BLOG MUHAMMAD MUTTAQIN

5 Langkah Lupakan Amarah

2010-08-03T04:25:00.000-07:00

Masa lalu kerap kali menyimpan memori buruk yang ingin kita hapus dari daftar ingatan. Sayangnya, tak mudah membebaskan diri dari rasa marah atau dendam. Padahal, penelitian menunjukkan bahwa sebagian besar penyakit bersumber dari amarah dalam hati.

Kecemasan, depresi, kekhawatiran, insomnia, dan penyakit fisik adalah sedikit dari penyakit yang disebabkan faktor amarah tadi. Dengan memaafkan dan mengucap kata maaf, sebenarnya kita sudah mengambil kembali kendali hidup kita. Ditambah lagi bonus positif untuk kesehatan. Salah satunya adalah turunnya tekanan darah.

Dalam studi The Stanford-Ireland Hope Project, Frederic Luskin PhD dan Carld Thoresen PhD melakukan penelitian tentang dampak memaafkan. Dalam studi ini dilibatkan 17 pria dan wanita yang anggota keluarganya pernah menjadi korban pembunuhan. Selama beberapa waktu para responden itu diberikan training “memaafkan”.

Setelah satu minggu, 35 persen para responden yang kehilangan pasangan, anak, orangtua, atau saudaranya itu melaporkan penyakit sakit kepalanya berkurang. Demikian juga dengan berbagai penyakit yang terkait stres lainnya. Sementara itu, 20 persen responden mengaku gejala depresinya berkurang.

Banyak orang mengakui, memberikan kata maaf bukanlah hal yang mudah. Meski demikian, ada 5 cara yang bisa kita pakai agar hati lebih tulus memaafkan seperti yang dijabarkan oleh Joan Borysenko PhD, penulis buku Inner Peace for Busy People.

1. Memahaami maksud dari memaafkan
Pada umumnya orang tak mau memberikan maaf karena mereka merasa hal itu sama saja dengan menyatakan bahwa orang lain tak berbuat salah atau kita berdamai dengan orang yang telah menyakiti hati kita.

Joan Borysenko PhD, psikolog, mengatakan, memaafkan adalah hal tentang melepaskan amarah yang selama ini menyandera Anda. Ini sama artinya dengan menerima Anda salah dan memutuskan untuk membebaskan diri dari hal yang menyakitkan.

2. Duka untuk yang hilang
Agar kita bisa memaafkan dengan tulus, kita harus merasakan kesedihan. Hal itu butuh waktu, tetapi setelah Anda memutuskan untuk melepaskan amarah, hati akan terasa lebih ringan secara bertahap. Pada saatnya, memori pada kejadian di masa lalu akan lebih jarang diingat dan rasanya tak lagi menyakitkan.

3. Jangan menunggu permintaan maaf
Terkadang orang yang kita anggap telah menyakiti hati kita tak menyadari perbuatannya salah. Atau mungkin juga mereka tak mampu memahami dan berempati. Permintaan maaf dari orang tersebut memang bisa menyembuhkan luka, tetapi memutuskan untuk membuang harapan ada permintaan maaf juga memiliki dampak yang sama.

4. Mencoba memahami alasan
Fakta menunjukkan, perilaku buruk adalah hasil dari emosi yang kurang matang. Ini terbukti dari pelaku kriminalitas yang mayoritas mengalami kekerasan fisik atau psikis pada masa kecilnya. Empati akan membantu kita mengikis rasa marah, bahkan mengubah hidup kita.

5. Sambut yang akan datang
Kehidupan merupakan sebuah sekolah tempat kita belajar banyak hal, termasuk yang menyakitkan. Kita tak bisa menghindarkan diri dari rasa sakit, tetapi kita bisa memilih untuk keluar dari bayang-bayang dendam seumur hidup kita.

Memilih untuk melepaskan dan melanjutkan hidup akan membuat Anda menjadi individu yang baru. Ini akan memberi Anda kedewasaan dan belas kasihan kepada sesama dan juga diri Anda

Sumber : Kompas.com

PRUSTASI "NO WAY"

2010-08-03T01:44:00.000-07:00

Dalam situasi tertentu kita dapat mengalami frustrasi. Persoalannya adalah bagaimana menghadapinya, bahkan mencegahnya, agar tidak berubah agresif, apalagi depresif, lalu bunuh diri.

Seorang laki-laki muda dengan wajah kusut, murung, dan lesu duduk termenung di teras rumah. Ia melakukannya berjam-jam setiap pagi sejak beberapa hari lalu. Ia seorang sarjana, lulus dengan nilai cukup.

Hampir enam bulan ia keliling kota Jakarta, masuk kantor yang satu ke kantor yang lain, tetapi hanya jawaban “tidak ada lowongan” yang ia terima. Beberapa lowongan yang diiklankan dilamarnya, tetapi ia selalu gagal pada saat-saat akhir tes.
“Apa artinya ijazah saya ini, Bu?” katanya kepada ibunya, “saya benar-benar frustrasi!”

Ada lagi profesional muda yang kembali dari perantauan di Eropa. Ia tinggal di Jerman sejak masuk SMA hingga lulus sebagai doktor dalam bidang teknik. Dengan usia cukup matang, ia bertekad kembali dan bekerja di Indonesia.

Diploma in Nursing

2008-11-28T02:24:00.000-08:00

A Diploma in Nursing or Nursing Diploma is an entry-level tertiary education nursing degree.

In the United States, this type of degree is usually awarded by hospital-based nursing schools. Students awarded a Diploma in Nursing are qualified to sit for the NCLEX-RN and apply for licensure as a Registered Nurse.

At one time, all nurses in the United States were diploma-prepared. The Cherry Ames series of children's books was created to encourage girls to go into the nursing profession during World War II. She was a "hospital diploma" nurse.

Although the number of hospital-based nursing schools continues to decrease, many still exist. Some require that non-nursing prerequisite courses be completed at another school prior to admission or coordinate their program with classes at a nearby school, though many are still self-contained.

Myspace Funny Picture Comments & Graphics

Nursing as a profession

2008-11-28T01:45:00.000-08:00

The authority for the practice of nursing is based upon a social contract that delineates professional rights and responsibilities as well as mechanisms for public accountability. In almost all countries, nursing practice is defined and governed by law, and entrance to the profession is regulated at national or state level.

The aim of the nursing community worldwide is for its professionals to ensure quality care for all, while maintaining their credentials, code of ethics, standards, and competencies, and continuing their education. [5] There are a number of educational paths to becoming a professional nurse, which vary greatly worldwide, but all involve extensive study of nursing theory and practice and training in clinical skills.

Nurses care for individuals who are healthy and ill, of all ages and cultural backgrounds, and who have physical, emotional, psychological, intellectual, social, and spiritual needs. The profession combines physical science, social science, nursing theory, and technology in caring for those individuals.

In order to work in the nursing profession, all nurses hold one or more credentials depending on their scope of practice and education. A Licensed practical nurse(LPN) (also referred to as a Licensed vocational nurse, Registered practical nurse, Enrolled nurse, and State enrolled nurse) works under a Registered nurse. A Registered nurse (RN) provides scientific, psychological, and technological knowledge in the care of patients and families in many health care settings. ($30,000-$50,000/yr base). Registered nurses may also earn additional credentials or degrees enabling them to work under different titles such as:

Advanced Practice Registered Nurse (APRN)- Provides primary care and specialized advanced nursing services to patients and families. Principle types of APRNs include: Clinical Nurse Specialist (CNS), Nurse Practitioner (NP), Certified Registered Nurse Anesthetist (CRNA), and Certified Nurse Midwife (CNM) ($40,000-$65,000/yr+)

Nurse Educator - Utilizes educational methodologies to present current information in patient care settings, universities, and communities. Types of nurse educators include: Clinical Instructor, College/University Professor, Staff Development Specialist, and Patient Education Specialist($30,000-$75,000/yr+)

Nurse Administrator - Coordinates the use of human, financial, and technological resources to provide patient care. ($40,000-$90,000/yr+)

Nurse Researcher - Utilizes statistical methodologies to discover or establish facts, principles or relationships. ($40,000-$75,000/yr+)

There is no profession which offers as many opportunities for diversified roles as does nursing. Nurses may follow their personal and professional interests by working with any group of people, in any setting, at any time. Some nurses follow the traditional role of working in a hospital setting. Within the hospital setting, nurses may work in areas including:

Critical Care; Emergency; Maternal/Child Care; Medical: Cardiology, Diabetes, Gastroenterology, Gerontology, Nephrology, Neurology, Oncology, Pulmonary, Rehabilitation, Renal, Rheumatology, Urology; Operating Room/Recovery Room; Pediatrics; Psychiatric/Mental Health; Surgical: Burn, Cardiovascular, Ear/Nose/Throat, Gastroenterology, Orthopedics, Plastic Reconstructive, Transplant

Others may work in non-hospital settings including:

Public/Community Health; Mental Health Agencies; Home Health Care; Physician's Office; Health Maintenance Organizations and Managed Care Companies; Insurance; Occupational Health; Research Centers; Extended Care Facilities; Clinics; Outpatient Surgery Centers; Hospices; Community Schools, Day Care Centers; Military Branches; Independent Practice; Schools of Nursing; Senior Centers, Shelters, Churches

Nurse

2008-11-28T01:30:00.000-08:00

From Wikipedia, the free encyclopedia
Jump to: navigation, search
This article is about the occupation. For the field, see Nursing. For other uses, see Nurse (disambiguation).

A nurse working in a nursing home.

A nurse is responsible—along with other health care professionals—for the treatment, safety, and recovery of acutely or chronically ill/injured people, health maintenance of the healthy, and treatment of life-threatening emergencies in a wide range of health care settings. Nurses may also be involved in medical and nursing research and perform a wide range of non-clinical functions necessary to the delivery of health care. Nurses also provide care at birth and death. There is currently a shortage of nurses in the United States and a number of other developed countries.

Education and regulation

The nursing career structure varies throughout the world. Typically there are several distinct levels of nursing practitioner distinguished by scope of practice. The major distinction is between task-based nursing and professional nursing. Nurses throughout the world are increasingly employed as registered nurses, advanced practice nurses, clinical nurse specialists and nurse practitioners. At the top of the educational ladder is the doctoral-prepared nurse. Nurses may gain a PhD or another doctoral degree, specializing in research, clinical nursing, and so forth. These nurses practice nursing, teach nursing, and carry out nursing research. As the science and art of nursing has advanced, so has the demand for doctoral-prepared nurses.

In various parts of the world, the educational background for nurses varies widely. In some parts of eastern Europe, nurses are high school graduates with twelve to eighteen months of training. In contrast, Chile requires any registered nurse to have at least a bachelor's degree.

Nurses are the largest group of providers in the health care system--there are over two million registered nurses in the United States of America (U.S.) alone, comprising about 13% of the fifteen million workers in the health care and social assistance category tracked by the U.S. Department of Labor.^[1]

Nursing is one of the most female-dominated occupations, but the number of males entering the profession is increasing. For example, in 2000 only 5.4% of registered nurses in the U.S. were male, however, that percentage represents a 226% increase over the previous two decades.^[2] In 2007, internationally, 10.7% of registered nurses and 10.4% of licensed practical nurses were male.^[3] Although the rise in the number of males entering and working in the nursing profession is an ongoing trend, females continue to predominate in nursing, as well as in the health care sector as a whole.

Governments regulate the profession of nursing to protect the public.

[edit] Other healthcare workers

Health care settings generally involve a wide range of medical professionals who work in collaboration with nurses.

Examples include:

Nursing assistants, orderlies, auxiliary nurses, medical assistants. These types of health care workers work both in acute and primary settings, with the supervision of registered nurses or licensed practical nurses (in the US). They assist nurses by giving basic care, taking vital signs, administering hygienic care, assisting with feeding, giving basic psychosocial care, housekeeping, and similar duties. See also hospital volunteers.
EMTs and Paramedics work closely with emergency and critical care nurses to stabilize life-threatening trauma and medical emergencies and to provide a seamless transfer of care from incoming ambulances to awaiting medical/surgical teams.
Technicians: for example, certified medication aides in the US, are trained to administer medications in a long-term care setting. There are also phlebotomy technicians, who perform venipuncture; surgical technologist (US), and technicians trained to operate most kinds of diagnostic and laboratory equipment, such as X-ray machines, electrocardiographs, and so forth.
Medical practitioners rely on nurses' ability to follow orders to ensure a continuity of patient care.
Pharmacists are responsible for the safe dispensing of medicine and offering of expert advice on drug therapies.
Allied health professionals such asrespiratory therapists, medical technologists, speech therapists, occupational therapists, nurses operating department practitioners (UK) and physical therapists work with nursing staff.

THEORIES & NURSING RESEARCH

2008-11-28T01:08:00.000-08:00

From: currentnursing.com
Introduction

* RESEARCH – Process of inquiry
* THEORY – Product of knowledge
* SCIENCE – Result of the relationship between research & theory
* To effectively build knowledge to research process should be developed within some theoretical structure that facilities analysis and interpretation of findings.
* Relationship between theory and research in nursing is not well understood. It may be give to the relative youth of the discipline and debates over philosophical world views. (Empiricism, constructivism, etc…)

Need to Link Theory and Research

* Research without theory results in discreet information or data which does not add to the accumulated knowledge of the discipline.
* Theory guides the research process, forms the research questions, aids in design, analysis and interpretation.
* It enables the scientist to weave the facts together.

Theories from Nursing or Other Disciplines?

* Nursing science is blend of knowledge that is unique to nursing and knowledge that is borrowed from other disciplines.
* Debate is whether the use of borrowed theory has hindered the development of the discipline.
* It has contributed to problems connecting research and theory in nursing.

Historical Overview of Research and Theory in Nursing

* Florence Nightingale supported her theoretical propositions through research, as statistical data and prepared graphs were used to depict the impact of nursing care on the health of British soldiers.
* Afterwards, for almost century reports of nursing research were rare.
* Research and theory developed separately in nursing.
* Between 1928 and 1959 only 2 out of 152 studies reported a theoretical basis for the research design.
* In 1970’s growing number of nurse theorists were seeking researchers to test their models in research and clinical application
* Grand nursing theories are still not widely used. In 1990’s borrowed theories were used more.
* Now the focus of research and theory have moved more towards middle range theories

Purpose of Theory in Research

* To identify meaningful and relevant areas for study.
* To propose plausible approaches to health problems.
* To develop or refine theories
* Define the concepts and proposed relationships between concepts.
* To interpret research findings
* To develop clinical practice protocols.
* Generate nursing diagnosis.

Types of theory and corresponding research

Type of theory

Type of research

* Descriptive
* Explanatory
* Predictive

* Descriptive or explanatory
* Co relational
* Experimental

How Theory is used in Research

Causal theory of planned behaviour

Theory Generating Research

* It is designed to develop and describe relationships between and among phenomena without imposing preconceived notations.
* It is inductive and includes field observations and phenomenology.
* During the theory generating process, the researcher moves by logical thought from fact to theory by means of a proposition stated as an empirical generalization.

Grounded Theory Research

* Inductive research technique developed by Glazer and Strauss (1967)
* Grounded theory provides a way to describe what is happening and understanding the process of why it happens.
* Methodology – The researcher observes, collects data, organizes data and forms theory from the data at the same time.
* Data may be collected by interview, observation, records or a combination of these techniques.
* Data are coded in preparation for analysis.

* Category development – Categories are identified and named
* Category saturation – Comparison of similar characteristics in each of the categories
* Concept development – Defines the categories
* Search for additional categories – Continues to examine the data for additional categories
* Category reduction – Higher order categories are selected
* Linking of categories – The researcher seeks to understand relationships among categories
* Selective sampling of the literature
* Emergence of the core variable – Central theme are focus of the theory
* Concept modification and integration – Explaining the phenomenal

Theory testing research

* In theory testing research, theoretical statements are translated into questions and hypothesis. It requires a deductive reasoning process.
* The interpretation determines whether the study supports are contradicts the propositional statement.
* If a conceptual model is used as a theoretical framework for research it is not theory testing.
* Theory testing requires detailed examination of theoretical relationships.

Theory as a conceptual framework

* Problem being investigated is fit into an existing theoretical framework, which guides the study and enriches the value of its findings.
* The conceptual definitions are drawn from the framework
* The data collection instrument is congruent with the framework.
* Findings are interpreted in light of explanations provided by the framework.
* Implications are based on the explanatory power of a framework.

A Typology of Research

* Testing
* Analyzing
* Experimentation
* Deducting
* Deductive research
* Quantitative research
* The scientific method
* Theory / hypothesis testing
* Assaying
*

Refining
*

Interpreting
*

Reflecting
*

Inducing
*

Inductive research
*

Qualitative research
*

Phenomenological research
*

Theory generation
*

‘Divining’; ‘heuristic’ research

Guidelines for writing about a research study’s theoretical framework

In the study’s problem statement

o Introduce the framework
o Briefly explain why it is a good fit for the research problem area
o At the end of the literature review
o Thoroughly describe the framework and explain its application to the present study.
o Describe how the framework has been used in studies about similar problems
o In the study’s methodology section
o Explain how the framework is being operationalized in the study’s design.
o Explain how data collection methods (such as questionnaire items) reflect the concepts in the framework.
o In the study’s discussion section
o Describe how study findings are consistent (or inconsistent) with the framework.
o Offer suggestions for practice and further research that are congruent with the framework’s concepts and propositions.

Conclusion

The relationship between research and theory is undeniable, and it is important to recognize the impact of this relationships on the development of nursing knowledge. So interface theory and research by generating theories, testing the theories and by using it as a conceptual framework that drives the study.
Reference

1. George B. Julia , Nursing Theories- The base for professional Nursing Practice , 3rd ed. Norwalk, Appleton and Lange.
2. Polit DF, Hungler BP. Nursing Research: Principles and Methods. Philadelphia: JB Lippincott Company; 1998.
3. Burns N, Grove SK. The practice of Nursing Research. 4th Ed. Philadelphia: WB Saunders Publications; 2001.
4. Treece JW, Treece EW. Elements of Research in Nursing (3rded.). St. Louis: Mosby; 1982.

Nursing Process

2008-11-27T04:16:00.000-08:00

From Wikipedia, the free encyclopedia
Contents
[hide]
• 1 Characteristics of the nursing process
• 2 Skills
• 3 Phases of the nursing process
o 3.1 Assessing Phase
 3.1.1 Models for data collection
o 3.2 Diagnosing Phase
o 3.3 Planning Phase
o 3.4 Implementing Phase
o 3.5 Evaluating Phase
• 4 See also
• 5 References
The nursing process is a process by which nurses deliver care to patients, supported by nursing models or philosophies. The nursing process was originally an adapted form of problem-solving and is classified as a deductive theory.
Characteristics of the nursing process
The nursing process is a cyclical and ongoing process that can end at any stage if the problem is solved. The nursing process exists for every problem that the patient has, and for every element of patient care, rather than once for each patient. The nurse's evaluation of care will lead to changes in the implementation of the care and the patient's needs are likely to change during their stay in hospital as their health either improves or deteriorates. The nursing process not only focuses on ways to improve the patient's physical needs, but also on social and emotional needs as well.
• Cyclic and dynamic
• Goal directed and client centered
• Interpersonal and collaborative
• Universally applicable
• Systematic[1]
The nursing process is not something foreign or unusually complex. On the contrary, we use the nursing process method on a daily basis without even realizing it. For example, a trip to the gas station to get fuel requires Assessing the various prices and the number of people waiting to get gas among other things. A subsequent decision, or Diagnosis, is made based on the former criteria. This may include pulling into the gas station to fuel up or going down the road for better prices and/or less of a crowd. The price is right and there's not much of a crowd, we're pulling in. Now the Planning can take place. This may include which pump to use, how much gas to put in the tank, whether or not to clean the windows along with other things. We're at the pump and ready to fuel up. We must now Implement what we planned prior to pulling up to the pump. We've pulled up on the passenger side because the gas tank resides on this side, part of our plan. We've also given ourselves enough room to exit without getting blocked in by another vehicle, part of our plan also. We now unscrew the gas cap and begin fueling or Implementing what we planned. Things went well. We are fueled up and have exited the gas station without complication. Our Evaluation of the trip to the gas station would be a good one. We may choose to use this method in the future. The Nursing process is that simple in theory. However, as a nurse, the nursing process tool will be used for more complex and difficult situations but is applied the same way as the gas station analogy.
Skills
The nursing process involves skills a nurse should possess when he or she has to initiate the initial phase of the process. Having these skills contributes to the greater improvement of the nurse's delivery of health care to the patient, including the patient's level of health, or health status.
• Cognitive or Intellectual skills, such as analyzing the problem, problem solving, critical thinking and making judgements regarding the patient's needs. Included in these skills are the ability to indentify, differentiate actual and potential health problems through observation and decision making by synthesizing nursing knowledge previously acquired.
• Interpersonal skills, which includes therapeutic communication, active listening, conveying knowledge and information, developing trust or rapport-building with the patient, and ethically obtaining needed and relevant information from the patient which is then to be utilized in health problem formulation and analysis.
• Technical skills, which includes knowledge and skills needed to properly and safely manipulate and handle appropriate equipment needed by the patient in performing medical or diagnostic procedures, such as vital signs, and medication administrations.[2]
Phases of the nursing process
The following are the steps or phases of the nursing process.
• Assessment (of patient's needs)
• Diagnosis (of human response needs that nurses can deal with)
• Planning (of patient's care)
• Implementation (of care)
• Evaluation (of the success of the implemented care)
Assessing Phase
The nurse should carry out a complete and holistic nursing assessment of every patient's needs, regardless of the reason for the encounter. Usually, an assessment framework, based on a nursing model or Waterlow scoring, is used. These problems are expressed as either actual or potential. For example, a patient who has been rendered immobile by a road traffic accident may be assessed as having the "potential for impaired skin integrity related to immobility".
Models for data collection
The following nursing models are used to gather the necessary and relevant information from the patient in order to effectively deliver quality nursing care. This will help the nurse determine the ranking of the problems encountered.
• Gordon's functional health patterns
• Roy's adaptation model
• Body systems model
• Maslow's hierarchy of needs[3]
How to collect data
• Client Interview
• Physical Examination
• Observation
Diagnosing Phase
Nursing diagnoses are part of a movement in nursing to standardize terminology which includes standard descriptions of diagnoses, interventions, and outcomes. Those in support of standardized terminology believe that it will help nursing become more scientific and evidence based.The purpose of this stage is to identify the patient's nursing problems. See Nursing diagnosis

Maslow's hierarchy of needs is used when the nurse prioritizes identified nursing health problems from the patient.
Types of Diagnosis
• Actual Diagnosis-a judgment on clients response to a health problem that is present
• High Risk-based on most likely to develop
• A Possible Nursing Diagnosis-a health problem is unclear and causative factor is unknown
• Wellness Diagnosis-indicating a well response of the patient
Components of a Nursing Diagnosis
• Problem Statement(diagnostic label)-describes the clients health problem
• Etiology(related factor)-the probable cause of the health problem
• Defining Characteristic-a cluster of signs and symptoms
e.g. Ineffective airway clearance related to the presence of tracheo-bronchial secretion as manifested by thick tenacious sputum upon expectoration.
Problem (Ineffective airway clearance) + Etiology (related to) + Defining Characteristics (as manifested by)
Planning Phase
In agreement with the patient, the nurse addresses each of the problems identified in the planning phase. For each problem a measurable goal is set. For example, for the patient discussed above, the goal would be for the patient's skin to remain intact. The result is a nursing care plan.
Implementing Phase
The methods by which the goal will be achieved is also recorded at this stage. The methods of implementation must be recorded in an explicit and tangible format in a way that the patient can understand should he wish to read it. Clarity is essential as it will aid communication between those tasked with carrying out patient care.
Evaluating Phase
The purpose of this stage is to evaluate progress toward the goals identified in the previous stages. If progress towards the goal is slow, or if regression has occurred, the nurse must change the plan of care accordingly. Conversely, if the goal has been achieved then the care can cease. New problems may be identified at this stage, and thus the process will start all over again. It is due to this stage that measurable goals must be set - failure to set measurable goals will result in poor evaluations.
The entire process is recorded or documented in an agreed format in the patient's care plan in order to allow all members of the nursing team to perform the agreed care and make additions or changes where appropriate.

Is Nursing A Profession?

2008-11-27T04:05:00.001-08:00

The question "profession or not" has never been satisfactorily answered, not least because the definition of 'profession' is not exactly a fixed item.
However, some aspects of the definition might be considered 'core items'.
1. A profession has a unique body of knowledge and values - and a perspective to go with it.
2. A profession has controlled entry to the group eg registration
3. A profession demonstrates a high degree of autonomous practice.
4. A profession has its own disciplinary system.
5. A profession enjoys the Recognition and Respect of the wider community.
1. Nursing DOES have a unique body of knowledge and values, but all too often adopts the medical perspective over its own; most acadamic nurses these days don't try very hard to inject new nurses with any values other than the medical model (Yes, there are exceptions!). In that sense, nursing can only ever be a 'profession allied to medicine', not a true profession in its own right.
2. Nursing does have controlled entry - most countries have a legally-enforced registration. This is beyond doubt, but of questionnable value, to some degree, it's a cheat - "Nursing is a profession because the law says it is".
3. Nursing has a variable degree of autonomy, but for the most part (Yes, there are exceptions!), has very little real freedom; indeed, nursing management, with it's 'cost saving' mentality, does its utmost to strangle any independent thought or action, for fear of expensive litigation; there are 'protocols' for everything, these days, and woe betide the nurse who dares to use initiative (Yes, there are exceptions!).
Nurse practitioners (etc.) usually take orders from docs and are accountable to them, because their specialties are branches of medicine. But in many areas, nurses are responsible for *nursing* and in that sense are (still) independent of doctors.
It is a shame - but historically beyond doubt, that nurses tend to give away the areas they are most expert in; physiotherapy and occupational therapy both grew out of a nursing role, respiratory therapy is going the same way. Stoma therapy is an area that utilizes many core nursing skills; how long before it breaks off to become a profession in its own right?
Perversely, wound management was, until recently, a medical responsibility, though nurses applied almost 100% of dressings. Now, specialist nurses are teaching others the principles of wound care.
4. In many countries, Nursing does have its own disciplinary system - but in many of them, this is being eroded in favour of making nurses "accountable to the public" - understandable, but reflecting a view that nurses "cannot be trusted" to deal with there own problems - this is a diminution of professional resect and value.
5. Nurses are recognized as 'nice', 'deserving better' and 'sexy' - the jury is out on whether any of those assist in the definition of 'professional'.
External recognition is vital, just as the legal side is 'so what' - few people would ever argue with doctor and lawyers as 'true' professionals; when the 'Church was one, united, catholic church', priests were similarly respected - I'm not so sure that's generally true any more; individual clergymen are respected by individuals, and by their own community; as are individual nurses. But both fall shy of general respect to the level required, sadly. (Though both are streets ahead of journalists, real estate agents and heating engineers!).
To conclude, part of the problem is the poor self respect of nursing; just twenty years ago, the Process of Nursing, care plans and nursing diagnosis looked set to sweep in an era of nursing confidence and a bright, professional future.
Why did it fail? This is not the place to discuss that in detail, but factors include:
• Overconfidence and a needless challenge to medicine - little illustrates the power of language better than the blinding stupidity of the term "nursing diagnosis". Nursing assessment, as a serious, conscious, methodical activity was in its infancy, when 'nursing diagnosis' was invented. this simple act guaranteed a fear reaction and backlash from doctors, themselves under attack from the accountants and litigators. From being our allies, doctors become distanced at best, enemies at worst. All that could have been avoided by a few minutes invested in Roget's thesaurus or a good dictionary
• A too rapid flight to academia - it is hard to argue against developments in Nurse education; God knows, a bit more has to be a 'good thing'; but talk of a graduate profession form a tiny graduate base in less than twenty years meant that many mediocre people were sucked into senior postions; many good people were seduced away from clinical nursing, and many clinical idiots became academic idiots. Sad; and bad because instead of supporting and defending clinical nursing, academia began to control it, and did not defend it.
• Failure to resist the suits - The inexorable rise of the accountant, who knows the price of everything, and the value of nothing, probably could not be stopped; but it was allowed to ride roughshod over nursing, destroying confidence and stopping development dead in its tracks.