PROFESSIONALISM

MR. SHIMULAMBA D MWAMBA

GENERAL OBJECTIVE
By the end of this lecture discussion, 1st year registered
nursing students should be able to acquire the
knowledge about professionalism and be able to
explain professionalism.
SPECIFIC OBJECTIVES
• Definition of terms
• Characteristics of a profession
• Ethics
• Nursing code of ethics
• Ethical dilemmas in nursing
• Nursing etiquette
CONT…
• Ethical aspects of nursing practice
• Legal aspects of nursing practice
• Legal responsibilities of the practicing nurse and
student nurse
• Rights and obligation of a nurse
• Right and obligation of the patient/client
DEFINITION OF TERMS
PROFESSION
An occupation that requires extensive training, study
and mastery of specialized knowledge
PROFESSIONALISM
the conduct, aims or qualities that characterize a
profession or a professional person.
CONT…
PROFESSIONAL
one specialized in a particular field or occupation,
affiliated to a mother body and upholding it’s code of
conduct.
REGULATION
This simply the control of something by means of rules.
CHARACTERISTICS OF A PROFESSION
• Skills are based on theoretical knowledge:
professionals are assumed to have extensive
theoretical knowledge and to possess skills based on
that knowledge that they are able to apply in practice.
• Professional association: professions usually have
professional bodies organized by their members,
which are intended to enhance the status of their
members. The associations also have carefully
controlled entrance requirements.
CONT…
• Extensive period of education: the most prestigious
professions usually require at least three years of
university education.
• Testing of competence: before one is admitted as
member of a professional body, one is expected to
pass prescribed examinations that are mainly based
on theoretical knowledge.
CONT…
• Institutional training: in addition to examinations,
there is usually a requirement for a long period of
institutionalized training where aspiring professionals
acquire specified practical experience a trainee role
before being recognized as a full member of a
professional body. Continuous upgrading of skills
through professional development is also mandatory
in many professions.
CONT…
• Licensed practitioners: professions maintain a register
of members so that only those individuals who are
licensed are recognized as bona fide members.
• Work autonomy: professionals tend to retain control
over their work, even when they are employed
outside the profession in commercial or public
organizations. They also retain control over their own
theoretical knowledge.
CONT…
• Code of professional conduct or ethics: professional
bodies usually have a code of conduct or ethics for
their members and disciplinary procedures for those
who infringe(violate) the rules.
• Exclusion, monopoly and legal recognition:
professions tend to exclude those who have not met
their requirements. This is often termed professional
closure and seeks to decline entry for the unqualified
and to sanction or expel incompetent members.
CONT..
• Mobility: the skill, knowledge and authority of
professions belongs to the professionals as
individuals, not the organizations for which they work.
Professionals are therefore relatively mobile in
employment opportunities as they can move to other
employers and take their talents with them.
Standardization of professional training and
procedures enhances this mobility.
ETHICS
According to Lexicom (2022), ethics are moral
principles that govern a person’s behaviour or how
activities are conducted. We can further define ethics
as morals and philosophical principles that define
actions as being either right or wrong.
CONT…
Ethical concepts touch on your practice as a nurse, as
you interact with other people, the society, co-workers
and the profession. Ethical principles are particularly
important in nursing because of our role as caregivers.
ETHICAL VALUES

These are universal rules of conduct that provide a

practical basis for identifying what kinds of actions,
intentions, and motives are valued (Ostman et al.,
2019).
VALUES

A value is a personal belief about the worthy of a given

idea, attitude, custom or objects that sets standard that
influence behaviour. The values that an individual holds
reflect the cultural and social influences and personal
needs.
CONT…
Values vary among people and they develop and
change over time. Understanding one’s own value
system and assessing the value system of others helps
to facilitate decision making while ensuring respect for
client autonomy.
CONT…
Nursing involves the negotiation of values, whether the
values are those of the client, the physician, the
employer or other groups. To negotiate values, it is
important to have clarity about one’s own values, that
is, what are they, where do they come from, and how
they stand in relationship to other people’s and societal
values.
INTEGRITY

Integrity is the practice of being honest and showing a

consistent and uncompromising adherence to strong
moral and ethical principles and values. In ethics,
integrity is regarded as the honesty and truthfulness or
accuracy of one's actions.
NURSING CODE OF ETHICS
The nursing code of ethic is a set of rules and principles
that guide nurses on how to discharge their
responsibilities in a manner consistent with quality in
nursing care and the ethical obligations of the
profession. In simple terms , they are standards of
professional conduct that you must observe in your day
to day decision making.
The following is the nursing code of ethics:
• The fundamental responsibility of the nurse/midwife
is to conserve life, promote health and alleviate
suffering
• The nurse must provide nursing care in accordance
with human need and with respect for dignity of man
with no regard for race, creed, nationality,
social/political/economic standing
• The nurse must not use his/her knowledge to the
detriment(harm) of the society
CONT…
• The nurse must keep in confidence all confidential
information about his/her patients
• The nurse must be a law abiding citizen
• The nurse has the duty to uphold the efforts of his/her
profession
• The nurse must continue to develop the professional
competence and assist others do the same
CONT…
• The nurse must help to establish and maintain
professional standards in nursing
• The nurse must be concerned with all legislation
affecting the health care of human beings
• The nurse does not advertise themselves (self
promote).
• The nurse has the responsibility to teach others and
prevent unskilled and unauthorized persons from
performing tasks that may endanger the patients
ETHICAL DILEMMAS IN NURSING
A dilemma is a situation in which a difficult choice has
to be made between two or more alternatives,
especially ones that are equally undesirable (Lexicom,
2022).
What is an ethical dilemma?

• An ethical dilemma in nursing is a situation where a

nurse must decide between competing values and
know that no matter what choice they make, there
are consequences. Ethical dilemmas may conflict with
the nurse's personal values or with the Code of Ethics
for Nurses (nursingprocess.org, 2022)
CONT…
There are many things that can be considered as ethical
dilemmas in nursing, and it is important for you to
know how to address them when they occur.
CONT…
The following are some examples of ethical dilemmas
that nurses face in their day to day work:
• The nurse does not participate in unethical practices.
• Nurses are faced with the challenges of cloning or test
tube babies; in as much as the profession demands
those patients’ obligations must be first priority;
nurses are guided by their morals.
CONT…
• Cases of termination of pregnancy bring in the
weighing of benefits to whom and risks to whom.
• Patient religious beliefs have to be upheld despite
personal convictions.
• Mercy killing or euthanasia is an issue still being
debated
CONT…
• The provision of total care to a criminal is not an easy
task for nurses.
• Many at times nurses have to care for family members
despite being an issue of ethics.
• Experiments on patients being unethical are
sometimes inevitable when conducting trials of drugs.
NURSING ETIQUETTE
Etiquette means a code of good manners or rules of
common courtesy.
Therefore, nursing or hospital etiquette is respect or
courtesy between members of nursing staff, other
health personnel, patients and visitors. Some of the
rules may vary slightly from one hospital to another,
but generally they are the same in all hospitals.
CONT…
The rules of nursing etiquette include:
1. A nurse should stand in the presence of a superior,
unless permission is given to sit.
2. When receiving instructions from a doctor or ward
in-charge, the nurse should stand, looking at the
speaker, listening well and answering e.g. "Yes
sir/Madam". If there is any doubt or question,
he/she should ask the speaker to repeat at this
time, not later.
CONT…
3. If you are asked a question you should answer
immediately in a clear, distinct voice. You should be
facing the one who asked the question. Your head
should be up and your hands away from the mouth.
4. If for some reason you cannot carry out the order,
notify the ward in-charge immediately.
CONT…
5. A nurse should be thankful for all the help and
teaching he/she receives. When spoken to about a
mistake, he/she should not grumble or talk back but
should be thankful for this and learn from mistakes.
A good attitude towards one’s work and co-workers
is more important than good marks in examinations.
CONT..
6. When accompanying a doctor or ward in-charge, be
as helpful and respectful as possible. Bring in the
screens, turn down bedclothes as required and stand
on the opposite side of the bed from the doctor.
7. Each nurse should remember that he/she is a host in
the hospital. Patients should be received in a kind
manner and made to feel at home. Be courteous to
patients' their relatives and visitors.
CONT…
8. A nurse should not run except in an extreme
emergency.
9. A nurse should not visit patients while on duty. If
there are friends or relatives admitted in hospital
whom he/she wishes to visit, he/she should do so
when he/she is off duty.
10. A nurse should leave the ward only when his/her
work requires it.
CONT…
11.A nurse should never leave the ward or department
where he/she is working without telling the one in-
charge where he/she is going.
12.A nurse should come on duty punctually so that
those whom he/she relieves may go off duty
punctually.
13.A nurse should allow a more senior person to pass
through the doorway first.
CONT..
14. When answering a telephone he/she should speak
clearly, and give information about his/her name
and the ward where he/she is.
15. A nurse should not sit on a patient's bed to prevent
cross infection
LEGAL ASPECTS OF NURSING PRACTICE

As a nurse, you have legal responsibilities just like other

ordinary citizens, as well as the responsibilities imposed
by the nature of your work. Legal aspects of nursing
refers to issues pertaining to your work, which can
make you subject to lawsuits or criminal prosecution.
CONT…
It is important for you to know your rights, as well as
the rights of patients and their families in order to
understand judicial processes.
 LEGAL RESPONSIBILITIES OF THE PRACTICING
NURSE AND STUDENT NURSE

Safe nursing practice includes an understanding of the

legal boundaries within which both students and
practicing nurses must function. As with all aspects of
nursing today, an understanding of the implications of
the law supports critical thinking on the nurse’s part.
PRACTICING NURSE

Practicing nurses must understand the law in order to

protect themselves from liability and to protect their
client’s rights. Currently the public is more aware about
their rights to health care. As health care evolves in our
society, nurses must understand that the legal
implications of health care practice is also evolving.
CONT…
Nurses’ familiarity with the laws enhances their ability
to be clients advocates as well. Professional nurses
must understand there legal limits that influence their
daily practice. This, coupled with good judgement and
sound decision making, ensures safe and appropriate
nursing care.
STUDENTS

Nursing students are responsible for their own actions

and are liable for their own acts of negligence
committed during the course of clinical experiences.
When you perform duties that are within the scope of
professional nursing, such as administering an
injection, you are legally held to the same standard of
skill and competence as registered professional
nurses.
CONT…
If you harm a client as a direct result of your actions or
lack of action, you, your instructor, hospital or health
care facility and educational institution will generally
share the liability for the incorrect action. As a nursing
student, you are expected to perform as a professional
nurse would in providing safe clinical care.
CONT…
While in the clinical area, you should be assigned
activity within your capability and given reasonable
guidance and supervision by your instructor. Your
nursing instructor is responsible for assigning you to
the care of clients and for providing reasonable
supervision.
CONT…
To fulfil your responsibilities to clients and to minimize
chances for liability, you need to:
1. Make sure that you are prepared to carry out the
necessary care for the assigned clients
2. Ask for additional help or supervision in situations
where you feel inadequately prepared.
CONT…
3. Comply with the policies of the organization in
which you obtain your clinical experience.
4. Comply with policies and definitions of
responsibility supplied by your school of nursing.
POTENTIAL LIABILITIES IN NURSING

Despite the efforts of dedicated professionals,

sometimes mistakes are made and unfortunately,
patients are injured. It is essential for nurses to take out
professional liability insurance to protect their assets
and income, in case they are required to pay monetary
compensation to an injured patient.
CONT…
Liability simply means having legal responsibility for
something. As a nurse, you can be held liable for any
of the following:
1. Negligence: this is a broad category that covers:
violation of client’s rights, causing distress or
mental anguish, failure to carry out medical orders
or carrying them out incorrectly, carelessness,
failure to meet standards of care etc.
CONT…
2. Malpractice: this is negligence or carelessness on
the part of a health professional. The nurse who
fails to meet the standards of care could be
charged with malpractice if the care he/she
provides results in harm or injury to the client.
RIGHTS AND OBLIGATIONS OF A NURSE
The rights of a nurse are what the nurse is entitled to
by virtue of his/her job. It goes with the job and must
be awarded to him/her.
The following are the rights/privileges of nurses:
• Right to reasonable wages for work
• Right to be paid for working extra hour
• sight to information on patients condition which
may pose a danger to the nurse
CONT…
• Right to be respected and awarded for good deeds
• Right to review patient records and intervene
• Right to consult other colleagues or physicians
• Right to reasonable accommodation
• Right to adequate rest from work
CONT…
• Right to proceed on local, occasional, vacation and
compassionate leave
• Right to advance in studies
• Right to seek care from preferred physician
• Right to assessment and promotion
CONT…
• Right to protective clothing
• Right to belong to any political party but not display
partisan politics at work or bring ideologies to work
but support the party of the day.
WHAT IS A PRIVILEGE
A privilege is benefit or incentive that the employer or
institution provides on local arrangement but could be
withdrawn at any time without giving any notice.
Examples include:
• Accommodation
• Transport
• Bonus
CONT…
• Lunch
• Tea break
• Uniform
 RIGHTS AND OBLIGATIONS OF THE
PATIENT/CLIENT
The following are the rights of your patients/clients:
• To be treated with respect and dignity
• To privacy and confidentiality
• Freedom of choice
• To involve an advocate of their choice
CONT…
• To information that is accessible, accurate, timely &
understandable. (The right to adequate information
regarding all aspects of services provided or treatment
available, in order to make informed choices regarding
their health care. The information should be easily
understood and in an appropriate language).
• To be consulted about needs and preferences, and be
involved in decision-making
CONT…
• To have cultural needs respected
• To have one’s needs met in a professional and ethical
manner
• To give or hold consent to services and/or programs.
(The right to consent to, or to refuse treatment, or to
refuse to participate in educational or research
programs, including treatment by students)
CONT…
• To express grievances and have them dealt with fairly
• To withdraw from the service at any time
• To regular reviews of service provision to ensure care
remains appropriate.
• To receive an efficient and effective service, delivered
in a timely manner
CONT…
• The right to quality and respectful health care
regardless of gender, race, social status or sexual
preference, taking into account such things as cultural
background, health status or special needs
• The right to request transfer to another staff member
• The right to participate in decision making about their
care, in line with a mutually agreed action plan.
CONFIDENTIALITY
Confidentiality is both a legal and an ethical concern in
nursing practice. Confidentiality is the protection of
private information gathered about a patient during the
provision of health care services. The code of ethics for
nurses states that, ‘the nurse has a duty to maintain the
confidentiality of all patient information’.
CONT…
A nurse should only disclose information that is
pertinent to a patient’s treatment and welfare to those
directly involved with the patient’s care.
CONT…
Clients have rights and privileges to their protection
and privacy without diminishing their access to quality
health care. Medical records may not be copied or
forwarded without clients consent. Health care
information, including laboratory result, diagnosis, and
prognosis, should not be shared with other people
without specific client consent.
CONT…
Indeed, even family members or friends should not be
allowed to acquire a clients health care information
without the patient’s consent.
CONT…
Today, the commitment to confidentiality is particularly
challenged due to the computerization of medical
records. Preservation of confidentiality is often in
competition with the need to facilitate access to
information. In such cases health care systems may
want to use access codes to protect clients
confidentiality.
CONT…
The nurse safeguards the client’s right to privacy by
judiciously protecting information of a confidential
nature. The nurse’s code of conduct has a few
exceptions to the obligation of confidentiality. These
include:
• discussing the care of patients with others health
workers who are involved in their direct care
CONT…
• quality assurance activities
• legally mandated disclosure
• public health authorities
CONT…
The code also recognizes the need to disclose
information without the patient’s consent when the
safety of innocent parties is in question.
RIGHT TO HEALTH

All individuals in Zambia have the right to health

irrespective of their ethnic origin, political affiliation,
religious beliefs, gender, traditional beliefs, values and
practices and personal attributes. Individual citizens
have the right to get health care whenever it is needed
regardless of their ability to pay from any government
institution.
RIGHT TO REFUSE CARE

As nursing care is being provided to clients from the

time of admission to discharge, the client has the right
to refuse the care being provided during this time. It is
the responsibility of the nurse to ensure that the
client’s rights are respected.
CONT…
As care is being provided clients are consulted on every
procedure to be carried out and consent provided by
the client and his/her family members or significant
others. It is especially important to understand client’s
cultural beliefs when explaining advance directives.
RIGHT TO DIGNITY

The General Nursing Council’s (GNC) professional Code

of Conduct recognises and respects the uniqueness and
dignity of each client and responds to their need for
care, irrespective of their ethnic origin, political
affiliation, religious beliefs, gender, traditional beliefs,
values and practices, personal attributes and the nature
of their health problem or any other factors.
CONT…
The fundamental principle that underlies all nursing
practice is the respect for the inherent worth, dignity,
and human rights of every individual, irrespective of
the nature of the health problem.
CONT…
The worth of the person is not affected by diseases,
disability, functional status, or proximity to death. This
respect extends to all who require the services of the
nurse for the promotion of health, the prevention of
illness, the restoration of health, the alleviation of
suffering, and the provision of supportive care to those
who are dying.
CONT…
The measures nurses take to care for the client enable
the client to live with as much physical, emotional,
social, and spiritual well-being as possible. Nursing care
aims to maximise the values that the client has
treasured in life and extends supportive care to the
family and significant others.
THANK
YOU