what is professionalism in nursing essay

30 Examples of How to Demonstrate Professionalism in Nursing

Whether you are a nursing student or a nurse with several years of experience, you know that professionalism is a significant trait all nurses should have. While nurses are referred to as healthcare professionals, many do not understand the concept of what true professionalism encompasses. Maybe you have asked yourself, "What is professionalism in nursing?” In this article, you will find information about nursing professionalism, including 30 examples of how to demonstrate professionalism in nursing. As you continue reading, keep in mind that each nurse is responsible for developing professional characteristics and implementing those characteristics into daily practice.

What Is Professionalism In Nursing?

Who determines the standards of professionalism in nursing, 10 reasons why professionalism is so important in nursing, what are the 7 key elements of professionalism in nursing, 1. leadership:, 2. professional values:, 3. professional development:, 4. basic care competency:, 5. altruism:, 6. social justice:, 7. human dignity:, how to demonstrate professionalism in nursing, example #1: learn effective communication, how to demonstrate it in nursing practice:, why is it important in nursing:, example #2: show compassion, example #3: participate in interdisciplinary collaboration, example #4: be accountable, example #5: never stop learning, example #6: have a positive attitude, example #7: provide high-quality patient care, example #8: dress the part, example #9: be ethical, example #10: practice cultural awareness, example #11: have a “patients first” mindset, example #12: mentor other nurses, example #13: practice integrity, example #14: be detail-oriented, example #15: become a critical-thinker, example #16: help resolve conflicts, example #17: be adaptable, example #18: lead by example, example #19: make yourself a priority by practicing self-care, example #20: show respect and appreciation to your co-workers, example #21: be a faithful patient advocate, example #22: show up for work, example #23: promote safe nursing practices, example #24: pursue personal growth and development, example #25: be willing to show empathy, example #26: be sympathetic to others, example #27: practice resilience, example #28: exercise your right to practice autonomously, example #29: be confident in your abilities, example #30: be willing to accept constructive criticism and advice, what are some examples of unprofessionalism in nursing, 1. participating in or causing conflict among team members:, 2. missing work unnecessarily:, 3. not protecting patient privacy and confidentiality:, 4. taking credit for someone else’s work:, 5. avoiding responsibilities:, 6. providing misleading or false information:, 7. abandoning patient care:, 8. accepting an unsafe patient assignment:, 9. failure to maintain professional boundaries with clients or their families:, 10. using unsafe practices:, consequences of unprofessional conduct in nursing, 1. increased absenteeism:, 2. hostility among staff:, 3. disciplinary action:, 4. loss of license:, 5. damaged professional reputation:, 5 most-common challenges to professionalism in nursing practice and how to overcome them, challenge #1: maintaining positive relationships with unprofessional peers, what is it:, how to overcome:, challenge #2: knowing where to draw the line with nurse-patient relationships, challenge #3: dealing with rude patients, challenge #4: unprofessional work environment, challenge #5: emotionally charged situations, 5 tips to enhance professionalism with patients in nursing practice, 1. make patient care a priority., 2. take time to hear what your patient needs to say., 3. speak up on your patient’s behalf., 4. protect your patient’s privacy., 5. demonstrate high standards of care., 5 tips to enhance professionalism with co-workers in nursing practice, 1. be honest with yourself., 2. encourage and participate in team collaboration., 3. recognize the accomplishments and contributions of your co-workers., 4. be accountable to your team members., 5. invite co-workers to join professional nursing associations with you., bonus useful resources to learn more about professionalism in nursing, blogs/websites, youtube videos, my final thoughts, frequently asked questions answered by our expert, 1. does nursing require a higher level of professionalism compared to other healthcare careers, 2. what are professional boundaries in nursing, 3. why nurses should set boundaries to maintain professionalism in nursing, 4. what is professional presence in nursing, 5. what is professional misconduct in nursing, 6. what is personal and professional development in nursing, 7. what is professional caring in nursing, 8. what is professional communication in nursing, 9. what is professional competence in nursing, 10. what is professional advocacy in nursing, 11.what is professional accountability in nursing, 12.what is professional socialization in nursing, 13.how does professionalism in nursing influence health policy, 14.how complaining in the nursing profession hurts professionalism, 15.how should professionalism be evaluated in nursing, 16.how do nursing schools teach professionalism, 17.what are the top 3 professional goals every nursing student should aim for.

Domain 9: Professionalism

Descriptor: Formation and cultivation of a sustainable professional identity, including accountability, perspective, collaborative disposition, and comportment, that reflects nursing’s characteristics and values.

Contextual Statement: Professionalism encompasses the development of a nursing identity embracing the values of integrity, altruism, inclusivity, compassion, courage, humility, advocacy, caring, autonomy, humanity, and social justice. Professional identity formation necessitates the development of emotional intelligence to promote social good, engage in social justice, and demonstrate ethical comportment, moral courage, and assertiveness in decision making and actions. Nursing professionalism is a continuous process of socialization that requires the nurse to give back to the profession through the mentorship and development of others.

Professional identity, influenced by one’s personal identity and unique background, is formed throughout one’s education and career. Nursing identity flourishes through engagement and reflection in multiple experiences that is defined by differing perspectives and voices. As a result, nurses embrace the history, characteristics, and values of the discipline and think, act, and feel like a nurse. Professional identity formation is not a linear process but rather one that responds to challenges and matures through professional experiences as one develops confidence as a nurse.

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Entry-Level Domain 9 Competencies

9.1 Demonstrate an ethical comportment in one’s practice reflective of nursing’s mission to society.

9.1a Apply principles of professional nursing ethics and human rights in patient care and professional situations.

9.1b Reflect on one’s actions and their consequences.

9.1c Demonstrate ethical behaviors in practice.

9.1d Change behavior based on self and situational awareness.

9.1e Report unethical behaviors when observed.

9.1f Safeguard privacy, confidentiality, and autonomy in all interactions.

9.1g Advocate for the individual’s right to selfdetermination.

9.2 Employ participatory approach to nursing care.

9.2a Employ the use of intentional presence to facilitate shared meaning of the experience between nurse and recipient of care.

9.2b Facilitate health and healing through compassionate caring.

9.2c Demonstrate empathy to the individual’s life experience.

9.2d Advocate for practices that advance diversity, equity, and inclusion.

9.2e Demonstrate cultural sensitivity and humility in practice.

9.2f Apply principles of therapeutic relationships and professional boundaries.

9.2g Communicate in a professional manner.

9.3 Demonstrate accountability to the individual, society, and the profession.

9.3a Engage in advocacy that promotes the best interest of the individual, community, and profession.

9.3b Demonstrate the moral courage to report concerns related to actual or potential hazards and/ or errors.

9.3c Demonstrate professional and personal honesty and integrity.

9.3d Take responsibility for one’s roles, decisions, obligations, actions, and care outcomes.

9.3e Engage in professional activities and/or organizations.

9.3f Demonstrate adherence to a culture of civility.

9.3g Advocate for social justice and health equity, including addressing the health of vulnerable populations.

9.3h Engage in peer evaluation.

9.4 Comply with relevant laws, policies, and regulations.

9.4a Advocate for policies that promote health and prevent harm.

9.4b Adhere to the registered nurse scope and standards of practice.

9.4c Adhere to regulatory requirements and workplace policies consistent with one’s educational preparation.

9.5 Demonstrate the professional identity of nursing.

9.5a Describe nursing’s professional identity and contributions to the healthcare team.

9.5b Demonstrate the core values of professional nursing identity.

9.5c Demonstrate sensitivity to the values of others.

9.5d Demonstrate ethical comportment and moral courage in decision making and actions.

9.5e Demonstrate emotional intelligence

9.6 Integrate diversity, equity, and inclusion as core to one’s professional identity.

9.6a Demonstrate respect for diverse individual differences and diverse communities and populations

9.6b Demonstrate awareness of personal and professional values and conscious and unconscious biases.

9.6c Integrate core principles of social justice and human rights into practice.

Advanced-Level Domain 9 Competencies

9.1h Analyze current policies and practices in the context of an ethical framework.

9.1i Model ethical behaviors in practice and leadership roles.

9.1j Suggest solutions when unethical behaviors are observed.

9.1k Assume accountability for working to resolve ethical dilemmas.

9.2h Foster opportunities for intentional presence in practice.

9.2i Identify innovative and evidence-based practices that promote person-centered care.

9.2j Advocate for practices that advance diversity, equity, and inclusion.

9.2k Model professional expectations for therapeutic relationships.

9.2l Facilitate communication that promotes a participatory approach.

9.3i Advocate for nursing’s professional responsibility for ensuring optimal care outcomes

9.3j Demonstrate leadership skills when participating in professional activities and/or organizations.

9.3k Address actual or potential hazards and/or errors.

9.3l Foster a practice environment that promotes accountability for care outcomes.

9.3m Advocate for policies/practices that promote social justice and health equity.

9.3n Foster strategies that promote a culture of civility across a variety of settings.

9.3o Lead in the development of opportunities for professional and interprofessional activities.

9.4d Advocate for polices that enable nurses to practice to the full extent of their education.

9.4e Assess the interaction between regulatory agency requirements and quality, fiscal, and valuebased indicators.

9.4f Evaluate the effect of legal and regulatory policies on nursing practice and healthcare outcomes.

9.4g Analyze efforts to change legal and regulatory policies that improve nursing practice and health outcomes.

9.4h Participate in the implementation of policies and regulations to improve the professional practice environment and healthcare outcomes.

9.5f Articulate nursing’s unique professional identity to other interprofessional team members and the public.

9.5g Evaluate practice environment to ensure that nursing core values are demonstrated.

9.5h Identify opportunities to lead with moral courage to influence team decision-making.

9.5i Engage in professional organizations that reflect nursing’s values and identity.

9.6d Model respect for diversity, equity, and inclusion for all team members.

9.6e Critique one’s personal and professional practices in the context of nursing’s core values.

9.6f Analyze the impact of structural and cultural influences on nursing’s professional identity.

9.6g Ensure that care provided by self and others is reflective of nursing’s core values.

9.6h Structure the practice environment to facilitate care that is culturally and linguistically appropriate.

9.6i Ensure self and others are accountable in upholding moral, legal, and humanistic principles related to health.

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Professionalism in Nursing: An Integrative Review of the Literature

2023, Journal of Holistic Nursing and Midwifery

Professionalism in nursing is a fundamental concept for providing effective and high-quality nursing care. Due to the complexity and multiple sides of this concept, it lacks a clear and precise definition. This ambiguity has created different and even poor interpretations of meanings and characteristics, making its accurate measurement difficult. Objective: This study aims to review the literature to provide the definition and attributes of "professionalism in nursing" and formulate a conceptual model for it. Materials and Methods: In the present study, the integrated review method was used in five stages: Specifying the problem, searching the literature, evaluating and extracting data, analyzing data, and presenting the results. The studies published in English or Persian were searched in international databases, such as CINAHL, EBSCO, PubMed, ProQuest, The Cochrane Library, EMBASE, SAGE, Science Direct, and Google Scholar search engine, as well as national databases, including SID, MagIran, IranDoc, and the medical sciences theses search engine. Results: After reviewing and analyzing 54 studies (17 qualitative studies, 27 quantitative studies, 4 mixed-method studies, 4 review studies, and 2 guidelines), the definition, attributes, antecedents, and consequences of "professionalism in nursing" were stipulated. The attributes included academic specialized knowledge, continuous pursuit of competence, autonomy, professional commitment, professional interaction, accountability, adherence to ethical principles and values, and advocacy. The antecedents were personal/occupational, organizational, and social factors. The consequences were individual and social outcomes. Conclusion: The results of integrative review of the literatures showed professionalism in nursing has evolved and encompassed new attributes and dimensions. Due to the comprehensiveness of the provided conceptual model, it can be used to design a tool to evaluate the professional qualities of nurses in their jobs.

Related Papers

Frontiers of Nursing

leila Afshar

Objective In today's world with sweeping changes, nurses are responsible for providing high-quality and cost-benefit care, which would almost be impossible unless they achieve their high professional status. To date, no precise and comprehensive definition of professionalism in nursing has been evidently proposed. In fact, many of the previously proposed definitions are either complicated or ambiguous. Moreover, there is no consensus in the literature on an exhaustive definition for “a professional nurse.” The present study aimed to illustrate the concept of professionalism in nursing and identify its defining characteristics. Methods In this study, concept analysis was conducted using Whittemore et al.'s method for the integrated review. A comprehensive search of electronic, scientific databases including Eric, PubMed, Scopus, Web of Science, EBSCO, PsychoINFO, Embass, MagIran, IranDoc, SID, and IRANMEDEX was carried out using the keywords such as professionalism, professio...

Maryam Momeni

Professionalism is a fundamental and elementary concept in nursing. The demand for nursing professionalization has become greater than ever in recent years. The present study aimed to examine Iranian registered nurses level of professionalism and associated factors. Methods: In this exploratory cross-sectional study, all qualified registered nurses working in two teaching hospitals (Imam Sajad and Rajaei hospitals) in North of Iran were invited to participate. The Hall's Professionalism Inventory (HPI) scale was used to assess the nurse’s level of professionalism. All statistical analyses were performed using SPSS software (v17.0; PASW Statistics). Results: Of the 133 nurses, 83.5% (n=111) were female and 16.5% (n=32) were male. The mean age of participants was 33.5±8.4 years and mean years of experience was 8.4±7.7 years. The mean score of nurse’s professionalism in all domains were 68.5±6.8. With regards to HPI scale domains, higher and lower mean score were related to autonom...

Journal of Professional Nursing

Filiz Hisar

International journal of nursing knowledge

mahvash salsali , Mohammad-Ali Cheraghi

The present study was conducted with the aim of clarifying and reducing the semantic ambiguities around the concept of professionalism. The concept analysis method of Walker and Avant was used. The analysis demonstrated that professionalism in nursing consists of three main pillars: principles of care, communication, and ethics. Given that the process of professionalism in nursing may have positive outcomes for the nurse, the nursing profession, and the health system of the community, these items have been attended to. The present concept analysis can open the way to conducting more extensive research and devising tools to identify the barriers, facilitators, and administrative arrangements by clarifying the concept.

Journal of Professional Nursing - J PROF NURSING

Christine Wynd

A serious nursing shortage is creating a crisis in the nation’s health care system. Many experienced nurses are leaving the field and young people are not selecting nursing as a potential career. Reassessment of professionalism in nursing therefore is indicated. A descriptive comparative/correlational design examined differences and relationships among levels of nursing professionalism, experience, educational degrees, organizational membership, and specialty certification in a random sample of registered nurses (RNs) (N = 774). The Professionalism Inventory Scale was used to measure attitudinal attributes of professionalism and its five dimensions (use of professional organizations as major referent groups, belief in public service, autonomy, self-regulation, and a sense of calling). A series of statistical analyses revealed that professionalism was related significantly to years of experience as an RN, higher educational degrees in nursing, membership in organizations, service as ...

Journal of Caring Sciences

Gulsah Arslan

Bakirkoy Tip Dergisi / Medical Journal of Bakirkoy

Emine Şenyuva

Journal of Nursing Scholarship

Dr. Lobna Khamis Mohamed

Lobna Ibrahim

Context: Professionalism is an essential ingredient in the nursing profession that begins during the foundational educational program when the student nurses learn the knowledge, skills, and attitudes and continue during their practices in the real world. Aim: This research aimed to assess the main attributes of professionalism among undergraduates nursing students and nurses. Methods: This study utilized a descriptive comparative correlational design. The current study was conducted in the faculty of nursing, as well as in Intensive Care Units, Neonatal Intensive Care Units, Cardiac Care Units, and Neurology Intensive Care Units at Tanta University Hospital. Subjects. The sample consisted of (897) nursing students and (149) nurses. The data collection's tool was the nursing professionalism attributes' questionnaire that was developed by the authors. It contains three dimensions, including; professional identity (12 statements), professional ethics (12 statements), and professional behaviors (16 statements). Results: This study suggested that the undergraduate nursing students perceived the high mean score in all professionalism attributes more than the practicing nurses did. Conclusion: This study concluded that the development of professionalism in nursing is an essential feature of the nursing profession and practice. The nurse students were high in areas of patients and colleagues' rights, obeying orders, commitment and collaboration, physical appearance, continuing education, and caring of the patient. While the nurses had very low scores in membership in the nursing association, autonomy, and research areas, this study recommended the encouragement of nurses and students' participation in scientific research activities, including; membership in professional organizations or associations, attending nursing conferences/workshops/symposium as a producer or consumer, and fellowship.

Procedia - Social and Behavioral Sciences

Gökhan Yilmaz

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Professionalism in Nursing: What It Is and Why It Matters

Professionalism is essential in nursing, and it starts with the individual nurse. 

Nursing is a career that requires a high level of professionalism. Professionalism in nursing means being respectful, empathetic, and reliable and going the extra mile to ensure patients receive the best care possible. It also means adhering to the highest standards of  ethical and legal conduct , taking responsibility for one's actions, and being a  role model to other nurses . It is of utmost importance that nurses maintain a professional attitude and demeanor at all times, as this plays a crucial role in providing quality patient care. 

What is Professionalism in Nursing? 

Professionalism in nursing  refers to the care nurses provide to their patients while consistently demonstrating the values that characterize them, such as respect, integrity, and accountability.

Nursing is a profession that requires a lot of trust from patients. A patient completely surrenders to the care of nurses. When they are excellent nurses, the results tend to be positive since their professionalism helps make nursing a worthy and noble profession.

A great nurse is someone who knows how to show the values that define empathy and professionalism, and regardless of their level within the nursing career, consistently demonstrates to patients the commitment they have. This is why professionalism is essential.

Sometimes some stories may cause the impression that nurses have too much control in their hands, and patients may be afraid to put their trust and their lives or their health in the hands of nurses. Thanks to the professionalism demonstrated by most nurses nationwide, this is only sometimes the case. Still, nursing is nationally regarded as the noblest profession to perform.

Nursing Professional Development

Even when working under pressure, nurses must respond in the same professional manner. This involves obtaining the skills to answer correctly in three critical areas:

• Cognitive area.  Continuous learning is essential in nursing professionalism. This means ongoing education and training in as many areas as possible, which is reflected in the nurses' work. This learning helps improve the way nurses act and make critical decisions in the most effective way possible.
• Attitude area.  Generally, the attitudinal area of professionalism is on par with what is expected in healthcare organizations and on par with global goals. In general, it refers to attitudes and ideas that help advance and sustain the work of nurses, with the understanding that nurses need to give up a lot for the wellness of their patients.
• Psychomotor area.  Throughout the nursing profession, there are many obligations that nurses can fulfill through their discipline and learning, generally referring to improving in the psychomotor areas and constantly learning about them.

Through these three areas, nurses are committed to higher nursing goals and can better develop the professionalism that distinguishes them.

How to Achieve More in My Nursing Career?

There are many ways to achieve more. For example, demonstrating professionalism in the nursing career through:

• Teamwork .  This requires nurses to stick to working with other healthcare professionals, with the motto of always thinking of their patients first, which tremendously demonstrates their commitment and professionalism to nursing.
• Advocate for patients.   In general, not being afraid to support patients in public and always look out for their welfare within the multidisciplinary team. Thinking of patients as they would think of themselves is a rare and precious quality.
• Effective communication.   For excellent teamwork, it is necessary to know how to communicate ideas in the best possible way so that any receiver can understand, comprehend and apply what needs to be done.
• A positive attitude.  Nothing reflects professionalism more than maintaining a positive attitude. Nurses can do this by being confident in the care they provide and the team they have.
• Maintain integrity and principles.  No matter how many complex cases they handle, nurses must stand by their principles and do their best to demonstrate their commitment to their profession.
• Deliver the best possible care.  By providing impeccable care, nurses can demonstrate that they are genuinely committed to their patients and the institution they represent.

All of these aspects are equally important, and there are a few skills to enhance them little by little, so it is recommended that any training or course taken should have these four core principles:

• The ability to resolve conflicts will improve communication, therefore improving teamwork.
• Adaptability in any situation. For example, when  working PRN shifts,  nurses must adapt to any situation the employer needs.
• Critical thinking. One of the most essential skills is knowing how to respond to situations as best and quickly as possible. By improving critical thinking, nurses can improve their ability to respond to conflicts or daily situations in their jobs.
• Leadership. Leadership, as knowing how to lead and delegate, is one of the most essential skills to improve the care nurses provide.

Through professionalism, nurses can improve and be remembered positively wherever they work, hence the importance of constantly improving these skills. Objectively, nursing is already considered a noble profession, given its professional implications. Still, nurses can devote more time to enhancing others' views of the profession, especially in these problematic post-pandemic times. In that case, they can restore hope and faith in medicine and get better care opportunities for the general population.

Miranda is a Registered Nurse, Medical Fact Checker, and Publishing Editor at Nursa. Her work has been featured in publications including the American Nurses Association (ANA), Healthcare IT Outcomes, International Living, and more.

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• Open access
• Published: 07 February 2023

What is nursing professionalism? a concept analysis

• Huili Cao 1 , 2 ,
• Yejun Song 3 ,
• Yanming Wu 1 ,
• Yifei Du 1 ,
• Xingyue He 1 ,
• Yangjie Chen 4 ,
• Qiaohong Wang 1 , 4 &
• Hui Yang 1 , 4  

BMC Nursing volume  22 , Article number:  34 ( 2023 ) Cite this article

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Nursing professionalism plays an important role in clinical nursing. However, a clear conceptual understanding of nursing professionalism is lacking.

Walker and Avant’s strategy was used to analyse the concept of nursing professionalism. We searched electronic databases, including PubMed, Scopus, and CINAHL, for studies published from 1965 to 2021. Quantitative or qualitative studies published in English that focused on nursing professionalism were included in the study.

The three attributes of nursing professionalism are multidimensional, dynamic, and culture oriented. Based on the analysis, nursing professionalism is defined as providing individuals care based on the principles of professionalism, caring, and altruism.

Conclusions

This study offers a theoretical definition and conceptual model of nursing professionalism that may be applied to develop standardized assessment tools or nursing professionalism training programs.

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Introduction

The COVID-19 outbreak has exposed deficiencies in the underinvestment of the global health system, including the shortage in nursing resources and nursing staff, and a similar situation is noted in China ( https://www.icn.ch/news/investing-nursing-and-respecting-nurses-rights-key-themes-international-nurses-day-2022 ). An unbalanced number of nurses and patients, high work pressure, lack of social occupational identity and other reasons have led to job burnout, low job satisfaction, and even the resignation of many nurses. Research has also shown that the lack of nursing professionalism adversely affects patient care and patient outcomes [ 1 ]. Ohman [ 2 ] pointed out that lower levels of professionalism may cause negative outcomes, such as turnover and attrition and lower productivity.

In recent years, researchers have tried to solve the above problems through professionalism.

However, nursing professionalism plays a more important role in clinical nursing. Some studies have shown that professionalism can improve the professional knowledge and skills of nurses and ameliorate reductions in institutional productivity and quality [ 3 ]. Higher levels of professionalism can improve nurses’ autonomy and empowerment, increase their recognition and facilitate organizational citizenship behaviours, establish nursing care standards and even improve quality services [ 4 , 5 ].

Nursing professionalism has been discussed for several decades. Hall (1968) developed the Professionalism Inventory Scale [ 6 ]. Miller et al [ 7 ] (1993) first specified the 9 standards criteria of nursing professionalism (educational background; adherence to the code of ethics; participation in the professional organization; continuing education and competency; communication and publication; autonomy and self-regulation; community service; theory use, development, and evaluation; and research involvement.). Yeun et al. (2005) summarized five themes regarding nurses’ perceptions of nursing professionalism: self-concept of the profession, social awareness, professionalism of nursing, the roles of nursing services, and originality of nursing [ 8 ]. Yoder defined nursing professionalism based on six components: acting in the patients’ interests; showing humanism; practising social responsibility; demonstrating sensitivity to people’s cultures and beliefs; having high standards of competence and knowledge; and demonstrating high ethical standards [ 9 ]. Although some researchers have explored the concept of professionalism. How can professionalism be evaluated in nursing clinical practice? Few studies have shown a clear conceptualization of nurses’ professionalism [ 10 , 11 ]. To nurture nursing professionalism, the concept of professionalism must be clarified.

Given that the meaning of professionalism varies across time, contexts, or cultures, it is difficult to define, quantify or measure professionalism [ 12 , 13 ]. The operational definition of nursing professionalism in studies has shortcomings. Sullivan et al. [ 14 ] found professionalism to be a multidimensional concept, but some papers have addressed only one dimension, such as values [ 15 ] or behaviours [ 16 ]. Moreover, professionalism is considered a complex concept. The links and dynamic processes between these different inner characteristics have not been included in the concept. Thus, a comprehensive definition of nursing professionalism, including its characteristics and the relations between them, is necessary.

Recognizing and understanding the concept of nursing professionalism may be an essential step towards providing quality care for people. It may also provide more information for further developing nursing professionalism for nurses.

Method of concept analysis

Walker and Avant’s method used linguistic philosophy techniques to contribute to the philosophical understanding of a concept [ 17 ]. The W & A method is considered a mark of the positivist paradigm, which views the concept as a stable factor that can be reduced or extracted from its context of application [ 18 ]. This study used Walker and Avant’s method, which assumes that nursing professionalism is a relatively mature and stable concept (numerous studies on nursing professionalism have been published to date). This approach to conceptual analysis, although not perfect, is helpful in clarifying the concept of nursing professionalism.

Using the structured method of Walker and Avant enables conceptual clarity to be obtained based on an inductive identification of the concept’s attributes, antecedents and consequences. The concept analysis helps to clarify meanings and develop operational definitions, considering evidence from a wide range of information resources for further research or clinical practice [ 17 , 19 ]. These features make this method particularly useful for the analysis of the concept of ‘nursing professionalism’. The conceptual attributes as well as antecedents and consequences are based on the research team's analysis of the literature using Walker and Avant’s strategy and are not the product of a priori theoretical categories.

Walker and Avant’s [ 17 ] eight-step method includes the following: 1) selecting a concept; 2) determining the aims or purposes of analysis; 3) identifying all uses of the concept; 4) determining the defining attributes of the concept; 5) constructing a model case; 6) constructing borderline, contrary, invented, and illegitimate cases; 7) identifying antecedents and consequences; and 8) defining empirical references.

Selection criteria

The inclusion criteria were as follows: related to the concept of nursing professionalism; included nurse professionalism, nursing spirit, or nurse spirit; written in the English language; qualitative, quantitative, mixed methods or systematic reviews; published between 1965 and 2021 (when professionalism was first introduced by nursing in 1965); and published in books or dictionaries. We excluded articles published in nonpeer reviewed journals, editorials and letters to the editor.

Data sources

We searched several online databases, including PubMed, Scopus, and CINAHL, for articles published from 1965 to 2021. We searched the words that appear in the title, abstract, and keyword section of the studies.

(((((((((Nursing professionalism[Title]) OR (Nursing professionalism[Title/Abstract])) OR (Nurse professionalism[Title])) OR (Nurse professionalism[Title/Abstract])) OR (Nursing spirit[Title])) OR (Nursing spirit[Title/Abstract])) OR (Nurse spirit[Title])) OR (Nurse spirit[Title/Abstract])).

TI Nursing professionalism OR AB Nursing professionalism OR TI Nurse professionalism OR AB Nurse professionalism OR TI Nursing spirit OR AB Nursing spirit OR TI Nurse spirit OR AB Nurse spirit.

TITLE-ABS-KEY (Nursing professionalism) OR TITLE-ABS-KEY (Nurse professionalism) OR TITLE-ABS-KEY (Nursing spirit) OR TITLE-ABS-KEY (Nurse spirit).

Any quantitative or qualitative studies published in English focusing on nursing professionalism were included in the study. Two researchers independently screened titles and abstracts to determine the selection criteria for electronic retrieval and application. The study was included only when both researchers agreed that the study met the inclusion and exclusion criteria. If the two researchers’ judgements were different, a third person was consulted to resolve the issue. Researchers identified the different usages of the concept and systematically recorded the characteristics of the concept that appeared repeatedly [ 17 ].

We used definitions and examples in the systematic record (Table 2 ) to define a cluster of antecedents, attributes and consequences (Figs. 1 and  2 ) frequently associated with the concept [ 20 ].

Flowchart of the study selection process of the concept analysis

We identified 6013 studies on nursing professionalism. After excluding duplicates, irrelevant studies, studies that were not original scientific studies or articles, and studies published in languages other than English, 138 studies were selected for analysis. Tables 1 and 2 show some typical literatures used in this study.

Uses of the concept

Dictionary definitions of the concept.

The Merriam-Webster Dictionary defines professionalism as ‘the conduct, aims, or qualities that characterize or mark a profession or a professional person’ [ 48 ], whereas the Cambridge Dictionary [ 49 ] defines professionalism as ‘the combination of all the qualities that are connected with trained and skilled people’. These definitions are generic and difficult to use to clarify the factors involved in nursing professionalism.

Definitions of the concept reported in the literature

Hwang et al. [ 50 ] defined professionalism as commitment to a profession and professional identity level. Health-care workers demonstrate professionalism through attitudes, knowledge, and behaviours, which reflect approaches to the regulations, principles, and standards underlying successful clinical practices [ 33 ]. Nursing professionalism reflects the value orientation, concepts of nursing, work attitude and standards of clinical nurses [ 51 ].

Subconcepts

The Nightingale Spirit, named in honour of the founder of professional nursing, refers to the spirit of altruism, caring, and honesty [ 52 ]. In the past, the Nightingale Spirit advocated that nurses are willing to dedicate themselves, but the term currently encompasses more innovation [ 53 ]. E-professionalism is defined as evidence provided by digital means, attitudes and behaviours reflects the traditional models of professionalism [ 54 ]. Nurses use the internet to communicate about work or daily life, blurring the boundaries between individuals and professions; thus, e-professionalism applies to nurses [ 55 ].

The defining attributes of nursing professionalism

The defining attributes of the concept aim to understand its meaning and differentiate it from other related concepts [ 17 ]. The key defining attributes are as follows.

Nursing professionalism is multidimensional

Nursing professionalism is a three-dimensional concept based on the knowledge, attitudes, and behaviours that underlie successful clinical practice [ 33 ].

Professionalism can be conceptualized as a ‘systematic body of knowledge’ with complex configurations of work expertise [ 21 ].

Professionalism refers to the attitude that represents levels of recognition and commitment to a particular profession [ 22 ]. Hall [ 6 ] noted that nurses’ attitudes have a high correspondence with the behaviours of the respondent. Measuring professionalism at the cognitive level can be thought of as measuring potential professionalism at the behavioural level. Researchers noted that given the reduced restrictions of environmental constraints, measuring professionalism at the cognitive level may be more precise than measuring it at the behavioural level [ 23 ].

Nursing professionalism is often described as a set of professional behaviours [ 11 ]. Some researchers judge whether nurses exhibit professionalism through their behaviours. Miller [ 24 ] (1988) developed the Wheel of Professionalism in Nursing Model. The model is considered a framework for understanding professional behaviours among nurses. Kramer [ 56 ] (1975) quantified professionalism by assessing the number of professional books purchased, subscriptions to journals, and the number of articles published.

In addition, the perspective of professional identity formation complements the behaviour-based and attitude-based perspectives on professionalism [ 57 ].

The formation and development of professionalism are dynamic processes

Nursing professionalism is an inevitable, complex, varied, and dynamic process [ 58 ].The professionalism concept is considered ever-changing, replacing static or definitive views [ 59 ].

Socialization process

Nursing professionalism is instilled through a process of socialization in formal nursing education [ 25 ]. Nurses’ socialization process begins with formal, entry-level education to acquire knowledge and skills.

Yeun et al. [ 8 ] (2005) discussed the developmental process of nursing professionalism in which the individual’s thoughts and beliefs are formed by socialization factors through perception. These thoughts and beliefs may in turn influence the individual’s professional image or self-concept, thereby influencing nurses’ actions and performance.

Process of interaction

The dynamic of professionalism is also reflected in the process of interaction. Dehghani et al. [ 26 ]noted that nursing professionalism means the appropriate interaction of the individual and the workplace and the maintenance of interpersonal communication.

Culture oriented

One study showed that altruism is an essential element of medical professionalism in Asia or North America but not Europe [ 27 ]. In China, medical professionalism was influenced by its longstanding Confucian traditions [ 28 ]. Therefore, any definitions of professionalism should match its rooted culture and be validated with respect to the culture and context in which it is applied [ 60 ].

The connotation of nursing professionalism

Professional, having a systematic nursing knowledge system.

The nursing process is considered a method for solving problems or dilemmas in a logical and scientific manner [ 11 ]. Freidson [ 29 ] (2001) noted that professionals perform their specialized work only with the required training and experience. Professionals have specific, tacit, almost esoteric knowledge to do their work [ 61 ]. Miller et al. [ 7 ] considered that a formal university education with a scientific background is critical for professionalism in nursing.

Professional certification

Nurses actively seek specialty certification given their personal commitment to the nursing profession [ 30 ]. Specialty certification promotes nursing professionalism. When attaining the highest levels of clinical knowledge, nursing professionalism also indicates personal responsibility and dedication to best practices [ 31 ].

Lifelong learning and participation in continuing education

Due to professional and ethical obligations, nurses should sustain continuous professional growth and development to maintain individual competence. Professional growth in nursing requires lifelong learning. Lifelong learning includes continuing education and self‐study, seeking advanced degrees, etc. [ 62 ].

Continuing education is one of the indicators of professionalism. Professionals keep up with the latest developments in the field and partake in continuing education. Additionally, continuing education is as important as other criteria for increasing professionalism in nursing [ 7 , 32 ]. Ongoing education brings fresh knowledge to health care, consequently leading to more efficient and quality service for people.

Evidence-based practice

Evidence-based practice (EBP) is a hallmark of professionalism [ 33 ]. Dollaghan [ 63 ] (2004) reported that we identify and use the highest quality scientific evidence as an integral part of our efforts to provide the best patient care; EBP is a knowledge base that responds to specific clinical issues in a clear, intelligent, and serious manner while considering clinical practice in the context of the highest-quality scientific evidence available.

Innovation in nursing helps to improve patient care quality and improve nurses’ job performance [ 64 ]. Shen et al. [ 34 ] noted that innovative education plays an important role in the professional quality of undergraduate nursing students.

Striving for excellence

Striving for excellence is a requirement and attribute of nursing professionalism. There is a growing need in nursing practice to possess knowledge and skills in quality improvement science, translational research, and implementation science [ 35 ]. Clinical nurses have the same responsibilities as nursing scientists.

Caring is considered the core attribute of nursing professionalism

The practice of caring is central to nursing [ 65 ]. Caring is defined as the moral ideal of nursing [ 36 ]. Therefore, caring is an important core attribute of nursing professionalism.

Creating a caring-healing environment

Nurses devoted to creating a caring-healing environment embody professionalism. Caring means nurses should create a healing environment at all levels by providing a supportive, protective environment as well as a corrective mental, physical, societal, and spiritual environment for patients. People’s basic needs include a clean environment, comfort measures, safety concerns, and feeling safe or protected [ 65 ].

Displaying kindness/concern/empathy for others

A nurse is defined as someone caring for the ill within the hospital setting [ 66 ]. Caring means showing or having compassion, concern and empathy for others [ 37 ]. Caring behaviours are an interactive and mental process between patients and nurses [ 38 ]. Displaying kindness and concern for others is shown by love, compassion, support and involvement [ 39 ].

Using all methods of knowing support and involvement

‘Human problems reside in ambiguity, paradox, and impermanence’. Therefore, suffering, healing, miraculous cures, and synchronicity are all part of knowing support and involvement.

Researchers suggest that nursing comprises Caritas Nursing, Energy Nursing, Transpersonal Nursing, Holistic Nursing, or Contemplative Nursing…… It goes beyond ordinary nursing. Nursing should have higher standards with excellence for caring, healing, and peace in the world. Therefore, caring means using all methods of knowing support and involvement [ 65 ].

Embracing the unknowns and miracles in life and practising loving

Nursing is a special profession. Nurses confront special circumstances daily and witness people’s struggles with life and death. Everyone has his or her own specific story about his or her experiences and predicaments. Each person seeks his or her own meanings to find inner peace and balance in the midst of fear, doubts, despair, and unknowns. Therefore, the care of nurses is not to blindly sacrifice their own needs but to be a real nurse, embracing the unknowns and miracles in life and caring for patients [ 65 ].

The central tenet of professionalism is to put the needs and best interest of others over self-interests. Altruism is an engagement in caring acts towards others without expecting something in return [ 67 ].

Patients first

To be altruistic means to put others’ needs before your own. Altruism is the selfless concern for others and doing things with the other person’s well-being in mind [ 40 ].

During pandemics, nurses were considered to have a high sense of duty and dedication to patient care [ 41 ]. Front-line nurses perceive high work engagement, especially in self-dedication [ 42 ]. Grøthe et al. [ 43 ] showed that cancer patients in a palliative unit appreciate nurses who have the most dedication and expertise characteristics.

Public service

Due to a strong sense of civic and social responsibility, nurses participate in public service. Nurses volunteer as participants in summer camps, schools, or health-care teams. Nurses are also committed to responding to large-scale crises, such as the terrorist attacks on the World Trade Center in New York, as well as national and international relief efforts, such as tsunamis and Hurricane Katrina [ 44 ].

Disaster and infectious disease rescue

Individuals involved in providing disaster relief face many challenges, experience fatigue and personal suffering, and encounter numerous personal stories of life and death [ 45 ]. Nurses have played a significant role in the fight against infectious diseases such as severe acute respiratory syndrome (SARS) and the coronavirus disease 2019 (COVID-19) pandemic [ 68 ]. Nurses are closest with patients. Nurses provide intensive care, regularly assessing and monitoring airways, tubes, medications, and physical therapy. Nurses are also devoted to reducing complications. Nurses assist with daily living activities when patients are unable to care for themselves [ 46 ].

Community service

In addition, emphasizing professionalism means respecting values and commitment to community service delivery [ 69 ].

According to Walker and Avant [ 17 ], cases help further clarify concepts.

Model cases (a real case example)

Model cases help demonstrate all the defining attributes of a concept and helps to better articulate its meaning [ 17 ].

MS A is a 63-year-old nursing director. She worked in clinical nursing and management for 42 years. As she progressed from a new nurse to a nursing expert, she gradually poured her enthusiasm (Multidimensional: Attitudes) into nursing work (Dynamic). She believes that the core of nursing professionalism in China is dedication and responsibility (Culture oriented). In 2020, COVID-19 broke out in Wuhan, China. She led a team to Wuhan to provide support (Multidimensional: Behaviours), reflecting the spirit of altruism (Altruism). She actively promoted exchanges and cooperation among disciplines and the development of academic conferences. She guided students to pay attention to practical innovation and develop evidence-based innovations (Professional). Although she is retired, she still imparts knowledge and experience to students everywhere (Multidimensional: Behaviours). She stated that the development of nursing professionalism is very difficult and requires nursing education and role models. (Multidimensional: Knowledge). The role of a nurse is like that of a mother, bringing care to the people (Caring).

Borderline cases (a real case example)

Borderline cases provide the examples that contain the most defining attributes of the concept [ 17 ].

B is a novice nurse. When working in the infection ward, she was so worried about being infected. She was reluctant to care for patients and wanted to escape from the ward environment. Fortunately, her nurse manager fully understood her situation and helped her adapt to work and reduce her anxiety. B observed that her nurse manager had been helping patients solve problems and giving them comfort and hope. This prompted her to think about what nursing truly means. In 2020, she volunteered to help COVID-19 patients (Altruism).

Related cases (a real case example)

Related cases are related to the concept but do not contain all its defining attributes [ 17 ].

C is a novice nurse. After graduating from nursing school, he became a nurse in the emergency department. He saw many patients who died or recovered, which made him realize the importance of caring (Caring). He said that emergency nurses need strong professionalism (Multidimensional: Attitudes). He participated in social service activities (Multidimensional: Behaviours), for example, promoting knowledge of cardiopulmonary resuscitation (Altruism) in the community. After working for five years, he returned to school for a master’s degree to help the head nurse conduct nursing research or evidence-based practice (Professional). In his Asian cultural milieu, his is embarrassed about his identity as a male nurse (Culture oriented), but he believes he can do well.

Contrary cases (a fictional case example)

A contrary case does not include any defined attributes of the concept [ 17 ].

D is a nurse in paediatrics. She disliked nursing when she was a nursing student and even did enjoy communicating with patients (poor dynamics). She was exhausted after work and felt her life was out of balance. One of the values of the hospital where she worked was dedication, which confused her (Poor culture orientation). She considers it unrealistic to require professionalism (Poor nursing professionalism knowledge) and thinks that taking care of new-borns is particularly troublesome (Poor nursing professionalism attitudes), so she is always careless in her work (Multidimensional: poor attitude). D’s child felt ill last week, so she secretly reduced a patient’s medicine (Poor nursing professionalism behaviours) and took the remaining medicine home for her child (lack of altruism). She stopped doing so after her colleagues sensed something strange. One day, a baby kept crying; D reported it to the doctor and did not make further observations (Poor professional). When the shift nurse took over, she observed abnormal limb activity on one side of the child. The child’s family asked the nurse to bear legal responsibility. D said it was no big deal; she no longer wanted to be a nurse (Poor dynamic, professionalism not established).

• Antecedents

Antecedents are events that occur before the intended concept [ 17 ].

Macro antecedents

Jin [ 28 ] suggested that the conceptualization of professionalism is influenced by culture. Employees defined organizational culture underlies an organization’s values and beliefs [ 70 ]. Nursing professionalism may be supported by a variety of cultures, so a firm understanding of and personal congruence with each particular culture is essential [ 71 ].

Religious beliefs

Religiosity is another contributing factor in the cultivation of altruism [ 72 ]. Taylor noted that nurses’ job motivation and views of the patient and nursing services are affected by their religious beliefs [ 73 ].

Micro antecedents

Snizek [ 74 ] (1972) reported that devotion to work is a professional value originating from a sense of calling to the field. Liaw et al. [ 75 ] (2016) found that nursing students who had caring and compassionate qualities as the most common personal characteristics strongly believed that they were called to nursing.

Individuals who pursue excellence in the workplace may be described as motivated and devoted to their work. Attree [ 76 ] (2005) noted that nurses’ perceived lack of autonomy over their practice could impact quality of care.

Personal characteristics

Nursing professionalism is influenced by various factors, such as educational background, personal interests, professional satisfaction, and professional values [ 77 , 78 , 79 ]. In each country, nurses with higher educational levels may have a higher level of professionalism [ 22 ]. Professionalism is thus a trait related to personal character and upbringing [ 80 ]. Researchers [ 81 ] have demonstrated that professionalism is positively associated with female gender, striving for professional goals, and acceptability. One study found that people’s values tend to shift to emphasize altruism over personal gain as they age [ 79 ]. Nursing professionalism is closely associated with personality traits (extraversion, conscientiousness, and agreeableness) [ 82 ].

Consequences of nursing professionalism

Consequences are events or incidents that are the result of the occurrence of a concept [ 17 ].

Consequences for patients 

Professionalism is one of the decisive factors that critically influences patient satisfaction [ 50 ]. Professionalism can also improve practising nurse career development and the quality of service [ 81 ].

Consequences for nurses

Studies have shown that professionalism and a sense of belonging with colleagues and managers affect the satisfaction [ 83 ] and retention rate of nursing students in academic institutions [ 84 ]. Izumi et al. [ 85 ] (2006) found that good nurses felt pride and happiness in caring for patients closely related to their professionalism.

Empirical references

As the last step to concept analysis, empirical references can further clarify the concept and facilitate its measurement [ 17 ].

Hall’s professionalism inventory scale

Hall’s Professionalism Inventory Scale [ 6 ] identified five attitudinal attributes of professionalism: (a) use of professional organizations as major referents, (b) belief in public service, (c) self-regulation, (d) a sense of calling to the field, and (e) autonomy. Nursing researchers used Hall’s Professionalism Inventory Scale to measure professionalism in nursing [ 22 , 47 ]. Snizek [ 74 ] (1972) modified the professionalism scale to more closely match the clinical context of nursing and better reflect the professionalism of nursing staff.

Kramer’s index of professionalism

Kramer (1974) [ 86 ] constructed an index of professionalism that includes indicators of behaviours, such as the number of professional books published, subscriptions to professional journals, hours spent on professional reading, continuing education, participation in professional organizations, number of professional publications, speeches given, committee activity, and participation in research.

The behavioural inventory for professionalism in nursing (BIPN)

The Behavioural Inventory for Professionalism in Nursing [ 7 ] (BIPN) identifies professional behaviours and values among nurses. The nine categories in the BIPN are (1) educational background; (2) adherence to the code of ethics; (3) participation in the professional organization; (4) continuing education and competency; (5) communication and publication; (6) autonomy and self-regulation; (7) community service; (8) theory use, development, and evaluation; and (9) research involvement.

Definition of the concept

Based on the present analysis, we define nursing professionalism as follows: ‘Nursing professionalism is a multidimensional concept manifested by the knowledge, attitudes, and behaviours that underlie successful clinical practice. Nursing professionalism is dynamicized through a process of socialization in formal nursing education. This feature is also reflected in the process of interaction. Therefore, nursing professionalism should match its rooted culture.

The connotations of nursing professionalism include professional, caring, and altruism. These connotations are detailed as follows:

Possesses a systematic nursing knowledge system; professional certification

Exhibits lifelong learning and participation

Participates in evidence-based practice

Demonstrates innovation

Strives for excellence

Creates a caring-healing environment

Displays kindness/concern/empathy for others

Uses various methods of knowing support and involvement

Embraces the unknowns and miracles in life and practices loving

Patient-first

A conceptual model of nursing professionalism is shown in Fig.  2 .

Antecedents, attributes, and consequences of nursing professionalism

Defining the connotation of nursing professionalism

Nursing professionalism has been defined as professional, caring, and altruistic.

Professional values are characteristic of nursing professionalism. Nursing work requires rich knowledge and scientific evidence-based work to improve the quality of nursing services for patients. Nurses need lifelong learning, qualification certification, and participation in academic and practical activities.

Caring is regarded as the core of professionalism. This study suggests creating a caring-healing environment, displaying kindness/concern/empathy for others, employing all methods of knowing support and involvement, embracing the unknowns and miracles in life and practising loving to care for people to obtain high professionalism. This study notes that nursing professionalism emphasizes care for the individual patient and that the nurse does everything possible to create a caring and healing environment for patients. In different health systems worldwide, nurses have incorporated caring about nursing professionalism into everything they do. This characteristic is consistent with Nightingale's view that “Nurses need to be sensitive. A nurse must use her brain, heart and hands to create healing environments to care for the patient’s body, mind and spirit” [ 87 , 88 ].

Nursing has an altruistic nature, and people interested in helping patients are attracted to this profession [ 89 ]. However, some studies have shown that altruistic care is equated with self-sacrifice, self-denial, and unidirectional and unconditional care [ 90 ]. Care for a nurse’s own needs is equally important, but nurses should be able to put aside their own needs when required to focus on the needs of others [ 91 ]. Nurses should view self-care and altruism as dialectical. Self-realization and providing care for others are not conflicting concepts [ 92 ].

Defining the attributes of nursing professionalism

In this study, we defined nursing professionalism as multidimensional, dynamic, and culture oriented.

Nursing professionalism is a multidimensional concept that includes knowledge, attitudes, and behaviour. Previous studies have defined professionalism as the degree of commitment by individuals to the values and behavioural characteristics of a specific career identity [ 6 , 7 ]. However, current research on nursing professionalism is mostly single dimensional. The Behavioural Inventory for Professionalism in Nursing (BIPN) is based on Miller’s model and is used to measure professional behaviours among nurses [ 7 ]. Hall’s Professionalism Inventory Scale [ 6 ] identified five attitudinal attributes of professionalism. This study highlights that it is also necessary to focus on the knowledge dimension of professionalism. Nursing students and nurses should first understand the nursing professionalism that is necessary to become a nurse, which may be the first step in developing professionalism. Nursing students and nurses need to know the values that are necessary to practice the nursing and not have vague impressions. Some studies have shown that nursing students or nurses learn values and norms in informal trainings [ 93 ]. Therefore, this study suggests that the development of assessment tools for the knowledge dimension of professionalism is also necessary. Multidimensional evaluation tools are not available for nursing professionalism. Thus, clarifying the multidimensional nature of nursing professionalism will contribute to the development of multidimensional evaluation tools.

Moreover, understanding the dynamics of professionalism is helpful for cultivating nursing professionalism in stages and steps. Inquiries into medical professionalism should be integrated into the culture of social media interaction [ 94 ]. Nursing educators and managers should dynamically cultivate nursing professionalism in their interactions.

Differences in the connotation of nursing professionalism are noted in different cultures. This study suggests that the cultivation and evaluation of nursing professionalism need to consider the cultural attributes of different regions and countries.

Future research directions

Exploring the antecedents of nursing professionalism can help schools or hospitals cultivate nursing professionalism and develop courses and specific measures.

The macro antecedents of nursing professionalism include culture and religion, and the micro antecedents include calling, autonomy, and personal characteristics. Some researchers have explored methods to cultivate nursing professionalism; for example, role modelling, feedback, group discussions, case-based discussions, reflection, holding ethical rounds, and reports potentially represent more effective methods [ 95 ]. Some researchers have tried to enhance professionalism through social media [ 96 ]. One of the findings this study is that nursing professionalism is complex and its cultivation difficult. Studies have shown that didactic lectures are ineffective for teaching professionalism [ 97 ]. The development of true nursing professionalism requires national advocacy and the immersion of a good professional environment that incorporates professionalism into daily nursing practice. Role modelling is considered an effective method for developing professionalism in nursing [ 98 ]. Therefore, this study suggest that studies should be actively conducted to deeply discuss the causes and processes affecting professionalism and to cultivate and intervene at macro and micro levels as well as the key time periods and populations that form professionalism to truly shape the formation of professionalism. Moreover, an environment for building professionalism [ 99 ] is very important. Williams [ 100 ] (2015) considered that the development of professionalism should begin as early as the first semester of an undergraduate nursing course. One of the themes of nursing students’ professional identity development is ‘doing-learning-knowing-speaking’. Students should develop professionalism in all these areas of nursing practice.

The relationship between nursing professionalism and health outcomes or nurses’ human resources needs to be further studied.

Our research suggests that the ultimate goal of nursing professionalism is to serve patients with professional knowledge and special professional quality. The public has become increasingly aware of certain possibilities, limitations, and consequences of professionalism. COVID-19 significantly increased the discussion of professionalism and patient outcomes.

Improving professionalism has a positive impact on job satisfaction, professional quality of life, and the willingness to continue in the profession [ 101 , 102 , 103 ]. Therefore, it is important to improve support for nurses, create a good environment for professionalism, and establish a training system for professionalism, thus paving the way to enhance training in professionalism and create opportunities for nurses.

Implications for nursing management

In April 2020, the World Health Organization (2020) issued the First State of the World’s Nursing 2020 [ 104 ]. The report highlighted that nursing professionals are the largest occupational group in the health sector, numbering 27.9 million worldwide. Nurses spend more time with patients than any other health care professionals [ 105 ].

Worldwide, nursing professionalism is considered important and associated with expectations. This study clarifies the concept of nursing professionalism and contributes to a framework for developing a theoretical model as well as instruments to measure the concept. A conceptual model of nursing professionalism may increase nurse managers’ insight into nurses’ behaviours and values, creating a good working environment.

Nurse managers should integrate nursing professionalism into their philosophy, mission, and objectives and provide necessary resources, tools, and projects to develop professionalism among nurses. Nurses should cultivate professionalism to provide good nursing services to patients. Further research should explore the relationship between nursing professionalism and patient health outcomes and formulate effective training programs for professionalism.

Limitations

This conceptual analysis has some limitations. First, research on nursing professionalism published in English may be conducted in different countries and cultures. However, it is also necessary to obtain a more comprehensive and mature concept of the study of different national languages. Second, the lack of research on the combination of all elements of professionalism may lead to overestimation of the impact of these subelements on professionalism. Third, the concept analysis focused on the research process and the researchers’ perspectives, possibly reflecting a lack of other professional understandings of nursing professionalism in medical groups. In addition, the concept analysis included a risk of selection bias, extraction bias, and analysis bias because the study selection process, data extraction, and analysis were all conducted by two researchers. Despite these risk, the studies were all described accurately and systematically.

Nursing professionalism is one of the important foundations of clinical nursing. It is multidimensional, dynamic, and culture oriented. Based on the analysis, nursing professionalism has been defined as providing people care based on principles of professionalism, caring, and altruism. The definition, attributes, antecedents, consequences, and reference analysis of the experience of nursing professionalism determined in this study provide a theoretical basis for future research. This information can be used to evaluate nursing professionalism, develop assessment tools, or generate theory-based training courses and interventions.

Availability of data and materials

Data used to support the findings of this study are available from the corresponding author upon request.

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The authors would like to thank Hui Yang for the great efforts made in designing the research. We would like to thank linbo Li for providing valuable suggestions for this study.

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Hl C and HY made substantial contributions to conception and design. HL C, YJ S, YM W, YF D Collectioned and analysis the data. Hl C was a major contributor in writing the manuscript. XY H, YJ C, QH W revised it critically for important intellectual content. All authors read and approved the final manuscript.

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Cao, H., Song, Y., Wu, Y. et al. What is nursing professionalism? a concept analysis. BMC Nurs 22 , 34 (2023). https://doi.org/10.1186/s12912-022-01161-0

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Professionalism in Nursing

Among the various professions and disciplines, professionalism is of the utmost importance, and especially in nursing. By definition of professionalism, nursing has been focused on professional values based on the humanistic qualities of integrity, respect, and compassion for others. Virtually, nursing is a commitment to care and uphold high ethical values for the development of oneself and others as well. It is about being accountable and taking up the responsibility for a broader practice, while consistently demonstrating the spirit of teamwork and being flexible. Besides, and most importantly, nurses must also ensure that they have the knowledge and skills required to perform the tasks as per expectation. In essence, nurses must agree to carry out their functions while upholding their professionality, because failure to do so is akin to neglecting their practice which can have severe consequences.

When nurses neglect or desert a patient, who has been assigned to them without prior arrangements for continued nursing care, they can be accused of patient abandonment, which is a severe impairment in the delivery of professional care to patients. As a nursing practitioner, the moment you receive a report on a certain patient, by default they become your responsibility until you pass them on to another nurse or they are discharged from your care (Reader & Gillespie, 2013). This means for as long the patient is under your care, you are not even allowed to rush out to pick something without notifying someone to check on them. If the patient were to get harmed in the absence of the assigned nurse, a malpractice claim could be filled with the facility, nurse, and the nursing program. Such cases of abandonment could also lead to severe cases such deterioration of patient’s medical condition to adverse effects including unplanned intensive care admission, cardiac arrests, or even death.

Whatever the circumstances, nurses are individually responsible and professional help accountable for the care they provide to their patients. Therefore, they should ensure that they have enough knowledge and skills to provide enhanced quality care, without risking patient abandonment.

1. Courtenay, M. (2001). Current issues in nurse prescribing. London: Greenwich Medical Media.

2. Reader, T. W., & Gillespie, A. (2013). Patient neglect in healthcare institutions: a systematic review and conceptual model. BMC Health Services Research, 13(156), p.1-15.

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Professionalism in Nursing and Role of Education Essay

Introduction, professionalism concerns.

Nursing is among the many careers where professionalism is of vital significance. The nursing profession depends on practitioners’ operation in a manner that characterizes the virtuousness of the wider discipline since all nurses have a code of ethics. Professionalism among nurses is imperative for enhanced patient outcome, and nurse educators ought to put emphasis on this fact for nursing to uphold professional practices (Balang, Burton, & Barlow, 2017). The nursing industry is extensive, comprises of different people in diverse situations and locations; this is where professionalism comes in handy attributable to the necessity of an element that connects all nurses. There is a fundamental need for human dignity and correspondence, which is a section of the anticipations of professionalism in nursing.

While undertaking their roles in a bid to ensure professionalism, nurses face numerous challenges. One of the greatest concerns is the diverse levels of education among the practising nurses (Yoder, 2017). Different educational levels might create a division among nurses if they do not strive to lessen its impact. In addition, the issue of gender may act as a challenge to nursing practice. For a long time, nursing has been perceived as a feminine profession. Nonetheless, in recent times, men are pursuing this career in a great way. This should be encouraged as a means of creating diversity and a wide pool of talent. The existing challenges should be carefully circumvented to provide grounds for nurses to put efforts into the enhancement of professionalism and reputation.

Patients have a belief that nurses in any place are competent and professional. This calls for nurses to uphold professionalism all the time so that patients remain assured of the availability of quality care wherever they are (Westrick, 2016). When patients are in need of the care of nurses, they do not have to know the nurse who will be attending to them in person, but they are always confident of receiving quality care irrespective of who the nurse is. Such confidence amounts to the professional reputation that nursing has acquired, and it is imperative that nurses continue to defend it. Professionalism in nursing compels nurses to comprehend that their discipline stretches past the individual and their joint effort is what ensures the positive patient outcome. On this note, professionalism drives nurses’ comprehension that they are a team and must operate jointly, not just with one another, but with other health professionals (from doctors to administrators) as well. Professional nursing practice is, therefore, having an undying dedication, passion, care, strong moral principles, sustained development of others and self, responsibility and liability for perceptive practice, and demonstration of the spirit of teamwork and flexibility.

Whenever people see nurses, they associate them with attributes such as patience and kindness. Though these are some of the vital qualities of nurses, they have to go further while seeking to maintain professionalism (Rexwinkel, Haenen, & Pilot, 2013). For instance, they require strong values and commitment to work in the best interest of patients at all times. Much anticipations rest on the shoulders of nurses, and this obliges them to go through proper training and operate in line with professional directives set for them. With the continued operation, nurses develop experience and skills for excellent services. This encompasses having a profound understanding of the theoretical frameworks that shape the profession. For instance, nurses should seek comprehension of different theories of care and their influence on the improvement of nursing practice. This ensures that nurses are in a position of making excellent decisions in their daily duties, which results in their overall professionalism.

Positive nurses’ state of mind is crucial for professionalism in nursing. Attitude is essential to the success of any endeavour, but it is vital to operating competently in the nursing profession. All nurses have to bear in mind that although their tasks may be stressful, it usually does not equal the anxiety generated by being a patient who is not confident of obtaining quality care or having hospitalized loved ones and not sure whether they are receiving proper medical attention. Though it is natural for nurses to become overwhelmed by their undertakings, it is essential that they do not allow it to influence the manner in which they provide patient care (Pan, Norris, Liang, Li, & Ho, 2013). If they choose to become dismissive or bad-tempered, the patients will feel disregarded and this could affect their attitude negatively or make them suffer desperation and dejection (Bisco, Cole, & Karl, 2017). Nurses must make efforts to approach all patients in an affable, cheerful, and caring style while leaving their personal interests behind when at work.

Integrity is vital for facilitated nursing professionalism. Similar to the way nurses are required to understand when to pull out in instances of conflict, they also have to be aware of when to stand firm. Professionalism demands nurses to operate as advocates for patients and must take up the responsibility of speaking out whenever they recognize an issue regarding the condition of a patient or find that he/she is not being given the required treatment. If the circumstances demand, nurses should report the occurrences of neglect or carelessness to the management (Pareek & Batra, 2015). On the same note, nurses have to examine their behaviour carefully while regularly assessing whether they are caring for patients in the best possible way, irrespective of being exhausted or stressed (Kim et al., 2017). Similarly, there is a need, to be honest with patients regarding diagnosis, prospects, and course of treatment.

Nurses must adhere to patient equality in their practice. Since nurses give care to patients from whichever race, religious background, nationality, or level of education, they have to treat them uniformly irrespective of aspects such as age or gender. Nurses have to avoid making presumptions concerning patients anchored in their looks (Öhman, Keisu, & Enberg, 2017). In its place, they should take time to study patients’ circumstances and history in an effort of providing care that best suits them (Lombarts, Plochg, Thompson, & Arah, 2014). For instance, if a nurse has earlier experienced problems while attending to an elderly patient, he/she must avoid assuming that all geriatric patients are problematical. Rather, a nurse ought to view every patient’s case as completely different from any other and strive to accord them utmost respect and concern.

Nursing is amid the numerous careers where professionalism is fundamental. The nursing sector is widespread, incorporates people from diverse situations and locations; this is where professionalism becomes pertinently linked to the requirement of a component that connects all nurses. Professionalism in nursing calls for endless enthusiasm, passion, care, strong ethical principles, constant development, responsibility, liability for perceptive practice, and expression of the spirit of solidarity and flexibility. Professional nurses should support workplace diversity and have a positive state of mind, patience, kindness, integrity, adherence to patient equality, strong values, and commitment to operate in the best interest of patients all the time.

Balang, R. V., Burton, R. L., & Barlow, N. A. (2017). Illuminating professionalism among nurses in their documentation within the Malaysia context: A qualitative study. International Journal of Business & Society , 18, 692-700.

Bisco, J. M., Cole, C., & Karl, J. B. (2017). The effect of government‐run healthcare on the salaries of nursing professionals in the US. Journal of Insurance Issues , 40 (2), 215-246.

Kim, Y., Jung, Y., Min, J., Song, E., Ok, J., Lim, C., Kim, K., & Kim, J. (2017). Development and validation of a nursing professionalism evaluation model in a career ladder system. PloS One, 12 (10), 1-14.

Lombarts, K. M., Plochg, T., Thompson, C. A., & Arah, O. A. (2014). Measuring professionalism in medicine and nursing: Results of a European survey. PloS One , 9 (5), 1-12.

Öhman, A., Keisu, B. I., & Enberg, B. (2017). Team social cohesion, professionalism, and patient-centeredness: Gendered care work, with special reference to elderly care–a mixed methods study. BMC Health Services Research , 17 (381), 1-12.

Pan, H., Norris, J., Liang, Y., Li, J., & Ho, M. (2013). Building a professionalism framework for healthcare providers in China: A nominal group technique study. Medical Teacher, 35 (10), e1531-e1536.

Pareek, B., & Batra, K. (2015). Factors influencing professionalism among nurse educators: A feasibility study. Baba Farid University Nursing Journal , 9 (2), 23-30.

Rexwinkel, T., Haenen, J., & Pilot, A. (2013). Evaluating the level of degree programmes in higher education: The case of nursing. Assessment & Evaluation in Higher Education , 38 (7), 857-874.

Westrick, S. J. (2016). Nursing students’ use of electronic and social media: Law, ethics, and e-professionalism. Nursing Education Perspectives , 37 (1), 16-22.

Yoder, L. (2017). Professionalism in nursing. MEDSURG Nursing . 26 (5), 293-294.

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"Professionalism in Nursing and Role of Education." IvyPanda , 24 June 2021, ivypanda.com/essays/professionalism-in-nursing-and-role-of-education/.

IvyPanda . (2021) 'Professionalism in Nursing and Role of Education'. 24 June.

IvyPanda . 2021. "Professionalism in Nursing and Role of Education." June 24, 2021. https://ivypanda.com/essays/professionalism-in-nursing-and-role-of-education/.

1. IvyPanda . "Professionalism in Nursing and Role of Education." June 24, 2021. https://ivypanda.com/essays/professionalism-in-nursing-and-role-of-education/.

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