Professionalism Is Another -ism

Professionalism is a hot topic among nursing professionals. On the one hand, we argue that we are our own profession (as opposed to “doctors lite”) and urge each other to support our profession by advocating for its recognition and educating the public about what we do. On the other hand, we splinter into dozens of factions unable to definitively answer the question “what is professional?”

Mirror mirror on the wall, who is the most professional of all?

One major problem is that nurses are held to higher standards than just about any other professionals except teachers. We are almost always the most trusted professionals according to Gallup polls (and, similarly to “if it’s on the Internet, it must be true,” Gallup must be right), and apparently the public holds us to a higher standard because of it. I am playing fast and loose with both correlation and causality because in this case it makes a great deal of sense.

The public’s judgment of nurses frequently surpasses the ridiculous to arrive at the sublime. I offer one recent typical example: I work in a jail. Qualifications and exceptions aside, most of my patients are therefore criminals, and most of them have led unsavory lifestyles including drugs, promiscuity, and diets so poor that inadequate does them no justice. Yet even these people judge nurses and to all appearances feel righteously indignant when we do something they consider unprofessional. One of my colleagues was conducting a clinical visit with an inmate when she (my colleague) had a coughing fit. The jail is basically filthy and moldy, and she has allergies. The inmate shook his head, disgusted. “You’re a nurse. You shouldn’t be smoking.”

Think about that for a minute. To the inmate patient population, coughing fits probably are reasonably attributed to smoking, so we will not debate the strangeness of his assumption that her cough was a result of smoking. The point is that he judged her and discounted her professionalism all in one fell swoop on the basis of nothing but his own preconceived notions about nurses. More to my point, an inmate in jail for a fairly egregious crime judged this nurse for smoking. Whether or not she is a smoker (she is not), this situation clearly outlines the problems nurses face in simply living our lives in a minefield of judgment. If a person in jail feels justified in telling a nurse what she should or should not do because she is a nurse, how much more then does the general public? Dollars to donuts, this would never occur with a physician, a law enforcement officer, or any other professional I can think of other than a teacher.

Along with the sense of pride that comes with being the most trusted profession, then, comes the problem of being held to higher standards by all societal factions. As illustrated by my example, all societal factions is truly all. Trying to meet this standard is frankly a waste of time and energy that can and should be spent used on, well, anything else: patient care, professional development, self-care…extend the list to infinity.

Is it our responsibility to, then, on the first hand, stay where we are in terms of being the most trusted profession and trying to maintain the public image of us as it is? Or, on the other hand, should we take on the task of being who we are, doing what we do, and educating the public about nursing and nurses? If we do, will we tarnish our “most trusted” reputation? Does it matter? Consider that medical doctors rank a fair bit below nurses in the public’s perception of honesty and ethical standards (a fair bit open to interpretation; see the Gallup results here), yet they garner far more respect from society in general.

In summary, should we be spending energy on trying to ensure the public continues to view us as highly ethical (nonsmoking) people? Or should we change the standards by which we obtain professional respect?

About Megen Duffy

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Megen Duffy, RN, BA, BSN, CEN, is a practicing nurse, blogger, and contributing editor for the American Journal of Nursing. Megen has practiced in a variety of settings from emergency rooms to prisons.