Are Ideas About Professionalism Changing?

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

A nurse leader recently mentioned that “she was mourning the loss of professionalism in nursing.” She is not alone, as many nurse leaders have talked with me about the following issues that, through their lens, are unprofessional behaviors:

Nurse’s attire at work
Tik Tok videos that nurses produce to share their viewpoints with the public
Frequent requests for mental health days
Disinterest in shared governance efforts
Visible tattoos
Declining enrollments in Nursing Ph.D. programs
A drop in professional organization membership
A lack of organizational loyalty
Disinterest in specialty certification
Marching on Washington to bring public attention to nursing concerns
A refusal to work overtime or take on-call assignments
A willingness to leave nursing for a different career choice
Nurses telling managers they will quit if not given the days off they request
Nurses questioning the pay and benefits of their executive team
Open discussion and a demand for transparency in salary and benefits
Facebook nursing groups formed to advocate for professional causes such as the RaDonda Vaught conviction
Openly discussing your sexuality at work

Professionalism is the conduct, aims, or qualities that characterize or mark a profession or a professional. Yet, the closer you look at the standards of professionalism, the more you can see how it was crafted to be exclusionary of anyone who violates the rules of groups currently in power.

When I first began as a nurse, wearing scrubs or sneakers would have been viewed as highly unprofessional. Nurses who did not wear caps were criticized for not representing professional values. Tattoos were unthinkable. Bringing any issues like childcare to discuss with a supervisor would have been very unprofessional. When social media was first introduced, many health systems developed very rigid rules on its use by their employees. Attempts to become “a social influencer” would have been viewed as highly unprofessional. Loyalty to organizations and teams was expected. Nurses who went on strike or protested were fired.

Baby Boomer and Generation X’s ideas about professionalism are different from those of Millennials and Generation Z. Our values and beliefs largely come from our experiences and upbringing. Former generations of nurses placed their work at the center of their lives but no longer. These younger generation’s values associated with professionalism include honoring work-life balance, feeling rewarded for their work, open discussion about issues, having a flexible schedule, feeling respected by co-workers, and being their authentic selves at work. Evaluating a career change outside of nursing is not seen as casting aside a profession but rather using your skills and talents in other ways.

Now, more casual dress in the workplace and customizing your uniform are viewed as promoting personal authenticity in the workplace. The rules about expressing your sexuality are changing. Adopting pronouns that best represent who you are is socially accepted. Discussing money openly is seen as a way to ensure that there is organizational transparency. Demanding work-life balance is viewed as critical for both mental health and their commitments to their families. Striking or holding a public protest is seen as a legitimate way to voice professional concerns. These generations don’t see the patient as always being right if they don’t demonstrate human respect.

COVID-19 has accelerated a social change in ideas about professionalism and values. The pandemic has scrambled so much of the “normal” professional experience—commutes, workspaces, business hours, childcare, business travel—that it’s also rewiring our concept of professionalism itself. When your life is in turmoil, ideas about professionalism change. So many nurses have talked about how the boundaries between work and home have become blurred so bringing your whole self to work including your challenges is part of dealing with the challenges. Microsoft Vice President, Jon Friedman, noted in his article in Fast Company that we are “more holistically showing our lives and personalities, the pandemic is accelerating a new definition of professionalism that’s refreshingly human.”

I hear much discussion today about rebuilding nurse identity. While I agree that this will be important work moving forward, the question is whose professional values are we trying to rebuild. Times have changed. In a few short years, Millennial and Generation Z will be 75% of the nursing workforce. Their ideas about professionalism need to be carefully listened to if these efforts are to be successful.

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