Soap Box

Your say about nursing issues

Helen Calabretto
School of Nursing, University of South Australia, SA

PP: 143 - 144

Article Text

Well! What are you doing on Saturday afternoon?

I wonder. Do physiotherapists, occupational therapists, doctors, dentists, social workers, podiatrists and others spend hours, days, years even, contemplating the nature of their work? Do they organise conferences around a theme like 'The Nature of Podiatry-A Philosophical Approach'? Do they fill journals with debates on the problematic nature of physiotherapy in the 20^th century? No, I do not believe they do to the same extent as some nurses.

It would also seem to the casual observer that they know and understand exactly what it is they do. They also know their place in the big picture and they appear to understand the context of their practice. If nursing is, as I so frequently read, a practice-based profession, why do we devote so much time to such soul searching about the nature of nursing? Do we lack the skills to examine our practice, engage in new and different practice and generate information to share with other nurses? Do we have the skills to lobby for change or control the context of our practice? Much that I hear about nursing today concerns me, because I have been hearing it for the past 25 years. We are still asking the same questions in the late 20^th century that we were asking all those years ago and they are; 'What is nursing?' and 'Are we truly professionals?'

I am concerned for two reasons. First, because the criteria for a professional as cited in Conceptual Bases of Professional Nursing by Leddy and Pepper (1981) does not accurately describe nursing and, as such, nursing appears uncomfortable by exclusion. However, even though we find it difficult to define what exactly the nature of nursing is, we seem to know what it is not. For example nursing is not making beds, handling routine ward enquires and preparing and serving food (many would argue that we were wrong). Nurses have decided that these activities are 'non-nursing duties'. Not a startling exposure in itself but we are also allowing non-nurses to make other more damaging decisions for us, such as 'You do not require a nursing background to be a manager of patient services'.

Over the past 10 years I have heard more shouts of alarm as other health professionals are incorporating nursing activities into their practice. We are shocked and concerned about the proliferation of pseudo health professionals emerging from TAFE colleges. Are they filling a need in the community that nurses should be filling? My second area of concern relates to the time spent in reflection, not the reflective- practice kind, but the kind one expects from those people reaching the winter of their life. Looking back and looking in are not bad activities in themselves, but they must be accompanied by reflection with action.

Nurses need to accept that no knowledge belongs exclusively to one group; just take a walk through a bookshop or library. It is what we as a group do with that knowledge that is unique and exclusive. It is our practice that is unique and exclusive and we need to take control over the way we practise. In order to do this we need to become politically astute. Nurses comprise some 63% of the health workforce, therefore it is right and proper that nurses have the skills to shape health policy. We need to research and write about our practice. We need to understand the context in which we practise and assert our unique position.

So it is time for us to take action and move away from our tendency to allow others to shape our future and control the scope of our practice. We must take control of our profession, observing and commenting on our own practice. We must prepare our new professionals with the skills and confidence to take nursing into the next millennium. So next time the physiotherapist says 'This is my job' ask them what they are doing on Saturday afternoon.

Anita Lange, RN, RM, BEd, Grad Dip Ed(Comp), MPH
Faculty of Nursing, University of South Australia

The need for continuing education

In the nursing context, continuing education is defined as post-registration education undertaken by nurses throughout their careers. It covers a wide spectrum of educational opportunities, ranging from the reading of nursing journals and participation in in-service education at the workplace through to enrolment at tertiary institutions, leading to an academic award such as a bachelor, master or doctoral degree.

In today's rapidly changing world, nursing knowledge is continually being developed and refined. The knowledge gained by nurses may quickly become obsolete, necessitating a life-long commitment to continuing education in order to remain safe practitioners. Houle (1980) believes for continuing education to achieve its greatest potential it must fulfil the promise of its name and be truly continuing, not casual, sporadic or opportunistic. In an ideal world, nurses would recognise their professional responsibility to continually update their knowledge and do so automatically. Unfortunately, as Welch (1980) points out 'A large number of employed nurses are not engaging in educational endeavours and are basing their nursing judgements and actions on obsolete or insufficient knowledge'. Although it is necessary to recognise that nurses learn 'on the job', a belief that all one needs to know to keep up to date with new knowledge and techniques can be learned at work is foolish.

It is my belief that the continual renewal of practising certificates to nurses who have not undertaken continuing education cannot be justified, as those nurses may be placing their clients at risk by using outmoded techniques. Registration must be a privilege which is earned, rather than a right which is bestowed. Unless this occurs, nursing will be comprised of the practitioners it deserves, instead of those whom it requires for future advancement. The key issue as pointed out by Welch (1980) is not whether continuing education should be mandated or voluntary, but rather, why it has been that nurses have not sought new knowledge.

I would ask why nurses have not effected positive changes in their practice, or perceived a need to do so. Welch (1980) expresses this as possible reluctance or lack of motivation for nurses to maintain a professional approach to their nursing careers. Could this reluctance on the part of Australian nurses be related to a negative perception of nursing as a profession? While it is true that completion of an educational program is no guarantee of increased competence, it may be assumed it is the motivation for attending. Hutton's (1987) research indicated that mandatory continuing education improved performance in nurses' practice, and had a positive effect on patient care. This would suggest that continuing education leads to increases in both accountability and competence. Gone is the era when nurses exempted themselves from being professionally informed.

Continuing education is essential for professional development, advancement of the profession, and for the well being of clients. It leads to increases in competence, accountability, and quality of client care, as well as to increased personal and professional rewards.

John Clements, RN BN
Lockleys, South Australia

View references

Navigate: Archives | Contents | Top of page

Search

Translate

Related Publications from eContent Management