluation and conscious effort.
There could be many ways to improve selfawareness as discussed above; but one of the very
common strategies in nursing is reflection. It is
always important to reflect on our experiences and
appreciate the positives and learn from our
weaknesses. So reflections give the opportunity to
look back and analyze practices for further
development. Keeping portfolios for individual
achievements and skill is another strategy which
can be utilized. This gives insight to professional
development and to identify need for further work.
(Jack and Smith, 2007). Psychodrama techniques
are important educational strategies which nurses
can use to develop or improve self-awareness in
patient care setting. These sessions can be helpful
in identifying problems in therapeutic relationship
and finally through feedback and suggestion can be
improved. In addition, through this technique the
nurses can also see role models and incorporate
those learning into their communication and
relationship in patient care. The authors further
found out through their research that the
psychodrama technique helped the nurses to
understand themselves well, it gave the
opportunity to discover the viewpoints of others
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and finally to make the association between their
own feelings and thoughts and those of their
patients. (Oflaz et al, 2011). Psychodrama can be
an effective teaching strategy in addressing the
communication problems that arise in nursing.
Johari Window model and Self-Awareness
In addition, in this review article, Johari window
by Luft and Ingham, 1955, (As cited in Luft, 1982)
will be integrated to know about self-awareness
and the ways to improve self-awareness. (See Fig:
1).Nursing Practice For Professional Essays.
This model has total four quadrants (Open, blind,
hidden and unknown) and each quadrant gives
different information about self. The open area
means that we know and others also know about
us, whereas the blind mean that people know about
us but we do not have the awareness of that
particular characteristic. Hidden means we know
but others do not know about us and finally the
unknown is something which no one knows
including us. The more wide the open quadrant, the
more self-aware the person will be. So it’s better
that to talk to people about self and get feedback
from colleagues and friends to decrease the hidden,
blind and unknown quadrants. This is also at times
a painful process, as one has to do self-disclosure/
exposure and listen to people feedback which is
not always easy to accept specially the areas for
improvement. To decrease hidden area, one needs
to expose or do self-disclosure and ultimately will
increase the open area. To decrease the blind area
one needs information about self and that’s called
feedback from others. To decrease unknown
quadrant, it needs both self-disclosure and
feedback. It is important that if the person wants to
change, it needs voluntary effort, forced
intervention always lead to failure. The individual
readiness is important to develop self-awareness
and to change some behaviors and characteristics.
(Jack and Smith, 2007; Luft, 1982; Rowe, 1999).
Based on the Johari model Miller and Jack (2008)
recommended a framework. In this frame work
they have given three practical stages for change
and those are Now, Transition and Regroup stage.
It is very helpful framework especially for novice
nurses who have some problems or difficulty in
communication or therapeutic relationship. By
identifying those gaps, in Now stage, it gives the
insight and it may need help from colleagues. After
knowing the aspect to have more developmental
need then the individual can find resources or ways
to work on that limitation or need in the Transition
phase. Finally, in the last stage it is Regroup phase
where the change has already occurred and in this
phase it may have helped the individual in
reducing the hidden or unknown areas and we can
find interesting things about self. It may also be a
painful process as it is not easy to let go of
individual weaknesses but one needs to be more
receptive to change and to be a better person and a
better professional nurse to understand self and
others. To achieve this we need mentors and
support group for encouragement and motivation.
This framework can be very well integrated in
nursing curricula especially in Psychiatry to teach
nursing students about bringing change in self and
becoming more self-aware. Moreover, also in the
practical life where by mentorship program may
help in this process. (Jack and Miller, 2008).
In conclusion, self-awareness is considered as the
therapeutic tool for nurse client relationship. The
more the nurse will be self-aware the more the
therapeutic environment for caring will be
enhanced. Moreover, self-awareness also helps in
personal success and management. Reviewing
different literature gives the insight that for a
professional nurse self-awareness is the prime and
vital concept. Therefore, it is recommended that
nursing curricula should include some aspects on
development of self-awareness which for instance
could be some exercises throughout the program.
Also, in practice setup as this exercise is not of a
one day job but it takes time and continuous effort.
There should also be some opportunity for
professional nurses whereby they can get help and
guidance to learn about self as continues learning
process.Nursing Practice For Professional Essays.
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