Rethinking Nursing Professionalism

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

A blog reader recently asked me whether I thought some aspects of “nursing professionalism” might be racial or generational constructs. It was an excellent point because ideas about professionalism are tied to our cultural upbringing and experiences.

Leaders often talk to me about what they perceive as a “loss of professionalism in nursing,” which often translates into I think this is unprofessional behavior through my lens on the world. Some of these behaviors cited include the following:

• Nurse’s attire at work
• TikTok videos that nurses produce to share their viewpoints with the public
• Nurses who strive to be social influencers
• 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 or striking against your hospital 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. Discussing any issues like childcare with a supervisor would have been very unprofessional. When social media was first introduced, many health systems developed very rigid rules for 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 Boomers and Generation X’s ideas about professionalism are different from those of Millennials and Generation Z. Nurses with various cultural and ethnic values also have other ideas about professionalism.

Our values and beliefs primarily 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 authentic 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. Microaggressions toward nurses of color have long been tolerated in the name of professionalism but younger staff speak up and speak out to demand human respect.

Now, more casual dress in the workplace and customizing your uniform are viewed as promoting personal authenticity. 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 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 a legitimate way to voice professional concerns.

I think this reader raises a very good point. As hospitals look to strengthen their DEI efforts, the topic of views about what constitutes professionalism should be part of the conversation. 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 along with the ideas of our diverse workforce need to be carefully listened to if these efforts are to be successful.

© emergingrnleader.com 2023

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