Guest Authored by Nelda Godfrey, PhD, ACNS-BC, RN, FAAN, ANEF
What do beginning learners really know about the discipline they have chosen? In listening to nursing students over the years, it’s often a meaningful experience that leads them to choose professional nursing.
Thank You, Nurses
You do what
to be done
with sure hands and
you weave kindness
into the work
of managing our fragile bodies.
Thank you for braving
the universe of hurts.
-Nina Prater, Cedarville, AR
These experiences merge into the realities of formal education, where educators shape the novice into the effective practitioner of nursing, offer the best available knowledge and skills, and provide guidance toward a professional identity so the learner comes to “think, act, and feel” like a nurse.
Turbulent Outside Forces
Education and practice environments are inextricably connected in nursing. Nurse.org’s This is the State of Nursing report revealed that while 60% of nurses love being a nurse, 62% are concerned about the future of nursing. Themes are now well known by most of the public: Today’s acute care nurses are reeling from burnout, mental health issues, and an overall lack of support. Because so much of nursing-student learning occurs in nursing practice settings, students are well aware of nurses’ workload concerns and experiences with burnout.
In today’s acute health care, there is enormous emphasis on quality indicators and patient outcomes—and nurses, in their frontline work, find this to be a moment-by-moment reality. Nurses talk of a multitude of tasks, check-box charting, monitoring the work of other health professionals, and an overwhelming workload. In short, much of their work is transactional. And, at the end of the day, an overabundance of transactional work is not a fulfilling formula for human interaction or relationship building. Hence the nursing shortage.
Despite these reports, nurses can clearly speak to professional identity. In a survey of 718 nurses who had no formalized education on the term “professional identity,” 74% reported that professional identity was critical to functioning well as a nurse. Further, 92% reported that nurses with a strong professional identity in nursing stand out and have a higher impact than those who do not possess this attribute. As a result of this and other studies, a groundswell for fostering professional identity in practice environments is underway.
Students Taking the Lead
Remarkably, students are becoming equal partners in the Professional Identity in Nursing Initiative. The definition of professional identity in nursing, including the phrase “think, act, and feel like a nurse,” and the four domains of professional identity in nursing—values and ethics, knowledge, nurse as leader, and professional comportment—resonate profoundly with student nurses nationwide. The National Student Nurses Association (60,000 students strong!) has adopted the definitions and domains, and intentionally includes professional identity as their framework for programming, honor society recognition, and leadership activities. The student leaders say that these four domains “make so much sense” as they actively design their own professional nursing careers.
Students are quick to communicate that one’s personal identity is larger than one’s professional identity—and that one’s personal identity need not be diminished as one becomes a professional nurse. Instead, the definition of professional identity and the four domains of professional identity in nursing serve as signposts for them in charting their disciplinary journey.
Encouraging the Student Voice for Professional Identity
To see a stronger emphasis on professional identity in nursing education, the students’ voices will need to be encouraged. When encouraged, students have much to say! Below is one student’s response to the prompt: “Explain what it means to think, act, and feel like a nurse as an expression of your professional identity.” She was at the midpoint of her pre-licensure nursing education.
I think like a nurse when I respond to others with listening ears. I think like a nurse when my brain feels like it cannot possibly learn another piece of information, yet those around me encourage me to keep going. All the studying is not only for my personal development, but for those I will be caring for.
I act like a nurse when I step onto the clinical floor and introduce myself energetically to the nurse assigned to the patient I’m caring for.
I feel like a nurse when I’m reviewing my patient’s chart and see a DNR order that the parents have signed for their three-year-old child. I also feel like a nurse as I am about to walk out of that same patient’s room when a mother stops me in the middle of our conversation to tell me their family’s story. I stand and reflect how I had entered that room that day to collect a simple round of vital signs and left speechless. That day at clinical, I felt like a nurse.
All this is to say, I do not know everything. I am learning. I’m excited to be in a career where every experience inside and out of work will continue to develop my professional and personal identity.
To Think, Act, and Feel Like a Nurse
The words “think, act, and feel” helped this particular student explain and express her growing understanding of professional identity. Giving students the space to think and the words to use—even at a time when they are facing “a universe of hurts”—forms professional identity within the discipline, one student at a time.