Nursing As A Profession

P
Nursing
as arofessio
n
ALEJANDRO NONOG, JR., MSN, RN
Manila Doctors College of Nursing
DEFINITIONS AND
GOALS OF NURSING
Nursing
 Nursing is the protection, promotion, and

optimization of health and abilities, prevention of
illness and injury, facilitation of healing, alleviation
of suffering through the diagnosis and treatment of
human response, and advocacy in the care of
individuals, families, groups, communities, and
populations. (ANA)
Nursing
 Nursing encompasses autonomous & collaborative

care of individuals of all ages, families, groups &
communities, sick or well and in all settings. Nursing
includes the promotion of health, prevention of
illness & the care of ill, disabled and dying people.
Advocacy, promotion of a safe environment,
research, participation in shaping health policy and in
patient and health systems management &
education are also key nursing roles. (ICN, 2002)
Nursing
� “The unique function of the nurse is to assist the

individual, sick or well, in the performance of those
activities contributing to health, its recovery, or to a
peaceful death that the client would perform
unaided if he had the necessary strength, will, or
knowledge. And to do this in such a way as to help
the client gain independence as rapidly as
possible.” (V. Henderson, ICN 1973)
Goal of Nursing
ROGERS (1970) OREM (1971) LEININGER

Nursing is to The goal of (1978)
maintain and nursing is to care Nursing is to
promote health, for and help client provide care
prevent illness and attain total self- consisent with
care for and care nursing’s
rehabilitate ill and emerging science
disabled client and knowledge
through with caring as a
“humanistic central focus
science of
nursing”.
PROFESSION
AND
NURSING
Profession
 A vocation requiring
advanced training and
usually involving
mental rather than
manual work, as
teaching, engineering,
especially medicine
and law.
Profession
 Professions are those

occupations possessing a
particular combination of
characteristics generally
considered to be the
expertise, autonomy,
commitment and
responsibility.
Profession
 Intellectual
 Based on a body of knowledge that can
be learned
 Practical rather than theoretical
 Can be taught through a process of
professional education
 Has strong internal organization of
members
 Has altruistic practitioners
Occupation
 Training may be on job and duration varies

 The values, beliefs and ethics are not prominent
 The commitment and identification varies
 People often change jobs
 Accountability rest on employer
Profession vs Occupation
Profession Occupation
 College or University  On the job training
 Prolonged education,  Length varies, Largely
Mental creativity Manual work
 Decisions based on science  Guided decision making
or theoretical constructs  Values, beliefs & ethics: Not
 Values, beliefs & ethics: part of preparation
Integral part of preparation  Commitment may vary
 Strong commitment  Supervised
 Autonomous  Employer is primarily
 Individual accountability accountable
Criteria of Profession: Abrahan Flexner,
1916
 Intellectual (opposite of physical)

 Based on body of knowledge that can
be learned
 Practical rather than theoretical
 Can be taught through a process of
professional education
 Has a string internal organization of
members
 Has practitioner
Criteria of Profession: William Shepherd,
1948
 Based on scientific principles

 Demands adequate pre-
professional and cultural training
 Demands specialized and
systematized knowledge
 Must give evidence of needed
 Scientific technique-tested
experiences
Criteria of Profession: William Shepherd,
1948
 Time judgement / Duty performance

 Beneficial work, Group consciousness-scientific
knowledge
 Sufficient self impelling power
 Obligation to society: Code of ethics
PATRICIA BENNER’S
PATTERNS OF
KNOWING
Patterns of Knowing
 Dr. Patricia Benner introduced

the concept that expert nurses
develop skills and
understanding of patient care
over time through a sound
educational base as well as a
multitude of experiences.
Patterns of Knowing
 She proposed that one could gain knowledge and

skills ("knowing how") without ever learning the
theory ("knowing that").
Patterns of Knowing
 She further explains that the development of

knowledge in applied disciplines such as
medicine and nursing is composed of the
extension of practical knowledge (know how)
through research and the characterization and
understanding of the "know how" of clinical
experience.
Patterns of Knowing
� She described 5 levels of nursing experience as;
Advanced
Novice Beginner Competent Proficient Expert
Patterns of Knowing
�Novice
 Beginner with no experience

 Taught general rules to help perform tasks
 Rules are: context-free, independent of specific
cases, and applied universally
 Rule-governed behavior is limited and inflexible
 Ex. “Tell me what I need to do and I’ll do it.”
Patterns of Knowing
�Advanced Beginner
 Demonstrates acceptable performance

 Has gained prior experience in actual situations to
recognize recurring meaningful components
 Principles, based on experiences, begin to be
formulated to guide actions
Patterns of Knowing
�Competent
 Typically a nurse with 2-3 years experience on the

job in the same area or in similar day-to-day
situations
 More aware of long-term goals
 Gains perspective from planning own actions
based on conscious, abstract, and analytical
thinking and helps to achieve greater efficiency
Patterns of Knowing
�Proficient
 Perceives and understands situations as whole

parts
 More holistic understanding improves decision-
making
 Learns from experiences what to expect in certain
situations and how to modify plans
Patterns of Knowing
�Expert
 No longer relies on principles, rules, or guidelines

to connect situations and determine actions
 Much more background of experience
 Has intuitive grasp of clinical situations
 Performance is now fluid, flexible, and highly-
proficient
CARPER’S
4 WAYS OF
KNOWING
4 Ways of Knowing
Empirics
Ethics
Personal
Aesthetic
4 Ways of Knowing
 Carper’s work was based on the assumption that

the patterns and structure of nursing knowledge
provide the unique perspectives to the discipline
and suggested that these patterns are all
necessary, interrelated, interdependent and
overlapping and create the whole of knowing
4 Ways of Knowing
�Empirical knowing
 Is the principal form relating factual and

descriptive knowing aimed at the expansion of
abstract and theoretical explanations.
 It is information source or base of knowing.
 It emphasizes scientific research is important to
nursing knowledge.
4 Ways of Knowing
�Empirical knowing
 It focuses on evidence-based research for effective

and accurate nursing practice.
 It is where most theory and research development
is concentrated and some conceptual forms have
better capacity to explain nursing phenomena and
others.
4 Ways of Knowing
�Empirical knowing examples
 A nursing student answers a question posed by a

clinical instructor based on what he learned from
the school.
 A nurse researcher, uses scientific method to
produce desired study results.
 Nurse practices nursing interventions based from
accepted clinical practices
4 Ways of Knowing
�Aesthetic Knowing
 Is related to understanding what is of significance

to particular patients such as feelings, attitudes,
points of view (Carper, 1978).
 It is also the manifestation of the creative and
expressive styles of the nurse (Kenney, 1996)
4 Ways of Knowing
�Aesthetic Knowing
 Aesthetic knowing focuses on empathy – the

ability for sharing or vividly understanding
another’s feelings. This is the primary form of
aesthetic knowing.
4 Ways of Knowing
�Aesthetic Knowing examples
 Nurse places himself in the “patient’s shoes”

when communicating, giving judgment and
providing care.
 Nurse shows compassion, mercy and
understanding towards patients, co-workers and
supervisors.
 Nurse uses layman terms in explaining the needs
4 Ways of Knowing
�Ethical knowing
 Requires knowledge of different philosophical

positions regarding what is good and right in
making moral decisions, particularly in the
theoretical and clinical components of nursing.
4 Ways of Knowing
�Ethical knowing
 The code of moral or code of ethics that leads the

conduct of nurses is the main basis for Ethical
Knowing.
 It is deeply rooted in the concepts of human
dignity, service and respect for life.
4 Ways of Knowing
�Ethical knowing examples
 Nurse presents himself as a patient advocate and

defends his client’s right to choose care.
 A clinical instructor reprimands a student who
cheated on a quiz and explain the consequences.
 Nurse explains the concepts behind organ
donation to a terminally-ill patient.
4 Ways of Knowing
� Personal Knowing
 Encompasses knowledge of the self in relation to

other and to self. It involves the entirely of the
Nurse-Patient Relationship.
 It is the most difficult to master and to teach.
 It involves therapeutic use of self.
4 Ways of Knowing
� Personal Knowing
 It takes a lot of time to fully know the nature of

oneself in relation to the world around.
 It stresses that human beings are not in a fixed
state but are constantly engaged in a dynamic
state of changes. (Kenney, 1996)
4 Ways of Knowing
� Personal Knowing examples
 A nursing student, strives to promote a meaningful

personal relationship with his elderly patient.
 A nurse student, undergoes Psychological
Counseling and Self-Awareness sessions before his
Psychiatric Nursing rotation.
OVERVIEW OF THE
PROFESSIONAL
NURSING PRACTICE
Professional Nursing
1. Define Professional Nursing
2. Identify the roles and responsibilities of
a Professional Nurse
3. Identify the various fields in nursing
where nurses can practice their profession
 The performance for a fee, salary or other

reward or compensation of professional
services.
 Undertaking responsible nursing care and

supervision of patients involving the whole
management of care, requiring or application
of principles of the biologic, physical and
behavioral sciences.
 Observation of the
signs of physical as
well as mental
conditions and needs
requiring evaluation or
application of
principles of biologic,
physical and
behavioral sciences
 Accurate reporting and recording of facts

including evaluation of the whole case
 Supervision of others contributing to nursing

care of patients
 Execution of nursing procedures and

techniques
 Direction and education

to secure physical
mental care
 Application and
execution of legal
orders in writing of
physician’s orders
concerning treatment
and medication
LEVELS OF CARE
Levels of Care
Levels of Care in Nursing

Practice
Promotion Prevention Restoration Consolation

of Health of Illness of Health of Dying
Levels of Care
 Direction and education to secure physical

mental care
 Application and execution of legal orders in
writing of physician’s orders concerning
treatment and medication
NURSING
FUNCTIONS
Nursing Functions
Independent Function
Dependent Function
Interdependent Function
Nursing Functions
 Involve actions which the nurse initiates
herself
 These are autonomous actions based on
scientific rationale that is executed to benefit
the client in a predicted way related to the
nursing diagnosis and client-centered goals.
Nursing Functions
 These can solve client’s problems without
consultation to other health care
professionals
 E.g. health teachings
Nursing Functions
Dependent Function
 Are based on the physician’s response to a
medical diagnosis
 The nurse intervenes by carrying out
physician’s written orders, but requires
nursing judgment or decision making
 E.g. administration of medications
Nursing Functions
Interdependent Function
 Collaborative nursing
 Are therapies that require the knowledge,
skill and expertise of multiple health care
professionals
 E.g. referrals to different members of the health team for
patient management
ROLES AND
RESPONSIBILITIES
OF A PROFESSIONAL
NURSE
Nurse’s Roles
1. Identify, differenciate and appreciate
the different
nursing roles which
nurses perform in caring for
their clientele.
Roles & Responsibilities of a Professional
Nurse
 Nurses are instrumental in the delivery and

coordination of physical and psychosocial care
for a variety of patients, clients and their
families.
 They work both independently and as

members of larger health care teams in
ensuring that holistic care is provided.
Nurse
 Nurses play important roles in health

promotion, disease prevention and
maintaining health and wellbeing.
 Nurses care for patients in a wide range of

settings and at different points along their
care pathways.
Nurse
 In order to provide excellent and client

focused care nurses work in a variety of
settings from the patients home to
community facilities and also in more acute
settings like hospitals and health centers.
 Nursing involves working across all age

ranges and members of society.
The Professional Nurse
� Care Provider Communicator Teacher
Client
Counselor Change Agent
Advocate
Leader Manager Researcher
Case
Collaborator
Manager
Nurse
 Care provider
The nurse supports the client by attitudes

and actions that show concern for client
welfare and acceptance of the client as a
person. The nurse is primarily concerned with
the client’s needs.
Nurse
 Communicator
The nurse communicates with clients,

support persons and colleagues to facilitate
all nursing actions.
Nurse
 Teacher
� The nurse provides health teaching to effect

behavior change which focuses on acquiring
new knowledge or technical skills. This role
gives emphasis on health promotion and
health maintenance.
Nurse
 Counselor
� The nurse helps the client to recognize and

cope with stressful psychologic or social
problems, to develop improved personal
relationships and promote personal growth.
This role includes providing emotional,
intellectual and psychologic support.
Nurse
 Client Advocate
� The nurse promotes what is best for the

client, ensures that the client’s needs are
met, and protect client’s rights.
Nurse
 Change Agent
� The nurse initiates changes and assist the

client make modifications in the lifestyle to
promote health.
Nurse
 Leader
� The nurse through the process of

interpersonal influence helps the client make
decisions in establishing and achieving goals
to improve his well-being.
Nurse
 Manager
� The nurse plans, gives directions, develops

staff, monitors operations, gives rewards fairly
and represents both staff members and
administration as needed.
Nurse
 Researcher
� The nurse participates in scientific

investigation and sues research findings in
practice. Develop new knowledge about
health and the promotion of health.
Nurse
 Case Manager
� The nurse coordinates the activities of other

members of the health care team, such as
nutritionists and physical therapists, when
managing a group of client’s care.
Nurse
 Collaborator
� The nurse works in a combined effort with all

those involved in care deliver, for a mutually
acceptable plan to be obtained that will
achieve common goals. The nurse initiates
nursing actions within the health team.
FIELDS IN NURSING
Fields in Nursing
the different nursing firleds which
nurses can practice their profession.
The Nursing Field
 Institutional Nursing (Hospital

Nursing)
 Wide range of specialization and areas of
work
 Advantages: Supervision from superior,
Rotation to specialty, Updated to new trends,
Shifting, Promotion, Staff Development
 Disadvantages: Understaffing to overtime,
Lack time for continuing education, Job
The Nursing Field
The Nursing Field
 Nursing Education
 The career ladder in nursing education starts
with a Clinical Instructors’ position up to the
Dean of a College of Nursing.
The Nursing Field
 Nursing Education
 The career ladder in nursing education starts
with a Clinical Instructors’ position up to the
Dean of a College of Nursing.
The Nursing Field
 Public Health Nurse

 Main concern is prevention of diseases,
promotion of health and vigor of the people in
the rural areas
 Advantages: Focus is family. Perspective on
health programs to nation building, Develop
resourcefulness
 Disadvantages: Limited cases, More hazards,
No fixed hours of work, Not glamorous,
The Nursing Field
 Public Health Nurse

 Main concern is prevention of diseases,
promotion of health and vigor of the people in
the rural areas
 Advantages: Focus is family. Perspective on
health programs to nation building, Develop
resourcefulness
 Disadvantages: Limited cases, More hazards,
No fixed hours of work, Not glamorous,
The Nursing Field
 Private Duty Nursing

 Nurses in private practice are expected to be
expert clinicians as well as expert generalist
in nursing.
 PDN renders comprehensive nursing care to a
client on a one-to-one ratio.
 An independent contractor.
 Care is provided in the hospital or at home.
The Nursing Field
 Private Duty Nursing

 Nurses in private practice are expected to be
expert clinicians as well as expert generalist
in nursing.
 PDN renders comprehensive nursing care to a
client on a one-to-one ratio.
 An independent contractor.
 Care is provided in the hospital or at home.
The Nursing Field
 Industrial Nursing
 Looks after the health of the employees
 Function is to maintain a high standard of
nursing service in the company, interpret,
develop and administer the health programs
emanating from the health unit.
The Nursing Field
 Industrial Nursing
 Looks after the health of the employees
 Function is to maintain a high standard of
nursing service in the company, interpret,
develop and administer the health programs
emanating from the health unit.
The Nursing Field
 Military Nursing
 Comprehensive care to military personnel and
dependents.
 National Defense Act: 1940 (Commonwealth Act No. 386)

 Under this law, the Army Nurse Corps was created as component
of the medical service of the Philippine Army
 Later the name was changed to Nurse Corps
The Nursing Field
 Military Nursing
 Comprehensive care to military personnel and
dependents.
 National Defense Act: 1940 (Commonwealth Act No. 386)

 Under this law, the Army Nurse Corps was created as component
of the medical service of the Philippine Army
 Later the name was changed to Nurse Corps
The Nursing Field
 School Health Nursing

 They are responsible for the school’s activities
in the areas of health service, health
education and environmental health and
safety.
 School health nurses must like children a lot.
 They often work alone, out of touch with other
nurses, the hospital and all professional
supports they have known.
The Nursing Field
 School Health Nursing

 They are responsible for the school’s activities
in the areas of health service, health
education and environmental health and
safety.
 School health nurses must like children a lot.
 They often work alone, out of touch with other
nurses, the hospital and all professional
supports they have known.
The Nursing Field
 Clinic Nursing
 Clinic nursing requires that the nurse possess
general skills.
 It nurse acts as a receptionist, answers phone,
billing, takes x-rays and ECGs, changes
dressing, gives injections and assist in
physical examinations, keep records, order
and store supplies, make follow up calls and
referrals for patients.
The Nursing Field
 Clinic Nursing
 Clinic nursing requires that the nurse possess
general skills.
 It nurse acts as a receptionist, answers phone,
billing, takes x-rays and ECGs, changes
dressing, gives injections and assist in
physical examinations, keep records, order
and store supplies, make follow up calls and
referrals for patients.
NURSING SPECIALTIES
Nursing
Specialties
the different specialties in the field of nursing.
The Nursing Specialties
 Ambulatory Care Nursing

�
� Is the nursing care of patients who receive
treatment on an outpatient basis, ie they do not
require admission to a hospital for an overnight
stay. The setting can vary widely, from hospital-
based clinics to patient homes.
 Ambulatory Care Nursing

�
� Quality ambulatory care nursing has been
associated with fewer emergency room visits,
hospital visits and readmissions.
 Advanced Practice Nursing

�
� An advanced practice registered nurse (APRN)
is a nurse with post-graduate education in
nursing. APRNs are prepared with advanced
didactic and clinical education, knowledge, skills,
and scope of practice in nursing.
 Advanced Practice Nursing

�
Nurses practicing at this level are
educationally prepared at the post-graduate level
and may work in either a specialist or generalist
capacity.
 Medical Case Management

�
� Is a collaborative process that facilitates
recommended treatment plans to assure the
appropriate medical care is provided to disabled,
ill or injured individuals.
�
 Medical Case Management

�
� Medical case management requires the
evaluation of a medical condition, developing and
implementing a plan of care, coordinating
medical resources, communicated
healthcare needs to the individual, monitors an
individual’s progress and promotes cost-effective
 Critical Care Nursing

�
� Is the field of nursing with
a focus on the utmost care of
the critically ill or unstable
patients.
�
 Critical Care Nursing

�
� Critical care nurses can be
found working in a wide variety of
environments and specialties, such
as general intensive care units,
medical intensive care units,
surgical intensive care units,
trauma intensive care units, etc.
 Emergency Nursing
�
� Is a nursing specialty
concerned with the care of
patients who are
experiencing emergencies or
who are critically ill or
injured.
 Emergency Nursing
�
� Emergency nurses
frequently contact patients in
the emergency department
before the patients see
physicians.
 Flight Nursing
�
� Specializes in the field of providing
comprehensive pre-hospital, emergency critical
care and hospital care to a vast scope of patients.
The care of these patients is generally during
aeromedical evacuation or rescue operations
aboard helicopters, propeller aircraft or jet aircraft .
 Forensic Nursing
�
� Forensic nursing is defined as the application
of the nursing process to public or legal
proceedings, and the application of forensic
health care in the scientific investigation of
trauma and/or death related to abuse, violence,
criminal activity, liability, and accidents.
 Forensic Nursing
�
� The goal is to work with a possible victim and
make sure the proper medical but also forensic
tasks are accomplished.
 Legal Nursing
�
� A legal nurse consultant (LNC) is a registered
nurse who uses expertise as a healthcare provider
and specialized training to consult on medical-related
legal cases. LNCs assist lawyers in reading medical
records and understanding medical terminology and
healthcare issues to achieve the best results for their
clients.
 Nursing Informatics
�
� It is a multidisciplinary field that uses health
information technology (HIT) to improve health
care via any combination of higher quality, higher
efficiency (spurring lower cost and thus greater
availability), and new opportunities.
 Nursing Management
�
� Nursing management consists of the
performance of the leadership functions of
governance and decision-making within
organizations employing nurses.
 Nursing Research
�
� Nursing research is research that provides
evidence used to support nursing practice.
 Occupational Health Nursing

�
� Occupational health nursing is a specialty
nursing practice that provides for and delivers
health and safety programs and services to
workers, worker populations, and community
groups.
 Occupational Health Nursing

�
� The practice focuses on promotion,
maintenance and restoration of health,
prevention of illness and injury, and protection
from work-related and environmental hazards.
 Telenursing
�
� Telenursing refers to the use of
telecommunications and information technology
in the provision of nursing services whenever a
large physical distance exists between patient and
nurse, or between any number of nurses.
 Travel Nursing
�
� Travel nursing is a nursing assignment
concept that developed in response to the
nursing shortage. This industry supplies
nurses who travel to work in temporary nursing
positions, mostly in hospitals.
Nursing Organizations in the Philippines
Ang Nars
ADPCN ADNEP ANSAP APDNPP
Inc.
CCNAPI GNAP MNAP NLPGN OHNAP
ORNAP PHICNA PNA PNIA PNRS
PSECN RENAP SCVNPPI

PERSONAL &
INTERDISCIPLINARY
COMMUNICATION IN
NURSING
Communication
1. Define communication and identify its
elements
2. Name the factors that influence
communication
3. Distinguish the differences between the modes of
communication
4. Identify the three levels of communication
5. Identify types of communication utilized in
organizations
6. identify skills and ways to overcome barriers
The Elements of Communication Process
Communication is an
interactive process that
occurs when a person
(sender) sends a verbal
or nonverbal message
to another person
(receiver) and receives
feedback.
The Factors that Influence
Communication
Educational Group Positional Functional

Qualification Relations Relations Relations
Level of Hereditary Geographical

Experience
Understanding Difference Difference
Working Emotion &

Environment Feeling
Communication
Educational Qualification
Poor education hampers the creation as well as

understanding of any message; while sound
education influences better communication.
For example, if sender is highly qualified while receiver is

illiterate, then written communication between them will be
meaningless.
Communication
Group Relations
If both sender and receiver belong to same

group, then there are agreement in-terms of
class and-which influences better
communication.
For example, trade union acts as a group having unity and

uniformity towards its appeal to management.
Communication
Positional Relations
When boss communicates with subordinates,

communication becomes more fruitful because
boss is superior to subordinates interims of
knowledge, experience and position. Hence,
more importance is given to communication and
communication becomes more dynamic.
Communication
Functional Relations
If there is harmony of function of sender and

receiver, then the communication becomes more
active because there is similarity of level
thought and planning which influence their
attitude to communicate properly.
Communication
Experience
It always affects the communication because

sender and receiver both are known to each
other. Both better and bad past experience
influence the way to exchange words, news,
ideas and emoticon. If there exists better
experience, then communication remains sound.
While bad experience creates a communication
Communication
Misunderstanding
If there is any mistake, vagueness or confusion

regarding any word in communication then it
creates misunderstanding between sender and
receiver.
For example: ‘I am coming soon’. Here, time and date is absent.

As a result, receiver has uncertain idea with the term ‘soon and
Communication
Hereditary Difference
Such difference causes a person to be different

in terms of nature, attitude feelings, thinking and
emotions and for this reason communication can
be barred.
For example, a person from poor family and a person from rich
family are not same. The style of communication of-two people
Communication
Geographical Difference
If sender and receiver reside at different

geographical area, then the characteristics of
respective geography interims of language,
norms, values and others will obviously affect the
communication.
Communication
Working Environment
It affects the efficiency and productivity of

worker and employee because environment
shapes the behavior of a person. So, a person
working in a better environment will obviously
have good communication skills, while a person
working in a poor environment will obviously
have limitation in communication.
Communication
Emotion & Feeling
All people are not the same. It is natural that

different people have different emotion and such
difference in emotion affect the communication a
lot.
Modes of Communication
INTERPERSONAL
 Two-way
communication
 Spontaneity
 Negotiation of meaning
 Oral and written
communication
INTERPRETIVE
 One-way
communication
 Authentic materials
 Reading and listening
PRESENTATIONAL
 One-way
communication
 Rehearsed
performance
 Focus on form
 Speking and writing
Levels of Communication
PUBLIC INTRAPERSO INTERPERSO

Communicatio NAL NAL
n with a group Internal Communication
of people with communication between
a common within an individuals,
interest. individual. person to
person, or in
small groups.
Organizational Communication
Communication According to Organizational Structure
 Formal Communication
 Informal Communication
 Associated with the formal organization
structure and the official status or the position
of the communicator and the receiver.
 Travels through the formal channels officially
recognized positions in the organization chart.
 Mostly in black and white.
 Is a deliberate attempt to regulate the flow of
communication so as to ensure that
information flows smoothly, accurately and
timely.
 The main advantage is that the official
channels enable the routine and standardized
information to pass without claiming much of
managerial attention.
 Formal Communication Forms

 Also known as ‘Grapevine’.
 It is free from all sorts of formalities because it
is used on informal relationships between the
parties, such as friendship, membership in the
same club or association
 Such communication includes comments,
suggestions etc. It may be conveyed by a
simple glance, gesture, smile or mere silence.
 Serves a very useful purpose in disseminating
certain information which, in the general
interest of the organization, cannot be
transmitted through the official channels.
 It offers the high and higher ups a clearer
insight into what the subordinates think and
feel.
 It may be mentioned that this process very
often tends to pass distorted, misinterpreted,
and inaccurate and half- truth information and
facts, depending on the circumstances and the
message.
Communication According to Organizational

Direction Structure
 Downward Communication
 Upward Communication
 Horizontal Communication
 Downward Communication
 Communication flows from the superiors to
subordinates
 Executives exercise powers to achieve the
desired objectives by issuing orders,
instructions and policy directives to the
persons at the lower levels.
 Under downward communication, immediate
performance of a job is expected.
 5 Elements of Downward
Communication
1. Specific task directives; Job instructions.
2. Information designed to produce understanding of the
task and its relation to other organizational tasks; job
rationale.
3. Information about organizational procedures and
practices.
4. Feedback to the subordinate about his performance.
Katz And Kahn
5. Information of an ideological character to inculcate a

 The persons from the lower level are expected
to have communication with those who are
above them.
 It is just the reverse of downward
communication.
 This includes reactions and suggestions from
workers, their grievances etc.
 Contents include reports, reaction, suggestion
 Upward Communication Features

 It is condensed and summarized as it passes
through various levels in the hierarchy. It gives
feedback on the extent of effectiveness of
downward communication. This feedback is
used for improving communication
effectiveness.
 Upward Communication Features

 It provides the management about the
viewpoints, reactions, attitudes, feelings and
morale of employees.
 It provides means of control.
 It gives information and date for decision
making.
 May get distorted owing to the nature of
superior- subordinate relationships.
 An employee is not likely to give any
information which may affect him adversely.
Moreover, he may transmit wrong information
to impress his superiors.
 It flows through many media
 Lateral communication
 When the communication takes place between
two or more persons who are subordinates of
the same person or those who are working on
the same level of organization
 Maybe oral or written form
 Satisfies peoples’ needs to know from their
own peers without taking into account other
levels in the organization.
 Peer to peer communication necessary for co-
ordination and can also provide social need
satisfaction.
Communication According to Organizational

Direction
Way of Expression
Structure
 Oral/Verbal Communication
 Written Communication
 Is a direct communication between two
individuals.
 Both the parties i.e., sender and receiver
exchange their ideas through oral words either
in face to face conversation or through any
mechanical or electrical device such as
telephone, teleconference etc.
 This is generally possible where there can be
either a direct contact or message to be
conveyed is not of permanent nature.
 Meetings and conferences, lectures and
interviews are other media of such
communication.
 Advantages of Oral/Verbal
Communication
 Has the distinct advantage of being quick and
prompt. It provides the opportunity to both the
transmitter and receiver of the message to
respond directly.
 Facilitates close contact and thus fosters
mutual exchange of ideas, facts, understanding
and cooperation.
Communication
 Inculcates in the subordinates a sense of self-
importance which in turn acts as a motivating
factor.
 Enables the superior to make a quick appraisal
of subordinate’s action and reaction to any
message transmitted.
 This obviously helps the superior to minimize
Communication
 The personality of the communicator is brought
to bear in the communication process. This has
good effect on the subordinates and they
understand the communication properly.
 It can bring a friendly and cooperative team
spirit.
 Disadvantages of Oral/Verbal
Communication
 There is a possibility that the spoken words may
not be clearly heard or understood.
 It is not good for lengthy communications.
 It requires the art of expressing accurately and
appropriately, and listen to others emphatically.
 Disadvantages of Oral/Verbal
Communication
 It is inadequate where specific performance of
policies and rules is needed.
 The inexperienced subordinates do not follow
the facial expressions and the tone of
manager’s voice.
 When the communication is reduced to black
and white (writing), it is called written
communication.
 Written communications are extensively used
in organizations.
 This includes
 Sometimes, this form of communication
becomes indispensable as in the case of rules,
orders, schedules or policy matters etc.
 The circulars, magazines, notes and manuals
are some common forms of written
communication.
Communication Skills
Responding Confronting
• Active • Specific
Listening • Verbal • Concise • Working
jointly to
• Non-
resolve
Attending
verbal Clarifying conflicts
Overcoming Communication Barriers
Understand the Use common

receiver vocabulary
Communicate
Elicit feedback
assertively
Use two-way Enhance listening

communication skills
Overcoming Communication Barriers
Be sensitive to
cultural differences
Be sensitive to
gender differences
Engage in meta-
communication

Nursing As A Profession

Transféré par

Informations du document

Titre original

Copyright

Formats disponibles

Partager ce document

Partager ou intégrer le document

Options de partage

Avez-vous trouvé ce document utile ?

Ce contenu est-il inapproprié ?

Droits d'auteur :

Formats disponibles

Nursing As A Profession

Transféré par

Droits d'auteur :

Formats disponibles

P

 Nursing is the protection, promotion, and

 Nursing encompasses autonomous & collaborative

� “The unique function of the nurse is to assist the

ROGERS (1970) OREM (1971) LEININGER

 Professions are those

 Training may be on job and duration varies

 Intellectual (opposite of physical)

 Based on scientific principles

 Time judgement / Duty performance

 Dr. Patricia Benner introduced

 She proposed that one could gain knowledge and

 She further explains that the development of

� She described 5 levels of nursing experience as;

 Beginner with no experience

 Demonstrates acceptable performance

 Typically a nurse with 2-3 years experience on the

 Perceives and understands situations as whole

 No longer relies on principles, rules, or guidelines

 Carper’s work was based on the assumption that

 Is the principal form relating factual and

 It focuses on evidence-based research for effective

�Empirical knowing examples

 A nursing student answers a question posed by a

 Is related to understanding what is of significance

 Aesthetic knowing focuses on empathy – the

�Aesthetic Knowing examples

 Nurse places himself in the “patient’s shoes”

 Requires knowledge of different philosophical

 The code of moral or code of ethics that leads the

�Ethical knowing examples

 Nurse presents himself as a patient advocate and

 Encompasses knowledge of the self in relation to

 It takes a lot of time to fully know the nature of

� Personal Knowing examples

 A nursing student, strives to promote a meaningful

 The performance for a fee, salary or other

 Undertaking responsible nursing care and

 Accurate reporting and recording of facts

 Supervision of others contributing to nursing

 Execution of nursing procedures and

 Direction and education

Levels of Care in Nursing

Promotion Prevention Restoration Consolation

 Direction and education to secure physical

 Nurses are instrumental in the delivery and

 They work both independently and as

 Nurses play important roles in health

 Nurses care for patients in a wide range of

 In order to provide excellent and client

 Nursing involves working across all age

� Care Provider Communicator Teacher

Leader Manager Researcher

The nurse supports the client by attitudes

The nurse communicates with clients,

� The nurse provides health teaching to effect

� The nurse helps the client to recognize and

� The nurse promotes what is best for the

� The nurse initiates changes and assist the

� The nurse through the process of

� The nurse plans, gives directions, develops

� The nurse participates in scientific

� The nurse coordinates the activities of other