Prompting professional prerogatives: New insights to reopen an old debate about nursing

Abstract

A profession is defined by neither a set of structural qualities nor a description idiosyncratic to a single culture. Rather, a profession detects problems in an area of work, intellectualizes that work, and offers solutions, developing a logic of competition with coexisting occupations. The best that structural explanations can offer to nursing is rigid, unmovable definitions such as "a semi-profession," whereas the ecological theory of the professions regards the continuous interplay among occupations cohabiting in an interacting system as the fundamental process of gaining or losing professional status. In this theoretically driven article we draw upon the notion of "social ecology of nursing" as a vector of development, arguing that nursing's professional status lies in its ability to adapt to "landscape" transformations and to protect its jurisdiction from competitors, equating fully established professions. In discussing the application of this theory, we invite readers to reopen a debate about the professional nature of nursing, considering cross-national versions of nursing for more comprehensive definitions of the profession.

Methodology for developing competency standards for dietitians in Australia

“…Many of the main domains were similar to other health professions, such as CanMEDS (Royal College of Physicians and Surgeons Canada, ), with the exception of “nutrition expertise or the role in influencing nutritional health,” which distinguishes dietitians from other health professionals, just as “medical expert” is the only distinguishing domain in the CanMEDS framework for medical practitioners. The importance of the demarcation of professions within society and the subsequent need for work roles to evolve to be contemporary and situated within the current days practice has been previously reported (Ayala et al ., ).…”

“…Considering these limitations, it is acknowledged that competence is a process of continual development and is influenced by the complexity of the case and practice environment (Khan & Ramachandran, 2012). As an example, work in the nursing profession has described the historical evolution of the profession through a change in the key roles and systems in which the professional operates (Ayala et al, 2014). Similarly, as a result of this changing nature of healthcare provision and systems, there is a need to consistently review and refine entry-level competency standards to ensure dietitians are prepared for contemporary and future client and service needs.…”

The system of nursing in Chile: Insights from a systems theory perspective

“…Nursing has responsibility in caring for those going through experiences of health and illness, and it is generally accepted that its ethos is that of a caring profession (Watson, ). Nursing in Chile, however, has undergone a major conversion into different areas of healthcare, such as invasive procedures typical of the medical jurisdiction (Ayala, ), and high‐ranking management roles (Ayala, Vanderstraeten, & Bracke, ); to the point that nursing work in a given area might not be intelligible to nurses from another area.…”

“…Care practices, however, have been progressively understated in the realm of healthcare settings in the redefinition of nursing tasks, with nursing auxiliaries and technicians benefitting from bare areas that they now defend as part of their own occupational jurisdiction (Ayala, ; Risso, ). Therefore, and restricting our discussion to actual practices, it would be unsuitable not to consider these subordinate groups as a part of the new caring professions—even if they do not fit local representations of a profession proper—as university‐trained nurses become interested in ‘cleaner’ tasks and organisational roles (Ayala, Vanderstraeten et al., ). Management—that is, mobilising, coordinating and monitoring flows of work while running the wards—occurs away from the bedside more often than not, though it now consumes a great portion of a nurse's day (Ayala et al., ; Barrios et al., ; Seguel, Valenzuela, & Sanhueza, ).…”

“…A very telling example of the type of linkage between profession and discipline is the use of the university status and the length of the studies as a part of the prerogatives in profession building (Ayala, Vanderstraeten et al., ). Nurses argue that reducing the number of years, or worse, moving out of universities, would lead to losing status as well as the mystique surrounding the graduate professions (Ayala & Núñez, ).…”